University of Oulu

Bergström, T., Kurtti, M., Miettunen, J., Yliruka, L., & Valtanen, K. (2023). Out-of-home interventions for adolescents who were treated according to the Open Dialogue model for mental health care. In Child Abuse & Neglect (Vol. 145, p. 106408). Elsevier BV.

Out-of-home interventions for adolescents who were treated according to the Open Dialogue model for mental health care

Saved in:
Author: Bergström, Tomi1,2; Kurtti, Mia2; Miettunen, Jouko3,4;
Organizations: 1Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
2Department of Psychiatry, Wellbeing service county of Lapland, Kemi, Finland
3Research Unit of Population Health, University of Oulu, Oulu, Finland
4Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
5The Finnish Institute for Health and Welfare, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
Persistent link:
Language: English
Published: Elsevier, 2023
Publish Date: 2023-10-30


Background: The Open Dialogue approach (OD) emphasizes community-based psychiatric treatment for adolescents, but its success in achieving this is poorly documented.

Objective: To analyse out-of-home intervention usage in a national sample of adolescent psychiatric patients and determine if OD is linked to increased time until out-of-home intervention.

Participants and setting: The register-based cohort study included all adolescents aged 13–20 who received psychiatric treatment in Finland between 2003 and 2008. The research group (n = 780) included adolescents whose treatment was initiated in the Western Lapland catchment area, where OD covered the entire psychiatric service. The comparison group (n = 44,088) included the rest of Finland. National register data encompassed the period from treatment onset until the end of the 10-year follow-up or death. The primary outcomes of interest were the times to the first and second out-of-home intervention, including foster care, supportive housing, and hospitalization. The secondary outcomes included the clinical/demographic characteristics of adolescents treated out-of-home.

Methods: The hypothesis was tested via an inverse probability of treatment–weighted Cox hazard model, plus within- and between-group comparisons to analyse the secondary outcome.

Results: OD was associated with increased time to the first (adjusted hazard ratio [aHR]: 0.61, 95%CI: 0.52–0.72) and second (aHR: 0.75, 95%CI: 0.58–0.96) out-of-home interventions. In both service types, there was a subgroup of adolescents with repeated out-of-home interventions, who also demonstrated poorer long-term outcomes.

Conclusions: OD-based psychiatric services for adolescents are associated with fewer out-of-home interventions. The clinical significance of the findings warrants further research.

see all

Series: Child abuse & neglect
ISSN: 0145-2134
ISSN-E: 1873-7757
ISSN-L: 0145-2134
Volume: 145
Article number: 106408
DOI: 10.1016/j.chiabu.2023.106408
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
Funding: Supported, in part, by Finnish State Research Funding (VTR) granted by The Ministry of Social Affairs and Health, Finland. The funding source had no involvement in design, collection, analysis, and interpretation of the data.
Dataset Reference: The authors do not have permission to share data.
Copyright information: 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (