“Milieu Therapy Centre was my second home. Always there for me. Unconditional support, which was important to face any difficulties.”
Young (two years after staying)
TARGET GROUP OF THE MILIEU THERAPY CENTRE
Currently, Tartu Milieu Therapy Centre provides services to up to six children/adolescents and their families simultaneously. The target group of the service is composed primarily of children who have experienced violence and who are developing/have developed severe and profound mental disorders with complex problems; children aged 12-18 (19) with traumatic experiences or onset of chronic psychiatric illness from all over Estonia. The target group also includes children of the same age who need long-term post-hospital psychiatric follow-up treatment.
Children with traumatic experiences
- Domestic and non-domestic abuse (sexual, physical, mental, including neglect, institutional)
- Acute shock experience (death of a loved one, illness, accidents, etc.)
Children with a severe and profound mental disorder/ chronic psychiatric illness
- F30-39 Mood disorders (bipolarity, depression)
- F40-49 Neurological, stress-related and somatoform disorders (anxiety disorders, obsessive-compulsive disorder, severe stress reactions – PTSD, dissociative disorders)
- F50 Eating Disorders
- F51 Inorganic sleep disorders
- F70 Mild mental retardation
- F84 Pervasive developmental disorders
- F90 Hyperkinetic disorders
- F92 Mixed behavioural and emotional disorders
- F93 Child-specific emotional disorders (e.g. phobias, social phobias, fear of separation)
- F94 Communication disorders in children or adolescents (mutism, attachment disorders)
- F98 Other behavioural or emotional disorders of the child or adolescent (enuresis, encephalitis, stuttering)
Operation of the service of the therapy centre for the target group
As a preventive measure to: chronic psychiatric illness; chronic dysfunction; social isolation; criminalization; a closed childcare service; repeated hospitalization.
As a follow-up treatment to hospital treatment: in collaboration and referral to a psychiatric clinic if the hospital considers that the treatment period has ended but the child needs continued support from the treatment team in order to return to normal life; if the child does not show up for outpatient treatment; in cases when, according to the hospital, continued re-hospitalization does not help the child.
Based on the children’s willingness to cooperate: participate permanently in the activities and agenda planned by the therapy centre team (communication with peers and the team; development of responsibility; self-hygiene; adherence to hours, etc.); at the personal request of the child; without a court order, the appointment of a doctor or parent/guardian; the child is motivated and supported to stay in the therapy centre by the professional team.
Involving the family: weekly meetings with parents; opportunity to communicate with the staff of the therapy centre on weekdays; successful mutual cooperation; home visits.
Who does not belong to the target group
- Mental retardation (moderate (F71), severe (F72), profound (F73))
- Dissocial personality disorder (F60.2)
- Addiction disorders (to be distinguished from addictive behaviours) to an extent that endangers the safety and well-being of the child and his or her companions in the environment of the therapy centre.
- Acute psychosis
- Active suicide – a constant real threat to life, repetitive and consistent targeted life-threatening activities (to be distinguished from attention-seeking, anxiety-relieving self-harm), those who need a secure environment in a closed medical institution where there is no chance of injuring oneself to a life-threatening extent.