Ariëlle de Ruijter: “Let us build the best knowledge base in the world”

The woman who wired ESCAP

A highly qualified biannual congress on child and adolescent psychiatry. This was the ESCAP track record until recently, when the Board decided that it should enter the internet age. On the recommendation of ESCAP President Ruud Minderaa, a vision on the online future of the Society was presented to the members at the official Assembly meeting by Ariëlle de Ruijter, managing director of the Dutch Knowledge Centre for Child and Adolescent Psychiatry.

Ariëlle de Ruijter speaking.A thorough elaboration of her presentation was published recently in ECAP, the official ESCAP Journal. The opening sentence: “Everything is migrating to the internet.” And shortly after this July 2013 presentation, indeed ESCAP got online. An interview with the woman who wired the European Society for Child and Adolescent Psychiatry.

You quoted good old Kevin Kelly, co-founder of Wired Magazine. Don't you think his ideas are a bit outdated by now?

 Ariëlle De Ruijter: “Kelly published his 'radical strategies for a connected world' some fifteen years ago now. And yes: internet technology changes rapidly and has made giant leaps since pioneers like Kelly first presented their vision. But mind you: in terms of vision he was way ahead of his time. He forecasted the connected world that we know today – predicted the success of Facebook before it even existed... He was one of the first to understand the way an expertise network – like ours, in young people's psychiatry – may become extremely powerful if you enable this new technology in the right way.”

Meaning that having a well maintained website will not be enough?

 “Oh no, it takes a lot more effort than that. Publishing information can easily be done with the old methods, ink and paper. In exchanging knowledge you will find completely different dynamics. An online network will only function if enough people are participating. Don't be mistaken: the technology will do nothing on its own. All the knowledge we have within ESCAP is in those clever minds of the experts, the people. These clever minds are imprisoned, so to speak, by isolation. OK, they meet at congresses now and then, and some of them cooperate in cross border projects... But that's nothing compared to the thinking power we could release by having all of them working together online. The power is in the network, no: the network is the power.”

So the network does not start functioning before the members become active?

 “That's right. And the ESCAP community does have the substance. Around a thousand participants at every conference and 32 national member societies represent such a very large number of child psychiatry professionals all over Europe and beyond. If we are able to connect this expertise, we have a real treasure in our hands!”

“The result could be an extremely rich harvest of knowledge of which every practitioner, every young patient may benefit. Moreover, European child psychiatry could save large amounts of money by online cooperation and the exchange of knowledge. No more duplication of research, no more re-inventing the same clinical protocols, the biggest and the best knowledge base in the world, accessible at any time, at any place.”

That is good news for children's mental health!

 “Wait just one second. I said if we are able to connect. A first prerequisite is that European child and adolescent mental health professionals become active on the internet. If we want to learn, we have to contribute – 'feed the web first' Kelly used to say, and that condition still goes. We are now in that first phase: a hand full of frontrunners, child psychiatrists and researchers are starting to feed the web. They contribute to the ESCAP website, submit their country profiles, publish their blogs and start to Twitter to lead the way. This is small scale, slow starting business if you compare it to the way our trainees are in touch by their LinkedIn and Facebook platforms. The idea is that we should all become active members of our online community. Anyone with any knowledge on child and adolescent psychiatry and allied professions is more than welcome to participate. To understand how revolutionary this could become in health care in general, one should read The creative destruction of medicine by Eric Topol.”

What will happen before these dreams may come true?

 “We do have a 'miniature' model up and running, so you could take a look at that: in the Netherlands we have already connected the majority of CAP experts to our online platform. Child and adolescent psychiatrists, academic experts and researchers, and of course experiental experts – the children and their parents. This network has produced diagnostic and treatment protocols for all the important disorders. More importantly: today a hundred percent of the Dutch practitioners in child and adolescent psychiatry consult these protocols every day on the internet. We have open access web platforms for professionals, parents and children in both Dutch and English.”

“We are a small country and still this did not happen overnight. Let's be realistic: it will take time to get this done on a European level. But this is too big an opportunity for child psychiatry to let it go. A European platform for CAP knowledge, a meeting place for researchers, clinical experts and policy makers. That is the feasible first step. ESCAP can form this community. But: only if the relevant players participate.”

 On the average, child psychiatrists are not exactly early adopters...

 “So be it. In that case they will have to adopt a little bit later. I would suggest: now, fifteen years after the likes of Kelly. There is no doubt that the world wide web will become increasingly important, also in child and adolescent psychiatry. I quote professor Eric Taylor who said at the Dublin Trainee Conference that the internet will rapidly increase its role in child and adolescent psychiatry, as in science and in society in general – professor Taylor is in the heart of our network, and he wasn't even born and raised in the internet age, you know. Perhaps most child psychiatrists aren't exactly computer wizards, but I do expect them to have a mentality of working together. The first steps to participate in ESCAP Online can't be hard: the only thing the Board asks for the moment is to contribute to Simply by responding. By adding knowledge, opinions, insights. By submitting blogs or articles. Whatever. To become active is the issue here. Feed the web!”

Child psychiatrists cannot have ignored the internet completely?

 “No, of course not. Trainees and professionals are already using the net in many ways. For example by using their mobile devices for various kinds of training. Trainee societies established common Facebook pages and numerous discussion groups can be found on LinkedIn and other social media platforms. Communities of patients and parents track and publish their experiences, find their peers and buddy's online, search for help and pose their questions. Professionals present themselves online in many forms with online or blended therapeutical services. They carry out online research, publish online or online first and conduct online reviews. Some researchers find that online treatment may well be effective. Policy makers use Twitter and Facebook to influence governmental budget cuts and advertise the importance of youth mental health. Child psychiatry basically migrates to the internet, as everybody else does for pretty much all of their activity.”
“So maybe the time has come to migrate some of the ESCAP activity as well. The web is a great opportunity to the Society, bringing in knowledge to the online platform should be obvious. Just imagine how fruitful it could be to share ideas, pose questions and publicly discuss our visions. A member of the ESCAP Board, Brendan Doody, said: This is about openness and about a mentality of working together. I fully agree with him.”

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Read the article by Ariëlle M. de Ruiter MSc in the ECAP Journal.