In a ten-year registry follow-up, adolescents treated according to the Open Dialogue treatment model had a lower risk of receiving out-of-home care compared to those receiving other forms of mental health treatment. Based on the results, low-threshold network psychotherapeutic treatment models can safely reduce the need for inpatient adolescent psychiatric care without a significant increase in alternative out-of-home interventions. However, both treatment groups included young people who were regularly treated outside their homes in hospitals, child protection units, and supportive housing facilities, and who had an elevated risk of disability and mortality.
Adolescent psychiatric wards in Finland have become overwhelmed. The problem has been partly attributed to the scarcity of adolescent psychiatric inpatient beds. On the other hand, both psychiatric inpatient care and other out-of-home interventions involve risk factors such as institutionalization, disrupted relationships, and retraumatization. Because of this, the benefit-risk ratio of out-of-home interventions must always be carefully considered. Moreover, institutional care incurs significant societal costs.
As an alternative to institutionalization, the development of network-oriented and systemic outpatient treatment models can be considered. One example of such a treatment model is the Open Dialogue model, which in previous studies has been associated with reduced use of psychiatric hospital care. However, there has been a lack of research evidence on whether the Open Dialogue treatment system compensates for psychiatric inpatient care with other forms of out-of-home interventions, such as child protection and supportive housing services.
In a promising development for adolescent mental health care, the Open Dialogue treatment model has shown its potential to reduce the need for out-of-home treatment. This innovative approach emphasizes early intervention, family involvement, and open communication to address mental health challenges within the home environment.
The Open Dialogue model, initially designed for psychosis treatment, has been adapted to support adolescents facing various mental health issues. A recent study has highlighted its effectiveness in reducing the necessity for hospitalization or residential care among young individuals.
By engaging adolescents and their families in collaborative discussions, Open Dialogue fosters a supportive atmosphere where concerns can be addressed promptly. This proactive approach helps prevent the escalation of mental health crises, potentially avoiding the need for more intensive and costly out-of-home care.
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