Teamwork to open new paths
Rosa's eyes convey kindness, patience, and gratitude. They are smiling eyes despite the hardship of a life filled with uncertainty, fear, and struggles for a child with a severe mental health disorder that surfaced at a very young age. There have been many years of misunderstanding within her own family, at school, and among friends. "We've lost many friends because the situation is so complex that people don't want to come around. You find yourself alone, very alone. Only families going through the same thing understand," Rosa tells us.
Rosa's son's circumstances are similar to those of many other young people with serious mental health disorders who have exhausted all mental health resources and services without finding a path that would allow them to develop a life plan. These are stories of multiple diagnoses, few solutions, and unbearable family strain.
In Catalonia, some of these complex cases have been managed since the end of 2021 through the Equip Guia program, a comprehensive intervention program that serves individuals between 12 and 25 years old who lack a life plan, have a clinical diagnosis of neurodevelopmental disorders (autism spectrum disorder, fetal alcohol syndrome, or ADHD), borderline intellectual functioning, and mental disorders (depressive disorder, bipolar disorder, psychotic disorder), and exhibit disruptive behavior that causes significant alarm in their social, family, educational, or work environments. These are interdisciplinary teams that address the cases with a community-based approach and a fresh perspective.
An intervention program for highly complex cases
"Our goals are no longer the goals of a therapist," explains Vanessa Vilella, psychiatrist at the Equip Guia Ámbito Metropolitano Sur and Vallès Oriental of the Sant Joan de Déu Hospital in Barcelona , "or of an educator or a social worker; they are much simpler goals, more about what happens in that house with that boy or girl."
“Rosa’s son’s case came to us at a time when the family was overwhelmed because, despite having the best intentions and a lot of love, they had run out of ideas on how to manage the situation,” Vanessa explains. “My son had already been through different resources, where he had been diagnosed with ADHD, ASD, oppositional defiant disorder, screen time problems, social isolation, hygiene problems, and eating problems,” Rosa recounts.
The Guia Team approaches each case with the understanding that it's a team effort involving themselves, the family, and the young person. It's a long-term process in which they test strategies to change routines and dynamics and help the individual become functional. Rosa's son reached a critical situation, with his life at risk, due to his extreme screen addiction. Once the situation stabilized, they worked to find appropriate therapeutic and educational resources and make small steps to create new life and relationship opportunities for Rosa's son. "This whole process hasn't been without worries, fears, and doubts on the part of the family," explains Vilella, "which is why we provide very close support. In situations like this, we try to offer understanding and support, time for reflection, and empowerment so they can continue seeking alternatives and give families space to gather strength."
“He’s a different child now, though he still has his difficulties, there are still many things to work on, but he’s much better,” Rosa explains. The small advances may seem like baby steps, but for the family they mean the world, they are new opportunities and small glimmers of hope in the face of so much adversity.
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