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

A nationwide register study

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

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.

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References

  1. Fombonne E (1995) Anorexia nervosa: no evidence of an increase. Br J Psychiatry 166:462–471

    Article  PubMed  CAS  Google Scholar 

  2. 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):413–419

    Article  PubMed  CAS  Google Scholar 

  3. 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

    Google Scholar 

  4. Kohn R, Saxena S, Levav I, Saraceno B (2004) The treatment gap in mental health care. Bull World Health Organ 82:858–866

    PubMed  Google Scholar 

  5. The world health report 2001- Mental Health: New Understanding, New Hope (2001) Genoa, World Health Organisation

  6. STAKES (2003) Statistical Yearbook on Social Welfare and Health Care. National Research and Development Centre for Welfare and Health (STAKES), Helsinki (in Finnish)

  7. 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 57:37–43

    Article  PubMed  Google Scholar 

  8. Khenissi C, Erkolahti R, Ilonen T, Saarijärvi S (2004) Adolescents’ involuntary psychiatric treatment. Psychiatria Fennica. 35:131–141

    Google Scholar 

  9. Kaltiala-Heino R (2004) Increase in involuntary psychiatric admission of minors. A register study. Soc Psychiatry Psychiatr Epidemiol 39:53–59

    Article  PubMed  Google Scholar 

  10. 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 52:367–371

    Article  Google Scholar 

  11. Mental Health Act 1116/1990. http://www.finlex.fi. 21.12.2005 (in Finnish)

  12. Kaivosoja M (2000) Child and adolescent forensic psychiatric services. National Research and Development Centre for Welfare and Health (STAKES), 5/2000, Helsinki (in Finnish)

  13. Child Welfare Act 683/1983. http://www.finlex.fi. 21.12.2005 (in Finnish)

  14. Browne K, Hamilton-Giachritsis C, Johnson R, Ostergren M (2006) Overuse of institutional care for children in Europe. BMJ 332:485–487

    Article  PubMed  Google Scholar 

  15. 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

    Google Scholar 

  16. Jaworowski S, Zabow A (1995) Involuntary psychiatric hospitalisation of minors. Med Law 14:635–640

    PubMed  CAS  Google Scholar 

  17. Burns BJ, Hoagwood K, Marzek PJ (1999) Effective treatment for mental disorders in children and adolescents. Clin Child Fam Psychol Rev 2:199–254

    Article  PubMed  CAS  Google Scholar 

  18. 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 55:811–817

    Article  PubMed  Google Scholar 

  19. Engberg M (1991) Involuntary commitment in Greenland the Faroe Islands and Denmark. Acta Psychiatr Scand 84: 353–356

    PubMed  CAS  Google Scholar 

  20. Riecher A, Rossler W, Loffler W, Fatkenheuer B (1991) Factors influencing compulsory admission of psychiatric patients. Psychol Med 21:197–208

    Article  PubMed  CAS  Google Scholar 

  21. Engleman NB, Jobes DA, Berman AL, Langben LI (1998) Clinicians’ decision-making about involuntary commitment. Psychiatr Serv 49:941–945

    Google Scholar 

  22. 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 12:209–214

    Article  PubMed  Google Scholar 

  23. STAKES (2003) http://www.stakes.info/files/pdf/REK/Terveyshilmo.pdf. 13.12.05 (in Finnish)

  24. STAKES (2003) http://www.stakes.info/files/pdf/REK/lastensuoj.pdf. 13.12.05 (in Finnish)

  25. 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. 8:131–134

    Article  Google Scholar 

  26. 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 7:3–14

    Article  PubMed  CAS  Google Scholar 

  27. Winters K (1999) Treating adolescents with substance use disorders: an overview of practice issues and treatment outcome. Substance Abuse 20:203–225

    Article  PubMed  Google Scholar 

  28. Collishaw S, Maughan B, Goodman R, Pickles A (2004) Time trends in adolescent mental health. J Child Psychol Psychiatr 45(8):1350–1362

    Article  Google Scholar 

  29. 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. 43:1134–1145

    Article  Google Scholar 

  30. 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):418–425

    PubMed  CAS  Google Scholar 

  31. 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. 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 56:733–740

    Article  PubMed  CAS  Google Scholar 

  33. Ministry of Social Affairs and Health (2000) Alaikäisten tahdosta riippumattoman psykiatrisen hoidon järjestämistä selvittäneen työryhmän muistio. Working Group Memorandum. 2000:7, Helsinki. (in Finnish)

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Authors and Affiliations

  1. Dept. of Nursing Science, University of Turku, Turku, Finland

    Ulla Siponen MNSc, RN &  Maritta Välimäki PhD, RN

  2. Lauritsankuja 1, 20740, Turku, Finland

    Ulla Siponen MNSc, RN

  3. The Hospital District of Southwest Finland, Turku, Finland

    Maritta Välimäki PhD, RN

  4. Dept. of Child Psychiatry, University of Turku, Turku, Finland

    Matti Kaivosoja MD

  5. Keski-Pohjanmaa Hospital District, Kokkola, Finland

    Matti Kaivosoja MD

  6. Dept. of Psychiatry, University of Kuopio, Kuopio, Finland

    Mauri Marttunen MD

  7. Kuopio University Hospital, Kuopio, Finland

    Mauri Marttunen MD

  8. Dept. of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland

    Mauri Marttunen MD

  9. Dept. of Adolescent Psychiatry, Peijas Hospital, Hospital District of University of Helsinki, Vantaa, Finland

    Mauri Marttunen MD

  10. Dept. of Adolescent Psychiatry, Tampere University Hospital, Pitkäniemi Tampere, Finland

    Riittakerttu Kaltiala-Heino MD

  11. Tampere School of Public Health, University of Tampere, Tampere, Finland

    Riittakerttu Kaltiala-Heino MD

Authors
  1. Ulla Siponen MNSc, RN
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  2. Maritta Välimäki PhD, RN
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  3. Matti Kaivosoja MD
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  4. Mauri Marttunen MD
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  5. Riittakerttu Kaltiala-Heino MD
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Corresponding author

Correspondence to Ulla Siponen MNSc, RN.

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Siponen, U., Välimäki, M., Kaivosoja, M. et al. Increase in involuntary psychiatric treatment and child welfare placements in Finland 1996–2003. Soc Psychiat Epidemiol 42, 146–152 (2007). https://doi.org/10.1007/s00127-006-0148-x

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  • DOI: https://doi.org/10.1007/s00127-006-0148-x

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