Inpatient treatment of mood disorders in the era of de-institutionalisation, depression awareness campaigns and development of new antidepressants

• Published in: Journal of affective disorders 2003-09, Vol.76 (1), p.31-37
• Main Authors: Kaltiala-Heino, R., Laippala, P., Joukamaa, M.
• Format: Article
• Language: English
• Subjects: Antidepressive Agents - therapeutic use; Biological and medical sciences; De-institutionalisation; Deinstitutionalization; Depressive Disorder - therapy; Finland; Health Care Surveys; Health Policy; Hospital use; Hospitalization - statistics & numerical data; Humans; Inpatients; Institution therapy. Inpatient treatment; Length of Stay; Medical sciences; Mental health; Mental Health Services - statistics & numerical data; Mood disorders; Nursing Homes; Prevention. Health policy. Planification; Psychiatric services; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Registries - statistics & numerical data; Service planning; Social psychiatry. Ethnopsychiatry; Treatments
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/S0165-0327(02)00063-0

Objective: To analyse changes in inpatient treatment for mood disorders during the period of de-institutionalisation, de-centralisation of service planning, economic recession, attempts to increase depression awareness and increasing biological treatment possibilities. A special interest is paid to whether de-institutionalisation at specialist level psychiatric care results in transfer of inpatient care into non-specialised institutions. Method: A register study of all inpatient treatment due to psychiatric disorders from four health care districts in Northern Finland, with a population of more than 600,000. Treatment undertaken by psychiatric hospitals and wards, primary care wards and medical and surgical wards in general hospitals are distinguished. Results: Inpatient treatment for mood disorders increased vastly in all kinds of health care institutions. The increase was due to growing inpatient treatment of depression. Limitations: The National Discharge Register does not include treatment episodes in private nursing homes or details about the contents of the treatment. Conclusion: Even during explicit active de-institutionalisation, other policies may have a greater impact on hospital use, resulting in unexpected changes in patient populations and service utilisation. In Finland, de-institutionalisation failed concerning mood disorders. The depression awareness policies during the 1990s increased inpatient use of depression across institutions.