Easter Bunny enjoys Christmas light decorations

Fortunately I had not taken away the Christmas season light decorations from the balcony. When it snowed for Easter there was actually a better Christmas Eve dream weather than during Christmas time.

Christmas and Easter seem almost inseparable anyway, because it has been so hectic time with participating in creating the planned enormous health and social care reform where we shall satisfy everybody’s desires without delay and yet save a lot of money, especially from child and adolescent psychiatry and child welfare.

As I mentioned earlier (All or nothing?), the request for adolescent psychiatric services is all increasing. This was clearly seen when we negotiated next year’s services with the municipalities who own Tampere University Hospital. Some sharp critic was expressed because many feel that adolescents do not enter our services quickly enough and get enough help. Surely it is in the hands of those municipalities to increase our budget so that we can employ more experts and increase treatment provided…

Many actors, for example in schools, primary care, child welfare and other collaborating services would particularly like to see adolescents hospitalized in psychiatric wards for essentially longer times so that they would be “properly treated” before they return to everyday activities (being cured, of course). I would really like everybody to stop and rethink here. Adolescent psychiatric disorders that warrant specialist level services are usually long lasting. In adolescent psychiatric treatment, it is important to work both with reducing the symptoms and with supporting adolescent development. The developmental tasks of adolescence are all endangered by severe mental disorders. Integration to normative activities – family life, school, hobbies, friendships – is of outmost importance for completing the age-appropriate developmental steps. Due to this, adolescents should only be in inpatient care when the safety provided by 24/7 supervision by adolescent psychiatric professionals is absolutely needed.

Instead, more intensive outpatient treatment and besides, individually tailored support to school, leisure time and to family should be provided. But first it should be admitted that many mental disorders in adolescence (and adulthood) are indeed long-term, require long term psychiatric treatment and also support and interventions from other services, and have better and worse phases. We don’t usually blame either the patient or health care when illnesses like rheumatoid arthritis, inflammatory bowel disease or type 1 diabetes do not disappear for good. Who would say to a patient with insulin-dependent diabetes that you have already had a whole year of insulin treatment, so now you have to manage on your own? Or that you already had 40 doses of insulin, this must be enough? Psychiatric services are increasingly required to set such limits.

Nevertheless, even if we didn’t start increasing inpatient care, we’d really need more resources, not less, to provide adequately intensive and long-term adolescent psychiatric treatment for those who need it. May be united powers of Santa Claus and Easter Bunny will come to help…