Mental Health Services in Finnish

Health Centers

Maria Vuorilehto M.D.

Specialist in General Practice and Psychiatry

Some facts about Finnish health care

About 4000 GPs are working in 163 health centers

The number of psychiatrists per 100 000 population is 26

(compare: 3 in Albania, 1 in Turkey)

3500 psychiatric hospital beds

Facts about Finnish mental health

About 5 % of the Finnish

population suffer from

depression

Even more people suffer

from anxiety disorders :

panic, social phobia, GAD

1-2 % suffer from psycotic

disorders

A common patient case in primary care (1)

Woman in her fifties

Sleeping problems and

fatique

Worried about her health

No status or laboratory

findings

Becks depression

inventory score (BDI) 20

Problems in her family life

What is GPs role in Finnish mental health

care?

GPs deal with common

mental health problems:

identifying and referring

people with problems

diagnosing problems

regularly treating people

with common disorders

Concerning severe mental

disorders GPs play a

major role in

identification, and referral ,

but specialists are

expected to give

treatment,

Common problems in primary care

Mild and moderate depression

Mild and moderate anxiety

disorders

Addiction problems

Crisis interventions

Mental problems with only

somatic symptoms

Somatization problems

Assessement of psychotic

patients when they need non-

volontary hospital treatment

First aid for all mental

problems

A common patient case in primary care 2.

A young male student is

complaining about not

being able to concentrate

on his studies

He is tired, does not want

see his friends, ….many

other symptoms of

depression

He asks for a doctor’s

certificate for the

university

GPs’ education on mental health

One term during the

medical education

containing no practice

Working as a resident in

psychitric care for 6-12 kk

on voluntary basis

Primary care mental health workforce

GP

Specialist nurse

Addiction nurse

Other nurses

Nurses an psychologists in

child and maternity health

care

A-clinics for addicts

A common patient case 3.

An old lady with many

chronic diseases and living

alone

Accusing the home nurse

of stealing

Refusing domestic help

Sometimes confused and

disoriented

Most treatments may be offered also in

primary care:

Pharmacological: antidepressants, antipsychotics, etc in simple combinations

Psychosocial support by GP:s and specialist nurses

Short psychotherapies comprising from 5 to 10 visits

Psychoeducatin groups for depression

Internet based therapies

Specialized care is resposible for

In-patient treatment

Complicated diagnostic

assessements

Complicated

pharmacotherapy including

most treatment with

antipsychotics and mood

stabilizers

Electroconvulsive therapies

Complicated plans for

treatment and rehabilitation

Most psychotherapies

Differencies from non-European countries

Lower stigma? easier to talk to health care

professionals, more visits due to mental health problems

It is OK to stay at home when suffering from depression or anxiety but you need a doctor’s certificate for your employer

Social benefits if you are not able to work due to mental health problems

Many patients prefer talking to pharmacotherapy? – need of many visits and other professionals than GPs in the team

THANK YOU FOR YOUR ATTENTION