RT Journal Article
SR Electronic
T1 Hard routes of mental health in Portugal: what can we offer to an adolescent with serious mental illness and multiple social risk factors?
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e229120
DO 10.1136/bcr-2018-229120
VO 13
IS 4
A1 Goncalves, Rita
A1 Marques, Mafalda
A1 Cartaxo, Teresa
A1 Santos, Vera
YR 2020
UL http://casereports.bmj.com/content/13/4/e229120.abstract
AB Worldwide, millions of children and adolescents are suffering due to a lack of efficient mental healthcare. Although some progress has been made to address the mental health problems in this age group, currently, even developed countries fail in providing psychiatric patients with the best practice care. We present a case of a Portuguese adolescent with a first episode of psychosis in whom multiple social and environmental risk factors were identified as triggers to his clinical presentation, as well as fundamental determinants of prognosis in the short and long term. In this case, we demonstrate how social determinants, including poverty, family dysfunction and difficulties in accessing appropriate mental healthcare, strongly influence the development, maintenance and prognosis in early psychosis during adolescence. Furthermore, we consider the implications of an absence of community-based mental healthcare and rehabilitation services and reasons for why this may complicate the management and limit opportunities to this patient population.