The association between Open Dialogue to young Danes in acute psychiatric crisis and their use of health care and social services: A retrospective register-based cohort study

Niels Buus*, Elise Kragh Jacobsen, Anders Bo Bojesen, Aida Bikic, Klaus Müller-Nielsen, Jørgen Aagaard, Annette Erlangsen

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Background: Although most mental disorders have their onset in early life, the mental health needs of young people are often not addressed adequately. Open Dialogue is a need-adapted approach that mobilizes psychosocial resources in a crisis struck person's social network. Open Dialogue is organised as a series of network meetings and seeks to promote collaborative integrated care, and a non-directive psychotherapeutic stance. Its effectiveness for young people has not previously been assessed. Objectives: The aim of the study was to examine whether a Danish Open Dialogue approach directed at young people, who sought help from Child and Adolescent Mental Health Services, reduced their utilisation of psychiatric and other health services, compared to peers receiving usual psychiatric treatment. Design: A retrospective register-based cohort study. Methods: Using clinical and national register data, a cohort of patients aged 14–19 years (n = 503) enrolled from one region during 2000 to 2015 were compared to a matched comparison group from two other regions using propensity scores. Utilisation of psychiatric health services, GP services, and social markers were assessed after 1, 2, 5 and 10 year of follow-up using logistic and Poisson regression models. Results: Patients receiving Open Dialogue intervention had more psychiatric outpatient treatments at one year of follow-up (RR = 1.2, CI: 1.1–1.4) than the comparison group, but not at subsequent follow-ups. Recipients of the intervention had fewer emergency psychiatric treatments (1 year follow-up: RR = 0.2, CI: 0.1-0.5; 10 years follow-up: RR = 0.5, CI: 0.3-0.8) and less use of general practitioner services (1 year follow-up: RR = 0.90, CI: 0.82-0.99; 10 years follow-up: RR = 0.85, CI: 0.78-0.92). There was no significant reduction in the number of psychiatric hospitalisation contacts or treatment days. Conclusions: Open Dialogue was significantly associated with some reduced risks of utilising health care services. These mixed results should be tested in a randomized design.

OriginalsprogEngelsk
TidsskriftInternational Journal of Nursing Studies
Vol/bind91
Sider (fra-til)119-127
ISSN0020-7489
DOI
StatusUdgivet - 1. mar. 2019

Fingeraftryk

Health Services
Cohort Studies
Delivery of Health Care
Adolescent Health Services
Propensity Score
Mental Health Services
General Practitioners
Mental Health
Research Design
Outpatients
Logistic Models

Citer dette

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title = "The association between Open Dialogue to young Danes in acute psychiatric crisis and their use of health care and social services: A retrospective register-based cohort study",
abstract = "Background: Although most mental disorders have their onset in early life, the mental health needs of young people are often not addressed adequately. Open Dialogue is a need-adapted approach that mobilizes psychosocial resources in a crisis struck person's social network. Open Dialogue is organised as a series of network meetings and seeks to promote collaborative integrated care, and a non-directive psychotherapeutic stance. Its effectiveness for young people has not previously been assessed. Objectives: The aim of the study was to examine whether a Danish Open Dialogue approach directed at young people, who sought help from Child and Adolescent Mental Health Services, reduced their utilisation of psychiatric and other health services, compared to peers receiving usual psychiatric treatment. Design: A retrospective register-based cohort study. Methods: Using clinical and national register data, a cohort of patients aged 14–19 years (n = 503) enrolled from one region during 2000 to 2015 were compared to a matched comparison group from two other regions using propensity scores. Utilisation of psychiatric health services, GP services, and social markers were assessed after 1, 2, 5 and 10 year of follow-up using logistic and Poisson regression models. Results: Patients receiving Open Dialogue intervention had more psychiatric outpatient treatments at one year of follow-up (RR = 1.2, CI: 1.1–1.4) than the comparison group, but not at subsequent follow-ups. Recipients of the intervention had fewer emergency psychiatric treatments (1 year follow-up: RR = 0.2, CI: 0.1-0.5; 10 years follow-up: RR = 0.5, CI: 0.3-0.8) and less use of general practitioner services (1 year follow-up: RR = 0.90, CI: 0.82-0.99; 10 years follow-up: RR = 0.85, CI: 0.78-0.92). There was no significant reduction in the number of psychiatric hospitalisation contacts or treatment days. Conclusions: Open Dialogue was significantly associated with some reduced risks of utilising health care services. These mixed results should be tested in a randomized design.",
keywords = "Delivery of health care, integrated, Mental health services, Psychosocial support systems, Psychotherapy, Retrospective studies",
author = "Niels Buus and {Kragh Jacobsen}, Elise and Bojesen, {Anders Bo} and Aida Bikic and Klaus M{\"u}ller-Nielsen and J{\o}rgen Aagaard and Annette Erlangsen",
year = "2019",
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pages = "119--127",
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The association between Open Dialogue to young Danes in acute psychiatric crisis and their use of health care and social services : A retrospective register-based cohort study. / Buus, Niels; Kragh Jacobsen, Elise; Bojesen, Anders Bo; Bikic, Aida; Müller-Nielsen, Klaus; Aagaard, Jørgen; Erlangsen, Annette.

I: International Journal of Nursing Studies, Bind 91, 01.03.2019, s. 119-127.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - The association between Open Dialogue to young Danes in acute psychiatric crisis and their use of health care and social services

T2 - A retrospective register-based cohort study

AU - Buus, Niels

AU - Kragh Jacobsen, Elise

AU - Bojesen, Anders Bo

AU - Bikic, Aida

AU - Müller-Nielsen, Klaus

AU - Aagaard, Jørgen

AU - Erlangsen, Annette

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Background: Although most mental disorders have their onset in early life, the mental health needs of young people are often not addressed adequately. Open Dialogue is a need-adapted approach that mobilizes psychosocial resources in a crisis struck person's social network. Open Dialogue is organised as a series of network meetings and seeks to promote collaborative integrated care, and a non-directive psychotherapeutic stance. Its effectiveness for young people has not previously been assessed. Objectives: The aim of the study was to examine whether a Danish Open Dialogue approach directed at young people, who sought help from Child and Adolescent Mental Health Services, reduced their utilisation of psychiatric and other health services, compared to peers receiving usual psychiatric treatment. Design: A retrospective register-based cohort study. Methods: Using clinical and national register data, a cohort of patients aged 14–19 years (n = 503) enrolled from one region during 2000 to 2015 were compared to a matched comparison group from two other regions using propensity scores. Utilisation of psychiatric health services, GP services, and social markers were assessed after 1, 2, 5 and 10 year of follow-up using logistic and Poisson regression models. Results: Patients receiving Open Dialogue intervention had more psychiatric outpatient treatments at one year of follow-up (RR = 1.2, CI: 1.1–1.4) than the comparison group, but not at subsequent follow-ups. Recipients of the intervention had fewer emergency psychiatric treatments (1 year follow-up: RR = 0.2, CI: 0.1-0.5; 10 years follow-up: RR = 0.5, CI: 0.3-0.8) and less use of general practitioner services (1 year follow-up: RR = 0.90, CI: 0.82-0.99; 10 years follow-up: RR = 0.85, CI: 0.78-0.92). There was no significant reduction in the number of psychiatric hospitalisation contacts or treatment days. Conclusions: Open Dialogue was significantly associated with some reduced risks of utilising health care services. These mixed results should be tested in a randomized design.

AB - Background: Although most mental disorders have their onset in early life, the mental health needs of young people are often not addressed adequately. Open Dialogue is a need-adapted approach that mobilizes psychosocial resources in a crisis struck person's social network. Open Dialogue is organised as a series of network meetings and seeks to promote collaborative integrated care, and a non-directive psychotherapeutic stance. Its effectiveness for young people has not previously been assessed. Objectives: The aim of the study was to examine whether a Danish Open Dialogue approach directed at young people, who sought help from Child and Adolescent Mental Health Services, reduced their utilisation of psychiatric and other health services, compared to peers receiving usual psychiatric treatment. Design: A retrospective register-based cohort study. Methods: Using clinical and national register data, a cohort of patients aged 14–19 years (n = 503) enrolled from one region during 2000 to 2015 were compared to a matched comparison group from two other regions using propensity scores. Utilisation of psychiatric health services, GP services, and social markers were assessed after 1, 2, 5 and 10 year of follow-up using logistic and Poisson regression models. Results: Patients receiving Open Dialogue intervention had more psychiatric outpatient treatments at one year of follow-up (RR = 1.2, CI: 1.1–1.4) than the comparison group, but not at subsequent follow-ups. Recipients of the intervention had fewer emergency psychiatric treatments (1 year follow-up: RR = 0.2, CI: 0.1-0.5; 10 years follow-up: RR = 0.5, CI: 0.3-0.8) and less use of general practitioner services (1 year follow-up: RR = 0.90, CI: 0.82-0.99; 10 years follow-up: RR = 0.85, CI: 0.78-0.92). There was no significant reduction in the number of psychiatric hospitalisation contacts or treatment days. Conclusions: Open Dialogue was significantly associated with some reduced risks of utilising health care services. These mixed results should be tested in a randomized design.

KW - Delivery of health care, integrated

KW - Mental health services

KW - Psychosocial support systems

KW - Psychotherapy

KW - Retrospective studies

U2 - 10.1016/j.ijnurstu.2018.12.015

DO - 10.1016/j.ijnurstu.2018.12.015

M3 - Journal article

C2 - 30682632

AN - SCOPUS:85060310284

VL - 91

SP - 119

EP - 127

JO - International Journal of Nursing Studies

JF - International Journal of Nursing Studies

SN - 0020-7489

ER -