Beyond Conventional Care: Supporting adolescents diagnosed with depression through rTMS treatment
UNICEF and the Bucharest Administration of Hospitals and Medical Services (ASSMB) support the modernization of Romania's public health system
Addressing the growing mental health needs of children and adolescents in Romania, the “Dr. Constantin Gorgos” Psychiatric Hospital for Children in Bucharest has taken a significant stride forward with the support of UNICEF, through their partnership with the Bucharest Administration of Hospitals and Medical Services (ASSMB).
The hospital has acquired a state-of-the-art repetitive transcranial magnetic stimulation (rTMS) device, purchased with UNICEF support through a grant awarded to UNICEF in Romania by the UNICEF Austria National Committee, with the objective of facilitating access to services for adolescents.
This innovative technology offers a non-invasive and comfortable therapeutic approach to complement existing medical care, and it will be used for the treatment of adolescents aged 12 to 18 diagnosed with and receiving treatment for clinical depression and other psychiatric and neurological conditions. Gorgos Hospital has become the first public healthcare institution in Romania to provide this treatment free of charge, facilitating access for every young patient, regardless of their family’s economic status.
“In the wake of the COVID-19 pandemic, mental health issues among adolescents have surged substantially, with depression and anxiety taking a heavy toll”, says Dr. Elena Tudorache, Primary Physician in Pediatric Psychiatry at the Pediatric Psychiatry Compartment of the Titan “Dr. Constantin Gorgos” Psychiatric Hospital. The medical staff at Gorgos Hospital is witnessing this impact firsthand and recognize the necessity of innovative solutions to address the challenges faced by youth in the community. “Improving mental health treatment options for adolescents is vital. In the age group of 15–24 years old, suicide represents the number two cause of death, and we are seeing a significant rise in numbers of adolescents dealing with complex mental health conditions, which are increasingly resistant to treatment. This is the reality we are living now, and that we will continue living in the coming years”, shares Dr. Gabriela Chiru, a Medical Rehabilitation specialist at the Gorgos Hospital, who has undergone training for operating the rTMS equipment, and who will be leading the treatment protocols.
We are seeing a significant rise in numbers of adolescents dealing with complex mental health conditions, which are increasingly resistant to treatment. This is the reality we are living now, and that we will continue living in the coming years.
How rTMS Works
The rTMS treatment is beneficial for adolescents struggling with depression and a range of other psychiatric and neurological conditions. This non-invasive procedure directly targets specific areas of the brain using magnetic fields, similar to technology used by MRIs, helping regulate neural activity and restoring balance. The targeted stimulation offers a complement to the traditional protocols of medication and therapy, enhancing treatment outcomes.
Accessing the treatment
Access to rTMS treatment at the Gorgos Hospital follows a clear process. Dr. Chiru explains that “The journey begins with a referral from a psychiatrist already involved in the patient's correct classic course of anti-depression care, including therapy and medication, as rTMS is not a first intention treatment”. This referral aids Dr. Chiru in establishing a comprehensive treatment plan tailored to each young patient's individual needs.
After this referral, the family visits Gorgos Hospital for an extensive screening and information session with Dr. Chiru. This session provides a clear understanding of the rTMS treatment process, addresses any concerns, and sets realistic expectations. “It is important for adolescents and their families to understand that this treatment is entirely non-invasive, and that it is safe and effective for adolescents, with no known long-term side effects”. Its non-invasive nature ensures minimal discomfort, making it well-suited for young patients. During the treatment, a low intensity sound may be heard, as the magnetic pulses are delivered to specific brain areas. However, Dr. Chiru emphasizes the importance of informed consent from the children and parents “we need people to understand that this treatment is an entirely non-invasive and voluntary procedure, and we want to make sure that parents and adolescents can comfortably give their informed consent”.
The treatment protocol spans approximately six weeks, consisting of five 19-minute sessions on five different days each week, without overnight care. This carefully spaced-out schedule maximizes the therapeutic effects of rTMS. Throughout the treatment period, medical staff closely monitor each patient's progress, making adjustments as necessary to ensure the best possible outcomes.
Improving mental health care and treatment options for children and adolescents in Romania
The inclusion of rTMS therapy as a complementary treatment at Gorgos Hospital signifies a positive shift in the landscape of mental health care for adolescents in Romania. The Bucharest Administration of Hospitals and Medical Services (ASSMB) played a pivotal role in facilitating the implementation of this initiative through accessing funding as part of their partnership with UNICEF.
Strengthening the emotional balance for every child and adolescent in Romania is at the forefront of our efforts, which is why our collaboration with UNICEF is a key partnership for our work.
Mr. Marian Negru, Counselor in the Director’s Office at ASSMB, shares, “We recognize the urgent need for effective and accessible treatments for adolescents battling mental health disorders. Collaborating with Gorgos Hospital and UNICEF to make this type of treatment available free of charge is a significant step forward in meeting this need and ensuring that young patients have access to innovative treatment options. Strengthening the emotional balance for every child and adolescent in Romania is at the forefront of our efforts, which is why our collaboration with UNICEF is a key partnership for our work”. Mr. Negru emphasizes ASSMB’s commitment to further develop innovative projects in the field: "We are working on the strategic development of activities to optimize the public pediatric health system, and a relevant example in the field of emotional balance is a sensory playground we are building at the "Prof. Dr. Alexandru Obregia” Clinical Psychiatric Hospital in Bucharest, designed to complement the treatment of children with diagnosed psychiatric and neurological conditions."
This forward-thinking approach serves as a model for public healthcare institutions in the country, inspiring them to explore and implement innovative treatment options. This initiative comes as a result of the partnership between UNICEF and ASSMB, initially forged for the collaboration on activities promoting children’s health, and tackled on three levels: health education, health protection and illness prevention.
By supporting the acquisition of emerging technologies like rTMS for state healthcare facilities in Romania through the key partnership with ASSMB, UNICEF reiterates its commitment to prioritizing mental health and improving the mental health care available for every child.