"Projet thérapeutique 79 - Réseaux et circuits de soins pédopsychiatriques: conduites perturbatrices d'intensité moyenne à sévère chez l'enfant et l'adolescent"

Introduction
From April 2011, the function of dialogue will receive a structural financial support for the mental health care in Belgium. This function will be partly built on the experience of the therapeutic projects “care networks”. This research work takes shape with the organisation of multidisciplinary meetings and dialogues around chronic and complex situations. Especially, the therapeutic project n°79 “disruptive children and adolescents behaviours from moderate to severe intensity” tends to provide tailor-made care and a better follow-up to these patients while maximizing complementarities between partners and avoiding as much as possible redundancy in care, help, support and supervision.

Purpose
To provide recommendations on the organization of consultation meetings and intersectorial collaboration.

Methodology
The therapeutic project n° 79 is aimed at children and adolescents aged 0 to 21, living in the province of Liège and showing a specific psychiatric pathology: conduct disorder, oppositional defiant disorder, attention deficit/hyperactivity disorder. This project is based on an empirical approach. It consists in organising multidisciplinary meetings and dialogues concerning patients and their families, with the aim of a individualized follow-up. The device used in these meetings is the care plan. It allows structure the debates considering a general goal for the child and the specific aims of the different services. This personalized care plan provides network coordination to the child and his family and avoids any situation of mutual returns. It also increases the visibility of each other’s role within the care plan. Moreover, it results in the definition of a schedule and evaluation periods.

Results
The project has followed 59 users, 44% of whom were adolescents above the age of 12. In each situation, an agent has been chosen to follow the case. His role is to keep in touch with the user and to be the contact person with the different professionals. He is in charge of the organisation and the management of the meetings. The agent can come from any sector. Recommendations on this topic have been reported.

Discussion/conclusion
The experience of the therapeutic project n° 79 turned out to be highly fruitful. All the purposes focusing on the user and his family were achieved and there were also many positive interprofessional relationships and collaborative work. Multidisciplinary consultation meetings turned out to be an effective way to get to know partners and it gives a clear view of their respective services and care offers as well as their functioning. The method applied in our project appeared to facilitate collaborative working and coordination between professionals from various areas acting in the users’ own interests.