Background
Little validation data has so far been published on scoring systems and the literature on prioritization in psychiatry is
especially meagre.
Objective
To explore if the priority criteria score for elective specialist level adolescent psychiatric care in Finland is associated
with treatment received and whether the association between the priority criteria scores and treatment given is similar among
different subgroups.
Methods
Adolescents currently in treatment contact in three adolescent psychiatric outpatient clinics (n = 450) were rated according to the criteria of the priority rating tool for specialist level adolescent psychiatric care
and information about adolescent’s age, sex, diagnosis, and treatments was gathered using a structured form.
Results
When sex, age and psychiatric diagnosis were controlled for, the likelihood of receiving specific therapies and medications
was significantly associated with the highest priority scores. Except for very frequent individual therapy, there were no
differences in the probability of receiving any psychosocial treatment or medication between the sexes. Receiving individual
therapy, lengthy treatment contacts and medications were more frequent among older adolescents. The rating tool worked best
among adolescents with affective or anxious disorders and worst among those with conduct disorders.
Conclusion
The present study indicates that the structured tool used in Finland, originally modified from a Canadian priority rating
tool for child and adolescent psychiatry, is able to identify adolescents requiring specified, multiple and lengthy treatments,
indicating a need for specialist level services. The scoring system tested is a good candidate for a transparent prioritization
tool for European adolescent psychiatric services.
Keywords prioritization - scoring systems - mental health services - adolescence