Skip to main content
Top
Published in: Social Psychiatry and Psychiatric Epidemiology 2/2007

01-02-2007 | ORIGINAL PAPER

Increase in involuntary psychiatric treatment and child welfare placements in Finland 1996–2003

A nationwide register study

Authors: Ulla Siponen, MNSc, RN, Prof. Maritta Välimäki, PhD, RN, DrMedSci Matti Kaivosoja, MD, Prof. DrMedSci Mauri Marttunen, MD, DrMedSci Riittakerttu Kaltiala-Heino, MD

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 2/2007

Login to get access

Abstract

Background

Emotional and behavioural problems are common in young people and mental health problems are frequently intertwined with social problems. Both involuntary psychiatric treatment and taking into care may be used in order to manage youth behavioural problems. Compulsory interventions always endanger violating basic civil rights and therefore careful monitoring of them is warranted.

Aim

The aim of this study was to evaluate trends in Finland in involuntary psychiatric inpatient treatment and taking into care 12- to 17-year-old adolescents from the mid-1990s to the early 2000s.

Method

A nationally representative retrospective register study of the period 1996–2003 using the hospital discharge register and child welfare register in Finland.

Results

Both types of compulsory interventions increased vastly during the study period. The numbers of involuntary psychiatric treatment periods and child welfare placements of adolescents varied considerably in relation to each other, and across different regions of the country.

Conclusions

As there is no evidence of a vast increase in mental disorders or serious behavioural problems in young people, there is an obvious need for further research on reasons of the significant increase in the use of coercion and for the wide regional variation. Possible explanations discussed are different service structures and treatment cultures.
Literature
1.
2.
go back to reference Williams S, Anderson J, McGee R, Silva PA (1990) Risk factors for behavioral and emotional disorder in preadolescent children. J Am Acad Child Adolesc Psychiatry 29(3):413–419PubMedCrossRef Williams S, Anderson J, McGee R, Silva PA (1990) Risk factors for behavioral and emotional disorder in preadolescent children. J Am Acad Child Adolesc Psychiatry 29(3):413–419PubMedCrossRef
3.
go back to reference James D, Lawlor M, Sofroniou N (2004) Persistence of psychological problems in adolescent: a one year follow-up study. Ir J Psychol Med 21:11–17 James D, Lawlor M, Sofroniou N (2004) Persistence of psychological problems in adolescent: a one year follow-up study. Ir J Psychol Med 21:11–17
4.
go back to reference Kohn R, Saxena S, Levav I, Saraceno B (2004) The treatment gap in mental health care. Bull World Health Organ 82:858–866PubMed Kohn R, Saxena S, Levav I, Saraceno B (2004) The treatment gap in mental health care. Bull World Health Organ 82:858–866PubMed
5.
go back to reference The world health report 2001- Mental Health: New Understanding, New Hope (2001) Genoa, World Health Organisation The world health report 2001- Mental Health: New Understanding, New Hope (2001) Genoa, World Health Organisation
6.
go back to reference STAKES (2003) Statistical Yearbook on Social Welfare and Health Care. National Research and Development Centre for Welfare and Health (STAKES), Helsinki (in Finnish) STAKES (2003) Statistical Yearbook on Social Welfare and Health Care. National Research and Development Centre for Welfare and Health (STAKES), Helsinki (in Finnish)
7.
go back to reference Laukkanen E, Pylkkänen K, Hartikainen B, Luotoniemi M, Julma K, Aalberg V (2003) A new priority in psychiatry: focused services for adolescents. Nord J Psychiatry 57:37–43PubMedCrossRef Laukkanen E, Pylkkänen K, Hartikainen B, Luotoniemi M, Julma K, Aalberg V (2003) A new priority in psychiatry: focused services for adolescents. Nord J Psychiatry 57:37–43PubMedCrossRef
8.
go back to reference Khenissi C, Erkolahti R, Ilonen T, Saarijärvi S (2004) Adolescents’ involuntary psychiatric treatment. Psychiatria Fennica. 35:131–141 Khenissi C, Erkolahti R, Ilonen T, Saarijärvi S (2004) Adolescents’ involuntary psychiatric treatment. Psychiatria Fennica. 35:131–141
9.
go back to reference Kaltiala-Heino R (2004) Increase in involuntary psychiatric admission of minors. A register study. Soc Psychiatry Psychiatr Epidemiol 39:53–59PubMedCrossRef Kaltiala-Heino R (2004) Increase in involuntary psychiatric admission of minors. A register study. Soc Psychiatry Psychiatr Epidemiol 39:53–59PubMedCrossRef
10.
go back to reference Sourander A, Korkeila J, Turunen M-M (1998) Involuntary psychiatric hospital treatment among 12- to 17-years-old in Finland: a nationwide register study. Nord J Psychiatry 52:367–371CrossRef Sourander A, Korkeila J, Turunen M-M (1998) Involuntary psychiatric hospital treatment among 12- to 17-years-old in Finland: a nationwide register study. Nord J Psychiatry 52:367–371CrossRef
12.
go back to reference Kaivosoja M (2000) Child and adolescent forensic psychiatric services. National Research and Development Centre for Welfare and Health (STAKES), 5/2000, Helsinki (in Finnish) Kaivosoja M (2000) Child and adolescent forensic psychiatric services. National Research and Development Centre for Welfare and Health (STAKES), 5/2000, Helsinki (in Finnish)
14.
go back to reference Browne K, Hamilton-Giachritsis C, Johnson R, Ostergren M (2006) Overuse of institutional care for children in Europe. BMJ 332:485–487PubMedCrossRef Browne K, Hamilton-Giachritsis C, Johnson R, Ostergren M (2006) Overuse of institutional care for children in Europe. BMJ 332:485–487PubMedCrossRef
15.
go back to reference Ellilä H, Sourander A, Piha J, Välimäki M (2004) Patient characteristics and psychosocial treatments in child and adolescent inpatient psychiatry in Finland. Psychiatria Fennica 35:116–130 Ellilä H, Sourander A, Piha J, Välimäki M (2004) Patient characteristics and psychosocial treatments in child and adolescent inpatient psychiatry in Finland. Psychiatria Fennica 35:116–130
16.
go back to reference Jaworowski S, Zabow A (1995) Involuntary psychiatric hospitalisation of minors. Med Law 14:635–640PubMed Jaworowski S, Zabow A (1995) Involuntary psychiatric hospitalisation of minors. Med Law 14:635–640PubMed
17.
go back to reference Burns BJ, Hoagwood K, Marzek PJ (1999) Effective treatment for mental disorders in children and adolescents. Clin Child Fam Psychol Rev 2:199–254PubMedCrossRef Burns BJ, Hoagwood K, Marzek PJ (1999) Effective treatment for mental disorders in children and adolescents. Clin Child Fam Psychol Rev 2:199–254PubMedCrossRef
18.
go back to reference McMillen JC, Scott LD, Zima BT, Ollie MT, Munson MR, Spitznagel E (2004) Use of mental health services among older youths in foster care. Psychiatr Serv 55:811–817PubMedCrossRef McMillen JC, Scott LD, Zima BT, Ollie MT, Munson MR, Spitznagel E (2004) Use of mental health services among older youths in foster care. Psychiatr Serv 55:811–817PubMedCrossRef
19.
go back to reference Engberg M (1991) Involuntary commitment in Greenland the Faroe Islands and Denmark. Acta Psychiatr Scand 84: 353–356PubMed Engberg M (1991) Involuntary commitment in Greenland the Faroe Islands and Denmark. Acta Psychiatr Scand 84: 353–356PubMed
20.
go back to reference Riecher A, Rossler W, Loffler W, Fatkenheuer B (1991) Factors influencing compulsory admission of psychiatric patients. Psychol Med 21:197–208PubMedCrossRef Riecher A, Rossler W, Loffler W, Fatkenheuer B (1991) Factors influencing compulsory admission of psychiatric patients. Psychol Med 21:197–208PubMedCrossRef
21.
go back to reference Engleman NB, Jobes DA, Berman AL, Langben LI (1998) Clinicians’ decision-making about involuntary commitment. Psychiatr Serv 49:941–945 Engleman NB, Jobes DA, Berman AL, Langben LI (1998) Clinicians’ decision-making about involuntary commitment. Psychiatr Serv 49:941–945
22.
go back to reference Ellilä H, Sourander A, Välimäki M (2005) Characteristics and staff resources of child and adolescent psychiatric hospital wards in Finland. J Psychiatr Ment Health Nurs 12:209–214PubMedCrossRef Ellilä H, Sourander A, Välimäki M (2005) Characteristics and staff resources of child and adolescent psychiatric hospital wards in Finland. J Psychiatr Ment Health Nurs 12:209–214PubMedCrossRef
25.
go back to reference Mears A, White R, O´Herlihy A, Worrall A, Banerjee S, Jaffa T, Hill P, Lelliot P (2003) Characteristics of the detained and informal child and adolescent psychiatric in-patient populations. Child Adolesc Ment Health. 8:131–134CrossRef Mears A, White R, O´Herlihy A, Worrall A, Banerjee S, Jaffa T, Hill P, Lelliot P (2003) Characteristics of the detained and informal child and adolescent psychiatric in-patient populations. Child Adolesc Ment Health. 8:131–134CrossRef
26.
go back to reference Kessler RC, Walters EE (1998) Epidemiology of DSM-III-R major depression and minor depression among adolescents and young adults in the National Comorbidity Survey. Depress Anxiety 7:3–14PubMedCrossRef Kessler RC, Walters EE (1998) Epidemiology of DSM-III-R major depression and minor depression among adolescents and young adults in the National Comorbidity Survey. Depress Anxiety 7:3–14PubMedCrossRef
27.
go back to reference Winters K (1999) Treating adolescents with substance use disorders: an overview of practice issues and treatment outcome. Substance Abuse 20:203–225PubMedCrossRef Winters K (1999) Treating adolescents with substance use disorders: an overview of practice issues and treatment outcome. Substance Abuse 20:203–225PubMedCrossRef
28.
go back to reference Collishaw S, Maughan B, Goodman R, Pickles A (2004) Time trends in adolescent mental health. J Child Psychol Psychiatr 45(8):1350–1362CrossRef Collishaw S, Maughan B, Goodman R, Pickles A (2004) Time trends in adolescent mental health. J Child Psychol Psychiatr 45(8):1350–1362CrossRef
29.
go back to reference Sourander A, Santalahti P, Haavisto A, Piha J, Ikäheimo K, Helenius H (2004) Have there been changes in children’s psychiatric symptoms and mental health service use? A 10-year comparison from Finland. J Am Acad Child Adolesc Psychiatr. 43:1134–1145CrossRef Sourander A, Santalahti P, Haavisto A, Piha J, Ikäheimo K, Helenius H (2004) Have there been changes in children’s psychiatric symptoms and mental health service use? A 10-year comparison from Finland. J Am Acad Child Adolesc Psychiatr. 43:1134–1145CrossRef
30.
go back to reference Lehtinen V, Joukamaa M, Lahtela K, Raitasalo R, Jyrkinen E, Maatela J, Aromaa A (1990) Prevalence of mental disorders among adults in Finland: basic results from the Mini Finland Health Survey. Acta Psychiatr Scand 81(5):418–425PubMed Lehtinen V, Joukamaa M, Lahtela K, Raitasalo R, Jyrkinen E, Maatela J, Aromaa A (1990) Prevalence of mental disorders among adults in Finland: basic results from the Mini Finland Health Survey. Acta Psychiatr Scand 81(5):418–425PubMed
31.
go back to reference Pirkola S, Lönnqvist J (2002) Psyykkisen oireilun ja mielenterveyden häiriöt. In Aromaa A, Koskinen S (eds.) Health and functional capacity in Finland. Baseline results of the Health 2000 health examination survey. Publications of the National Public Health Institute B3/2002, Helsinki Pirkola S, Lönnqvist J (2002) Psyykkisen oireilun ja mielenterveyden häiriöt. In Aromaa A, Koskinen S (eds.) Health and functional capacity in Finland. Baseline results of the Health 2000 health examination survey. Publications of the National Public Health Institute B3/2002, Helsinki
32.
go back to reference Suvisaari J, Haukka J, Tansakanen A, Lönqvist J (1999) Decline in the incidence of schizophrenia in Finnish birth cohorts born 1945–1965. Arch Gen Psychiatry 56:733–740PubMedCrossRef Suvisaari J, Haukka J, Tansakanen A, Lönqvist J (1999) Decline in the incidence of schizophrenia in Finnish birth cohorts born 1945–1965. Arch Gen Psychiatry 56:733–740PubMedCrossRef
33.
go back to reference Ministry of Social Affairs and Health (2000) Alaikäisten tahdosta riippumattoman psykiatrisen hoidon järjestämistä selvittäneen työryhmän muistio. Working Group Memorandum. 2000:7, Helsinki. (in Finnish) Ministry of Social Affairs and Health (2000) Alaikäisten tahdosta riippumattoman psykiatrisen hoidon järjestämistä selvittäneen työryhmän muistio. Working Group Memorandum. 2000:7, Helsinki. (in Finnish)
Metadata
Title
Increase in involuntary psychiatric treatment and child welfare placements in Finland 1996–2003
A nationwide register study
Authors
Ulla Siponen, MNSc, RN
Prof. Maritta Välimäki, PhD, RN
DrMedSci Matti Kaivosoja, MD
Prof. DrMedSci Mauri Marttunen, MD
DrMedSci Riittakerttu Kaltiala-Heino, MD
Publication date
01-02-2007
Publisher
D. Steinkopff-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 2/2007
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-006-0148-x

Other articles of this Issue 2/2007

Social Psychiatry and Psychiatric Epidemiology 2/2007 Go to the issue