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Here is the testimony of Dr. Paula Loureiro, Clinical Psychologist and Psychotherapist of the Sisters Hospitallers´ hospital in Sintra, Portugal


Did you know that the Sisters Hospitallers of Idanha are making a significant difference to the mental health of children and young people in Sintra? In partnership with the local council, they have run a unique project that has provided more than 500 specialised clinics since its launch in 2020. Learn more about this initiative led by Dr Paula Loureiro, Clinical Psychologist and Psychotherapist, and discover how it aligns with the Hospitaller mission to provide comprehensive and compassionate care to those who need it most.

What is the main objective of the project of mental health consultations for children and young people in the municipality of Sintra?

The Child and Adolescent Mental Health Area aims to provide a specialised response to the needs identified in the community. The interventions we carry out aim to improve the well-being and personal and social adaptation of children and young people, promoting the reduction of symptoms and the development of more adaptive psychological mechanisms.

How did the partnership between the Idanha Sisters Hospitallers and Sintra Town Council come about in order to carry out this project?

The Sisters Hospitallers and, in particular, the Idanha – Sintra Health Unit have the mission to implement the best responses to the needs of the environment. The municipality of Sintra, as well as other regions of the country, has a significant lack of intervention in the area of child and youth mental health. This aspect is particularly important because we know that there is a high prevalence of mental health problems in this age group, but also that this is an important predictor of mental illness in adult life. For these reasons, Sintra Town Council and the Sisters Hospitallers established a protocol for child psychological and psychiatric intervention with the most vulnerable population.

What specific mental health services are offered through these consultations for children and young people?

Since January 2016, we have been offering Paidopsychiatry and Child and Youth Psychology consultations, aimed at people between 6 and 17 years of age. Until the pandemic, there was also a socio-occupational structure for adolescents. This was a very interesting project, but as the population referred to resides in a more remote area of the municipality of Sintra, its implementation and maintenance was complicated due to the difficult movement of young people, especially during school periods. Coordination between the different entities is sometimes quite complex, making it difficult, for example, for a student to benefit from this type of intervention due to overlapping with academic activities.

What has been the impact of the project since its inception in 2020 to date in terms of number of beneficiaries and results achieved?

Since January 2016, 4899 consultations have been carried out, 1526 in Child Psychiatry and 3373 in Child and Youth Psychology. In other words, we have reached around 488 people and their families. The cases referred to our Health Unit are always of a high level of complexity. I believe that the smallest situations are referred to other community responses, such as associations and parish councils. For this reason, therapeutic processes are often lengthy. We receive referrals from School Groups, Child and Adolescent Protection Commissions, the General Directorate of Reinsertion and Penitentiary Services, Technical Support Teams for the Courts, among others.

Many of these young people are able to take advantage of this opportunity to develop emotional, behavioural and relational skills, which translates into a new and more adaptive opportunity for individual well-being and inclusion in society.

What is your role as head of the project and Head of the Psychology Service in the patient care process?

Of the referrals received, and because they are far beyond our immediate response capacity, triage is necessary. With the information we have and depending on the level of urgency of each situation, we refer them to Paidopsychiatry, Child and Adolescent Psychology or both. In regular meetings of the interdisciplinary team, we discuss these referrals and adjust the individual intervention plan for each child or young person. Although funding is directed towards consultations with children and young people, there is of course always important work that is done with families, either in terms of some emotional support and/or more psycho-educational work.

What values and principles of the Sisters’ Hospitaller mission apply specifically to this mental health consultation project?

The mission of the Hospitaller Sisters is to reach out to the most vulnerable with the best clinical practices. These children and young people who come to us from the schools belong to the neediest families or, as I mentioned earlier, are in situations of great vulnerability in their socio-familial environment. We also receive young people with educational measures under guardianship whose work involves personal development that translates into more adapted patterns of behaviour and interpersonal relationships, thus allowing for a better integration into society.

How do you envisage the future of the project, and are there plans to expand or add new initiatives related to mental health and wellbeing in the community?

We will continue to focus on mental health promotion, that is, working with the community on mental health awareness raising, specifically addressing issues such as risk factors and protective factors, warning signs, and working to reduce stigma and promote positive regard.

We would like to continue this important interdisciplinary clinical activity and, ideally, we would like to do some work with families, particularly with intervention groups. Also, the possibility of reactivating the socio-labour structure is very interesting, but we would need other conditions to ensure the participation of young people.


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