title: Socioeconomic and regional aspects in the use of specialized psychiatric care--a Finnish nationwide follow-up study.
abstract: BACKGROUND
  Mental health problems in childhood and adolescence are an important public health concern. The general aim of Finnish health policy is to offer equal services for all inhabitants according to need, irrespective of socio-economic background or place of residence. Here, we assess equity in access to psychiatric care in a long-term nationwide follow-up study from birth to early adulthood.
  
  
  METHODS
  All 60 069 children born in Finland in 1987 were followed up through health registers from 1987 to 2008. The cohort members' use of specialized psychiatric outpatient and inpatient care was assessed and linked to their socio-economic status and residential area.
  
  
  RESULTS
  Altogether, 14.4% of the cohort members had received specialized psychiatric care during the follow-up. Females used significantly more specialized psychiatric outpatient care than males. In addition, the use of specialized psychiatric care was more common among young people with a poor socio-economic background and those living in urban areas.
  
  
  CONCLUSIONS
  A notable number of the young adults born in Finland in 1987 used specialized psychiatric care during their childhood and adolescence. Use was clearly defined by sex and residential area, as well as by parental socio-economic status and education. The data indicate that equity in access to mental health services should be highlighted in health policies, as contemporary outpatient mental health care has not been equally available for people living within and outside urban areas.
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland. reija.paananen@thl.fi
authors.forename: Reija
authors.initials: R
authors.lastname: Paananen
authors.forename: Päivi
authors.initials: P
authors.lastname: Santalahti
authors.forename: Marko
authors.initials: M
authors.lastname: Merikukka
authors.forename: Antti
authors.initials: A
authors.lastname: Rämö
authors.forename: Kristian
authors.initials: K
authors.lastname: Wahlbeck
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data; D011570:Psychiatry; D012111:Residence Characteristics; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult