After Reform School Study: Main Findings and Clinical Implications

Reform school system (RS) in Finland works with adolescents with severe behavioral problems like juvenile delinquency, substance use and severe school dysfunction. After reform school study (ARSS) aims to provide reliable information on the adult age situation of former RS adolescents by combining different data registries. The RS subjects (N=1160) are organized in five cohorts: 1991, 1996, 2001, 2006 or 2011. In addition, a matched comparison group (N=5678) was obtained.

The results show that RS adolescents have a wide array of mental health problems compared to their normal population peers; Hazard Rates (HR) range from 4 to 45 depending on the psychiatric diagnosis group [1–3]. The probability for at least one criminal conviction in adulthood is 13-fold [4,5]. The all-cause mortality rate is 7-fold, and the risk for substance-related death 24-fold [6]. These results call for effective intervention and rehabilitation methods, which are tailored for the specific needs of RS population. The clinical implications and suggestions based on the results will be discussed.

The ARSS is the first extensive study on the Finnish RS population. The results will help developing care both in the RS and similar facilities working with adolescents suffering from severe behavioral problems.