Anyone who suffers from a mental illness as a minor and lives in the northern district sometimes has to travel a long way: there is an outpatient clinic for children and young people in Wolfratshausen, but for more comprehensive care they have to travel to Munich, for example. That should change in two years: then two day clinics should be built, one for adults, one for children and young people. The latter, an offshoot of the kbo Heckscher Clinic, is said to guarantee 16 places. In an interview, Katharina Bühren, the new medical director of the clinic, explains why they are urgently needed.
Katharina Bühren is the new Medical Director of the kbo Heckscher Clinic, which is building a day clinic for the mentally ill in Wolfratshausen.
(Photo: private/oh)
SZ: Ms. Bühren, if everything goes smoothly, the day clinics in Wolfratshausen could open in 2024. Your spokeswoman said it was high time. Why?
Catherine Buehren: The planning of the day clinic in Wolfratshausen had a long lead time. Our needs analysis showed several years ago that the day clinic places in Wolfratshausen are necessary. The corona pandemic has made the situation worse for young people who were previously mentally unstable or ill. The need for treatment places, be it outpatient, inpatient or part inpatient, has increased significantly as a result.
Which mental illnesses have been particularly evident in children and adolescents in recent times?
Depending on age, different disorders are relevant and require treatment. Elementary school children often come to us with attention disorders such as ADHD, partial performance disorders such as reading and spelling difficulties or pronounced fears. Young people suffer, for example, from depressive disorders, eating disorders or obsessive-compulsive disorders. These would all be diseases that we could treat in a day clinic. If patients are acutely suicidal, we have to treat them as inpatients.
Are there certain clinical pictures that have been particularly aggravated by Corona?
There were individual evaluations of health insurance data that indicate that there was a significant increase in inpatient treatment of anorexia. Other studies suggest – but these data really need to be taken with a pinch of salt – that more adolescents who attempted suicide required treatment in intensive care units. Media consumption also seems to have increased significantly. This is of concern as it is associated with a risk of neglecting social and school activities and exercising less. According to a survey by the University Hospital Hamburg-Eppendorf, children and adolescents were increasingly depressed and anxious during the lockdown.
What mental difficulties did the corona pandemic demand of children and young people?
Across the board, young people report that they really missed their social contacts. The decisive task in adolescence is detachment from the parents, in achieving autonomy. If I am with my parents all the time, I cannot fulfill this developmental task. Many children and young people have also described, depending on the teachers, that the situation in schools has become more difficult for them. Pupils who had difficulties at school before Corona were left behind very quickly. Once you missed the connection, you never got in again. When schools reopened, it proved to be a massive burden for many. We notice that much more than usual. It’s quiet during the holidays. But when we are at school, we have so many emergencies that our acute care units are massively overcrowded and we hardly know how to care for the patients.
To what extent do day clinics help children and young people?
A day clinic offers the possibility of very intensive and structured therapy without tearing the young people out of their usual family and social environment. They are at home in the evenings and at weekends and can practice what they have learned there. You can make adjustments in the day clinic: What didn’t go so well at the weekend? There is close contact with schools and parents. Day-clinic treatment can also be a good transitional step between inpatient and outpatient treatment.
What therapies are planned for the Wolfratshauser day clinic?
Medical and psychological staff, nursing and educational staff will work together in a multimodal manner. There is a school, there will be speech therapy, movement therapy, art therapy and occupational therapy. Parenting is an important point. A structured daily routine is important, it gives many children and young people stability.
What is the everyday life of a young person who goes to the day clinic?
Day care will begin at 8:00 a.m. and end at 4:30 p.m. In the mornings, the children and young people will go to class and have individual therapies. The afternoons are characterized by group offers, as well as special therapies, joint activities and parent talks.
On average, how long are children and adolescents treated in a day clinic?
It depends on the disorder and the severity of the symptoms. Four weeks is probably the shortest period of time, the therapy can last up to three or four months.
What is your advice to young people and their parents who already need day care?
Unfortunately, there are currently no offers in the Wolfratshausen area. The nearest day clinic of the kbo-Heckscher-Klinikum is in Munich-Giesing. That’s a long way for every day. Another day clinic is in Murnau-Hochried. This is probably even more difficult to reach from Wolfratshausen. Otherwise, you would still have to switch to inpatient or outpatient treatment. That’s why we’re so happy to be able to offer the young people in Wolfratshausen treatment soon.