Priority criteria tool for elective specialist level adolescent psychiatric care predicts treatment received

Little validation data has so far been published on scoring systems and the literature on prioritization in psychiatry is especially meagre.

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.

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.

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.

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.