• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권1호
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• pp.4-14
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• 2023

This study aimed to discuss mental health services for children and adolescents that are being implemented as initiatives of the Korean government and to review the functions and roles of these projects during the COVID-19 pandemic. Three government departments are in charge of providing mental health services for children and adolescents: Ministry of Education, Ministry of Gender Equality and Family, and Ministry of Health and Welfare. The Ministry of Education has implemented several policies to facilitate the early detection of mental health issues among school students (from preventive interventions to selective interventions for high-risk students). The Ministry of Gender Equality and Family additionally serves out-of-school children and adolescents by facilitating early identification of adolescents in crises and providing temporary protection or emergency assistance (as required) through the Community Youth Safety-Net Project. Furthermore, the Ministry of Health and Welfare operates relevant mental health agencies for individuals of all ages including children and adolescents. Any high-risk students who have been screened through the projects of the Ministry of Education are supported through referrals to the following institutions for appropriate treatment of their symptoms: specialized hospitals, the Youth Counseling and Welfare Center operated by the Ministry of Gender Equality and Family, the National Youth Healing Center, the Mental Health Welfare Center operated by the Ministry of Health and Welfare, the Suicide Prevention Center, and the Child Welfare Center. To assist students who are facing any psychological difficulties because of the COVID-19 pandemic, the Ministry of Education has established a psychiatric support group for providing emergency mental health care; furthermore, schools are promoting psychological surveillance (e.g., provision of non-face-to-face counseling services that are centered around the Wee Center). The Ministry of Education, Ministry of Gender Equality and Family, and Ministry of Health and Welfare have provided varied mental health support services in order to address the challenges faced by children and adolescents during the pandemic. Nevertheless, the mental health services operated by each ministry do show some limitations because their service provision system is insufficiently collaborative. The present study discussed the positive effects of each initiative as well as its limitations; furthermore, it suggested improvements for facilitating the healthy development of children and adolescents' mental health.

• 지식경영연구
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• 제25권3호
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• pp.121-143
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• 2024

코로나 팬데믹은 아동·청소년의 학습, 건강, 심리·정서, 일상생활 등 삶의 많은 영역에 영향을 미쳤다. 특히 아동·청소년의 우울감이나 스트레스, 이와 관련한 상담 건수가 지속해서 증가하고 있어 이들에 대한 정서관리가 시급하다. 본 연구에서는 한국 아동·청소년 정신건강 관련 환경과 현행 관리체계를 분석하고 개선 서비스 방향을 제시하였다. 특히, 증거기반 행정 차원에서 교육부, 보건복지부, 행정안전부 등 공공기관에서 관리하고 있는 데이터를 중심으로 아동·청소년의 정서관리 현황을 살펴보고, 데이터 확보, 연계, 통합을 고려하여 1단계-데이터기반 아동·청소년 정서관리 서비스, 2단계-취약계층 아동·청소년 특화 정서관리 서비스, 3단계-아동·청소년 맞춤형 정서관리 마이데이터 서비스를 제안하였다. 또한, 제안한 데이터기반 정서관리 서비스의 실현을 위해 관련 법적 근거와 쟁점을 검토하고 개선 방향을 제안하였다. 제안한 서비스와 법적 과제는 향후 아동·청소년 정서관리 정책 실현에 실무적으로 기여할 것으로 기대한다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제25권3호
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• pp.142-155
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• 2014

Objectives : The aim of this study was to develop an assessment tool for measurement of children's functioning in the mental health service. We conducted a preliminary study to develop a sensitive and inclusive scale focused on the functional changes of children rather than just focusing on their symptoms or screening. Methods : The Child and Adolescent Functional Assessment Scale and the Korean-Child Behavior Checklist (K-CBCL) were both administered to 134 parents of children with emotional or behavioral problems who participated in the Aizone program and also to 186 parents of elementary school children in the Seoul metropolitan area as a control group. SPSS version 12.0 was used for statistical analysis. Results : Most of the reliability coefficients were over 0.70 except those of the conduct behavior items, which showed relatively high internal consistency. The corrected item-total correlations ranged from .411 to 758, except those of conduct behavior items and special measure items. In a concurrent validity test with K-CBCL, the total behavior problem score of K-CBCL was highly correlated with the total score of the Child and Adolescent Functional Assesment Scale (r=.610). For the construct validity, confirmatory factor analysis was performed for each of four areas, including behavior (at home/school), achievement, peer relationship, and emotion. Conclusion : The results showed that the scale was statistically reliable and valid, except for conduct behavior items. This study was conducted only for parents with elementary children. An adolescents group should be included in future studies.

• 대한간호학회지
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• 제52권4호
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• pp.359-362
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• 2022

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권4호
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• pp.185-192
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• 2020

Objectives: Our study aimed to analyze the demographic and clinical characteristics of children and adolescents during their first visit to psychiatric outpatient departments for the management of suicidal ideation and behavior, and to compare the changes before and in 2012 or later. Methods: This multicenter study was conducted at five university hospitals in a metropolitan area in South Korea. Medical records of patients aged 6-18 years were retrospectively reviewed from January 2009 to December 2016. Patients were analyzed by classifying them into suicidal and non-suicidal groups based on their visit to the hospital for management of suicidal ideation or suicide attempt and other mental problems, respectively. Results: There were differences in the year of visit, diagnosis, education level, and referral sources between patients in the suicidal and non-suicidal groups. Multiple regression analysis was conducted based on the sex, education level, referral by school, and diagnosis of depression in patients in the suicidal group, which revealed significant association. Conclusion: Suicide-related problems were significantly associated with the sex, education level, referral by school, and a diagnosis of depression in the patients. A well-connected referral system would be necessary for professional mental health management of high-risk children and adolescents.

• 한국콘텐츠학회논문지
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• 제15권5호
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• pp.592-606
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• 2015

전 연령층에 걸친 우울증 및 정신질환과 꾸준한 자살률 증가는 정부경쟁력을 크게 떨어뜨리는 심각한 사회문제이다. 정부는 정신건강을 증진시키고 자살을 예방하기 위해 다양한 정책을 실시하고 있으나 시행과정 및 연계 관리 체계 등에서 여러 문제점들이 제기된다. 본 연구는 정신건강분야에 있어 ICT 융합방안의 실태와 방향성을 파악하기 위해 국내외 사례를 살펴보았다. 미국과 영국에서는 ICT를 융합한 원격 정신치료서비스를 지역노인, 소아청소년, 취약계층 등에 제공하고 있다. 국내는 노인자살을 방지하기 위해 독거노인을 대상으로 응급알림 장치를 설치하거나 우울증과 치매 완화를 위한 기술이 개발 중에 있다. 고령화시대에 사회경제적 비용을 줄이고 보편적 복지실현을 위해 ICT 융합 정신건강관리 서비스가 필요하다. 이에 원격정신진료와 관련하여 첨예하게 갈등을 보이는 의료법과 의료기기에 대한 사회적 합의, 생애전주기에 걸쳐 이용자의 정신적 특성을 고려한 효과성 연구, 인구 밀집도와 의료접근성이 낮은 지역 중심의 특화된 정책 등이 제고되어져야한다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권4호
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• pp.197-212
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• 2017

Objectives: This study aims to supplement the limitations of the preliminary study and expand the use of the Child-Adolescent Functional Assessment Scale by providing standardized T-scores for measuring function in different areas, as well as guidelines for their interpretation. Methods: The Child-Adolescent Functional Assessment Scale and Korean-Child Behavior Checklist were administered to a total of 623 individuals, including 467 parents of emotionally and behaviorally disturbed elementary school students, 45 parents of emotionally and behaviorally disturbed middle school adolescents and 111 parents of elementary school students with developmental disorders, as well as to a control group consisting of 186 parents of mainstream elementary school children in the Seoul metropolitan area. Results: In contrast to the preliminary study, the emotional domain was disassociated into two factors, negative affect and emotion regulation, and the coefficient of determination for misconduct was increased significantly. Also, the overall reliability and validity of the Child-Adolescent Functional Assessment Scale were similar to those in the preliminary study, and the item structure was consistent. This study provides standardized T-scores of function in different areas based on the revised scale, and provides guidelines for their interpretation. Conclusion: The Child-Adolescent Functional Assessment Scale can assist the Child Global Assessment in Functioning in providing the information necessary for case management and treatment planning by comparing the impairment severity in each area of functioning, and also determining changes in behavior and function after treatment interventions. On the other hand, this scale has yet to clearly distinguish between rebellious behavior and misconduct. Further research is necessary to provide standards for more diverse age groups and for its utilization.

• 보건행정학회지
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• 제31권4호
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• pp.508-517
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• 2021

Background: After the first case of coronavirus disease 2019 (COVID-19) in January 2020, Korea has experienced three waves in 2020. This study aimed to analyze changes in health care utilization according to the period of the 1st to 3rd waves of the COVID-19 pandemic. Methods: We analyzed 3,354,469,401 national health insurance claims from 59,104 medical facilities between 2017 and 2020. Observed-to-expected ratios (O:E ratio) with data from 2017 to 2019 as expected values and data from 2020 as observed values were obtained to analyze changes in medical utilization. T-test was used to test whether the difference of observed and expected values was statistically significant. Results: In 2020, the O:E ratio was 0.894, indicating a decrease in health care utilization overall during the pandemic. The O:E ratio of the 1st wave was 0.832, which was lower than those of the second (0.886) and third (0.873) waves. Health care utilization decreased relatively more among outpatient, women, children and adolescents, and health insurance patients. And health care utilization decreased more in small medical facilities and in Daegu and Gyeongbuk during the first wave. During the pandemic, the O:E ratios of respiratory diseases were 0.486-0.694, while chronic diseases and mental diseases were more than 1.0. Conclusion: Health care utilization decreased during the COVID-19 pandemic overall, and there were differences by COVID-19 waves, and by the characteristics of patients and medical facilities. It is necessary to understand the cause of changes in health care utilization in order to cope with the prolonged COVID-19 pandemic.

• 한국사회복지학회:학술대회논문집
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• 한국사회복지학회 2000년도 춘계학술대회 자료집
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• pp.615-628
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• 2000

스트레스란, 개인과 환경간의 특별한 관계가 개인의 안녕을 위협하고 개인이 가진 자원을 초과하는 것을 말한다. 븐 연구는 청소년 임신과 스트레스에 관한 문헌연구를 통하여 청소년 임신과스트레스와의 관계에 대해서 살펴봄으로써 임신력 있는 청소년들을 위한 스트레스 관련 임상사회 사업 서비스 개입 방안을 제시하고자 하는데 목적이 있다. 임신으로 인한 부모됨의 변화가 청소년기 자체의 인생 주기 상에서의 스트레스와 중복될 때, 누적된 스트레스는 보다 커진다. 변화의 중첩은 개인 역할의 애매함을 초래하여 스트레스를 가중시키고 발달 과업의 우선순위에 혼란을 가져온다. 청소년기의 임신은 성인기로 이동하는 청소년 당사자, 그 자녀, 사회이 부정적인 영향을 미친다. 이러한 부정적인 영향은 단기간에 끝나지 않으므로 임신한 청소년들의 대처 기술과 적응력을 향상시키기 위한 개입의 노력이 필요하다. 임신한 청소년들의 경우에는 개인 상담 접근만으로는 불충분하며 효과적인 예방 프로그램은 보다 나은 대안이자 동시에 목적이 될 수 있다. 이러한 개입은 임신한 청소년들을 출산 이후에 노출되기 쉬운 디스트레스로부터 보호해주고 성인으로 성장하게 될 청소년들의 건강한 정신건강 도모이 기여하는 것으로 나파났다. 이는 결국, 임신한 청소년들을 대상으로 한 스트레스 대처 능력을 향상시키고 긍정적인 인지를 발달시킬 수 있는 스트레스 관리 프로그램의 필요성을 암시하고 있다. 이러한 연구 결과가 갖는 결론과 함께 앞으로 실천적 개입방안에 대한 더욱 정교한 연구가 요구된다.