English summary: ARE ADOLESCENTS IN FOSTER CARE REFERRED FOR INPATIENT PSYCHIATRIC TREATMENT TOO EASILY?

Background The number of adolescents in foster care has increased 2-5 percent per year in Finland. Often these adolescents need psychiatric support but do not receive this support. This can lead to difficult situations in the foster homes and overhasty referral for inpatient psychiatric care. The report describes the situation of foster care adolescents admitted to adolescent psychiatric wards.

Methods The data was gathered over a period of one year. It included psychiatric assessment of adolescents, patients' own assessment of depressive symptoms (BDI; Beck Hopelessness Scale) and hopelessness (BHS; Beck Hopelessness Scale) and the data from the Finnish official database of inpatient psychiatric care (HILMO).

Results There were 238 admissions to adolescent psychiatric inpatient units during the year reviewed. Adolescents from foster homes were more often admitted against their will than others. The adolescents coming from foster homes did not themselves feel more depressed or hopeless than the other adolescents. Also their psychiatric diagnoses were less severe. The inpatient stays of the adolescents from foster homes were shorter than those of the other adolescents.

Conclusions The adolescents from foster homes were more often admitted to the psychiatric ward against will than the other adolescents, even though their psychiatric problems were less severe. During foster care more attention should be paid to the adolescent's possible need for psychiatric support. Assessment of conflict situations in foster homes is often too demanding for primary care doctors in emergency situations.