Browsing by Subject "reform school"

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  • Turkia, Mirva (Helsingin yliopisto, 2020)
    Objectives. Reform schools (RS) in Finland are foster care institutions where children and adolescents are placed when other child welfare services fail to provide adequate education and care. Former research has shown that the mental health problems of these adolescents are multiple and severe, and they often continue to adulthood. The aim of this study was to investigate how much those placed in RS participate in rehabilitation services provided by the Social Insurance Institution of Finland (Kela) and purchase psychopharmacons after RS placement, compared to their peers. Methods. This study was a part of After reform school study (ARSS), study project by the Finnish Institute for Health and Welfare (Terveyden ja hyvinvoinnin laitos, THL), the aim of which is to research adolescent’s life after RS placement. The data for the study project was acquired in the end of 2014, and included all the adolescents residing in RS in 1991, 1996, 2001, 2006, and 2011 and their matched peers. Data analyses were conducted using logistic regression, with RS placement, cohort year, and gender as independent variables. In the final analyses, dependent variables were psychotherapy and the purchases of antipsychotics, anxiolytics, drugs used for sleep disorders, antidepressants, psychostimulants used for ADHD and drugs used in alcohol dependence. Results and conclusions. First, even though the psychiatric morbidity among the persons with RS background is high, the results of this study showed that they do not participate in the Kela´s psychotherapy services more than their peers. Second, those with RS background purchase psychopharmacons remarkably more compared to their peers. In addition, women participate in Kela´s psychotherapy, and purchase psychopharmacons more than men, except stimulants used for ADHD. Also, the youngest cohorts participate in psychotherapy and purchase psychopharmacons less than the oldest cohort. In conclusion, the psychotherapy services currently available do not meet the needs of the persons placed in RS. There should be wider range of mental health services available, and it should be made as easy as possible to access them.
  • Koivukangas, Jenny (Helsingin yliopisto, 2018)
    Objectives Adolescents placed in reform schools (RS) are a special group with a risk for many types of lifetime problems. Previous studies on psychiatric morbidity among RS population indicate a wide spectrum of disorders among this population, but more representative information is needed. This follow-up study investigates the prevalence of psychiatric diagnoses among five cohorts of individuals with a history of RS placement. The prevalence rates are also compared to a matched general population sample. Methods The study sample consisted of a complete national cohort of all 1099 people placed in a reform school on the last day of the years 1991, 1996, 2001, 2006 or 2011, and information on psychiatric diagnoses, grouped into eight categories, was collected from the care register of specialized health care. The reform school subjects were compared to a population control group (n = 5437) matched by age, sex and place of birth, the follow-up time being 18 to 38 years. Results Among the individuals with a RS background, 57.4% had at least one diagnosis during the follow-up time, compared to 6.8% among the controls. 30.1% were diagnosed with conduct disorder and ADHD -category diagnosis, 26.4% with substance use disorder, 16.7% with affective disorder, 9.7% with personality disorder, 8.1% with schizophrenia spectrum disorder, 7.0% with mental retardation, 5.8% with disorder of psychological development, and 8.1% with other childhood disorder. All diagnoses were significantly more prevalent among the RS than control group. Conclusions The results of this study contribute to the earlier knowledge indicating that different psychiatric disorders are highly prevalent in RS population and that problems persist also after RS, reminding about the continuous need for support in this population.
  • Latvala, Reetta (Helsingin yliopisto, 2014)
    Objective. Based on previous studies, foster care adolescents placed due to behavioral problems have an elevated risk to psychosis. In this large register based longitudinal study we aimed to investigate the prevalence of psychosis among Finnish reform school adolescents compared to matched peers in general population. We also intended to assess the possible differences in psychosis liability among five cohorts of reform school adolescents and examined the possible correlation between instability of out-of-home placements or the age at the time of first out-of-home placement with later psychosis. It was hypothesized that reform school adolescents had greater risk for psychosis, the number of adolescents with psychosis in reform schools was increasing and that instability of placements and early age at the time of fist out-of-home placement would be associated with an elevated risk for psychosis. Methods. The subjects (N=1159, M/F=749/410) were chosen from the Finnish welfare registry by status "placement in reform school" the last day of the years 1991, 1996, 2001, 2006 or (/and?) 2011. A control group (N=5676) matched on age, gender and place of birth was obtained from the Population Register Centre, Finland. The information about child's involvement in child welfare services and out-of-home placements was collected from the Finnish welfare register, and the data from schizophrenia spectrum disorders was collected from the Finnish hospital discharge register. Results. Prevalence of psychosis among reform adolescents was 7.1%, which was significantly higher than among general population controls (0.8%) (χ² = 205.550, df =1, P<.000). After controlling for gender and cohort, reform school adolescents had a 9.44 fold risk for psychosis compared to controls (OR=9.440, p<.000). There was no difference in psychosis liability between the five study cohorts after controlling for the difference in cohorts' follow-up times. The instability of out-of-home placements and the age at the time of first out-of-home placement were not associated with an elevated risk to psychosis. Conclusions. Results of this study show clearly that psychosis is a common problem among reform school adolescents, and indicates that reform school adolescents are a population, where the identification of early psychosis should be readily and reliable accessible. Only by recognizing early psychotic symptoms it is possible to offer intervention procedures, which in turn might prevent psychosis from becoming a chronic illness, decrease other mental health and substance abuse problems and thus enhance the overall functioning and quality of life of reform school adolescents.