A Home-Treatment System in Child and Adolescent Psychiatry

Abstract

This article describes a working model in which an evaluation and intervention programme for child and adolescent psychiatric patients and their families is conducted in the family's home. To improve services for child psychiatric patients, a home-based evaluation, guidance and treatment programme was started in Satakunta Hospital District in 1995. Further goals were to improve connections between the child's environment and social network, to reduce the long waiting list for treatment and to offer an alternative to in-patient care. Conducting psychiatric care at home enables the clinical team to correct problematic forms of interaction in an effective and constructive manner. The whole family works with staff members, creating a strong therapeutic relationship and opportunities for therapeutic reflection. Parents' motivation to improve their parenting abilities is increased. The main benefits are comprehensiveness and a direct effect on the family's daily life. The largest numbers of patients, in both the home treatment and in-patient programmes (31 and 39%), were diagnosed with affective disorders. The second largest group in the home-treatment programme (18%) was diagnosed with developmental and organic disorders, and in the in-patient programme (33%) with conduct disorders. The number of patients in the home-treatment programme has steadily increased. By 2000,26% of patients were treated at home.