The outcome of adolescents treated within the open dialogue mental health treatment system in Länsi-Pohja compared to adolescents treated in other hospital districts
Background In the early 2000s, adolescent psychiatry in the Länsi-Pohja Hospital District was organized according to the open dialogue approach. The goal of this register study was to describe the outcomes of adolescents mental health treatment initiated in Länsi-Pohja compared to those who started treatment in other hospital districts.
Methods The cohort included adolescents who were enrolled to psychiatric care in 2003–2008 (n=56,865). Service utilization was observed for a 10 years from the start of treatment. Regression models were used to investigate how the initiation of treatment in different hospital districts was associated with treatment prolongation and mortality.
Results The cumulative exposure to medication and hospitalization days were lowest among those who started treatment in Länsi-Pohja. Disability allowances were lowest for adolescents who initiated treatment in Hus (Helsinki and Uusimaa Hospital District), Eastern Savonia, Vaasa, and Länsi-Pohja. The standardized mortality ratio was lowest in Hus, Eastern Savonia, South Ostrobothnia, and Länsi-Pohja. The probability of continued disability and mental health treatment was lowest in Länsi-Pohja, but the difference was not statistically significant compared to treatment initiation in Hus, Eastern Savonia, Häme, and Vaasa.
Conclusions Further exploration of the possibilities offered by the open dialogue to enhance mental health services is warranted.
Tomi Bergström, Jyri J. Taskila, Mia Kurtti, Jouko Miettunen, Jaakko Seikkula, Kari Valtanen
