Consultative and medical assistance in the outpatient psychiatric unit is the most important type of psychiatric treatment. This type of assistance in psychiatry requires high qualifications of a psychiatrist and specialization in related areas: in psychotherapy, psychology, speech therapy, etc. Their specialization is usually due to the profile of the medical advisory unit in which they work. In some cases, advisory and medical assistance provided in time can lead to full compensation of the child’s mental state, form the basis for further effective psychiatric treatment, and become the basis for effective interaction between the child’s parents and manifestations of mental disorder and a child psychiatrist.

In the Center for Rehabilitation "Child Psychiatry" named after S. S. Mnukhin (hereinafter referred to as TSL) various departments of consultative and medical assistance are developed and function successfully. Psycho neurological day hospital for children of preschool age and younger school age with mental disorders. The hospital receives children aged 3 to 7 years, in the direction of outpatient psychiatrists of the city, from the counseling departments of the Central Medical Clinic, as well as the transfer of the Central Medical Clinic from the hospital. The main indications for referral to Developmental Disabilities Services are: mental and speech development delayed by various psychopathological syndromes, mental retardation, residual organic brain damage, epilepsy, autism, schizophrenia, etc. In the work of Psychiatric and Neurodevelopment Disorders specialists, only an individual approach is used, as well as the principle of openness and availability of information for legal representatives of the child. All possibilities of modern psycho pharmacotherapy are used. Children study daily with highly qualified speech therapists. Speech therapists, in addition to working with children, conduct educational work with their parents, meeting them weekly in open classes. Psycho diagnostic and psycho correctional work with children is carried out by a psychologist. In the day hospital there are 3 groups of children with up to 18 people and one group for preparing children for school - for 12 people. Groups are divided by age. PNDDS works according to the regime of the preschool institution for children, which allows the child to adapt more easily and quickly when he enters the hospital and when he returns back to the DDU (Developmental Disabilities Unit).

Psycho neurological rehabilitation day hospital with a school of integrated education for children with cerebral pathology of residual-organic origin and intact intelligence. The department carries out a wide range of rehabilitation medical, psychological and pedagogical activities for children with specific disorders of school skills not related to mental retardation, impaired attention, memory, communication, as well as children with school maladjustment caused by neurotic disorders and personal characteristics that make it difficult stay in a regular school team. In the office there is a school of integrated education from the 5th to the 9th grade. Training is conducted in a mass program, but taking into account the individual psychological characteristics of students.

The Department of Medical-Social-Psychological and Psychotherapeutic Aid with the helpline (former crisis prevention department). The department provides assistance to a psychiatrist, psychotherapist, and psychologist. Psychotherapeutic and psycho-correctional work is conducted with children and families in the event of behavioral problems (deviant, delinquent, school maladjustment, family disadaptation, computer addiction), as well as at the risk of neuropsychiatric disorders associated with physical, sexual, psychological violence.

A 24-hour telephone service to provide emergency psychological assistance to children and adolescents was established at the institution in 1990, becoming a structural unit of the crisis department. In 2010, the organization of the Children's Trust Phone service was launched with a single all-Russian number on the basis of a central laboratory, which operates around the clock, every day. On average, 128 calls are received daily, an average of 30-32 calls per telephone line per day. For those who have contacted the helpline, it is possible to get advice from experienced, highly qualified specialists - psychotherapists and medical psychologists, teachers who have been trained in the field of crisis conditions.

Most of the subscribers, who applied to the Phone of Trust about a variety of difficult life situations, need more in-depth, long-term and comprehensive psychotherapeutic assistance. After providing psychological assistance on the Children's Phone of Trust, more than 35% of the callers are sent for face-to-face receptions to Oregon Marital Studies Program and PP specialists with the helpline, which also operates around the clock, and assistance is provided anonymously and free of charge. Organizational and methodological advisory department with a consultative reception conducts commission consultations of children and adolescents from 0 to 18 years, a comprehensive psychological and psychiatric examination. The specialists of the department also carry out computer processing and analysis of statistical data on the activities of specialists, as well as the formation of the Regional Register, the annual and quarterly need for preferential medicines. The advisory work is aimed at carrying out differential diagnostics, clarifying the diagnosis and resolving expert issues in particularly difficult cases. Doctors of dispensary and specialized departments of the Center, doctors of the city, and neurologists of the City Children's Diagnostic Center send patients for examination.

Patients referred for consultation are examined by a team method: all specialists, including a psychiatrist, a neurologist, a psychologist, a speech therapist, and, if indicated, an epileptologist and a psychotherapist. Cases that are especially difficult to diagnose are dealt with at extended consultative receptions with the participation of employees of departments and inviting the attending physicians and heads of the departments of the Central Laboratory.

Psychotherapy department

One of the tasks of the department is the rehabilitation of children suffering from neurosis, neurosis-like and speech pathology with their adaptation to the conditions of modern life in the family, at school, other public and childcare institutions and groups. Psychotherapists work with the family in the event of school maladjustment associated with academic overload, irregular regime moments, the occurrence of an unexpected situation in the family, which causes, in addition to rehabilitation, prevention of the development of borderline diseases. Specialists of the psychotherapeutic department provide medical psychotherapeutic, psychopharmacological, psychological and speech therapy assistance to the children's population of St. Petersburg aged from 0 to 18 years, and also carry out consultative cooperation with the doctors of the outpatient and inpatient departments of the Center, neurologists of children's medical institutions of the city in order to diagnose neurotic, neurosis-like and speech disorders in children and adolescents.

One of the main functions of the department is the advisory-diagnostic work and treatment of patients with non-psychotic mental, borderline mental disorders, speech pathology, adjustment disorders, and mental diseases in remission. The main direction of the department’s medical work is psychotherapeutic, psycho-corrective. In the department there are: individual (rational pathogenetic, positive, behavioural, corrective, play, hypnosuggestive psychotherapy; group (play, personal growth, hypnosuggestive groups) psychotherapy; family psychotherapy, correction of family relations; psychological counseling.

Thus, the Center provides all types of medical advice to the children's population of the city.

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Authors declare that there is no conflict of interest.