Authors: (including presenting author): :
Lee MWE, Choy LW
Affiliation: :
Child and Adolescent Psychiatry, Pamela Youde Nethersole Eastern Hospital
Keyword 1: :
Early Intervention
Keyword 2: :
Child and adolescent
Keyword 3: :
Mood problem
Keyword 4: :
Nurse clinic
Introduction: :
The demand for child and adolescent mental health services in Hong Kong has grown significantly, further intensified by the COVID-19 pandemic, which increased anxiety and depression rates among young people due to social isolation, disrupted schooling, and family stress (Chavira et al., 2022; Madigan et al., 2023). This surge has led to extended waiting times for child and adolescent specialist outpatient consultations, up to 96 weeks in 2024 at our clinic, delaying timely assessment and treatment, potentially worsening symptoms. To address this gap, a pilot early intervention program was launched in the nurse clinic, offering structured, evidence-based psychological care to children and adolescents awaiting specialist assessment.
Objectives: :
1.To promote early intervention strategies in child and adolescent psychiatric care through structured, non-pharmacological approaches. 2.To provide psychological and emotional support to patients during their waiting period for specialist consultation.
Methodology: :
The pilot targeted routine cases on the PYNEH Child and Adolescent Psychiatry SOPD waitlist (triage score 2–3) with mood-related concerns, implemented from May to July 2025. Exclusion criteria included intellectual disability and any history or suspicion of child abuse. Seventeen eligible cases over the subsequent six months were invited, with seven agreed to participate. The intervention included one intake session and three manual-based individual sessions, incorporating cognitive-behavioral therapy (CBT) concepts: emotional recognition (“Making Friends with Emotions”), identifying thought–emotion–behavior relationships (“Thought Detective”), and developing coping skills (“Emotional Toolbox”). Anxiety and depression were assessed using GAD-7 and PHQ-9 at baseline and post-intervention. Pre- and post- intervention GAD-7 and PHQ-9 scores were compared using paired t-tests to explore changes in anxiety and depressive symptoms within participants.
Result & Outcome: :
Significant clinical improvements were observed. The mean GAD-7 scores decreased by 4.14 (p = 0.012; 43.28% reduction), and PHQ-9 scores by 2.86 (p = 0.008; 29.96% reduction). Six of the seven participants no longer reported suicidal ideation, and all rated the program as satisfactory or very satisfactory. Recruitment was moderate (41%), possibly affected by the intervention implement during the examination period, which may have limited participation. Retention was strong, with no dropouts or defaults. This pilot demonstrates that a structured, nurse-led early intervention model is effective in reducing anxiety and depressive symptoms among children and adolescents awaiting specialist care, supporting its wider implementation to strengthen early intervention pathways in child and adolescent psychiatric services.
