For people not familiar with the Finnish health system, seeking mental health care can seem very difficult and hard to understand, particularly if you are in a state of distress and find all tasks challenging. The following is my guide to finding mental health care in Finland for adults, based on my experiences so far as a foreign-trained psychologist working here.
In case of emergency (e.g. suicidality or psychosis)
If you or a loved one is in a state of emergency regarding your mental health, you may want to call an ambulance (112) or attend a hospital emergency department. This might be the case if someone is acutely suicidal (e.g. cannot be left alone because the risk of suicide is so high) or having some kind of psychotic episode (having hallucinations, paranoia, etc…) that endangers their health or wellbeing or that of other people.
There is a crisis hotline in English for people in a crisis moment, but it is only open at certain times of the day during the week: Mon-Thu 9- 12 and 13-15, on Fri 9-12. It is operated by Mieli, the Finnish Association for Mental Health. The number is (09) 4135 0510. They can offer you appointments for counselling in English at a later time, but the service is very busy and the waiting times may be long.
In case of severe or moderate mental health difficulties that are affecting daily life
If you or a loved one is experiences severe mental health difficulties you should contact your local health station for a referral to a doctor, and then to a psychiatrist. For example if you are feeling very depressed and unable to go to work; experiencing anxiety that prevents you from doing your normal daily activities or have some other highly distressing mental health issue. You can also contact a private health company, if you have private health insurance or are willing to pay for doctor visits yourself, or your workplace health station to arrange an appointment with a doctor. The doctor may or may not refer you to a psychiatrist.
The 24 hr number for Helsinki residents for health advice (in English) is 09 310 10023.
If you call the public health station and they assess that the situation is not severe, they will usually refer you to a psychiatric nurse. The nurse might see you for 6 sessions. You will not necessarily get a referral to a psychiatrist. In fact the health system appears generally reluctant to make referrals to psychiatrists for everyone who requests them, but obviously for more severe cases you will get a referral to a psychiatrist.
Once you get a referral to a psychiatrist, then you are on the path to getting a referral to psychotherapy. This referral letter is known as “B-lausunto”. In Finland you are required to receive treatment from a psychiatrist for three months prior to getting the “B-lausunto” (usually three appointments and an option for a prescription of medication if you want it). Some private health care companies in Finland provide rebates for the psychotherapy sessions that take place prior to the issuing of the “B-lausunto”.
The “B-lausunto” entitles the person to 20 – 80 sessions of KELA subsidised psychotherapy for a year, extendable to 2 or 3 years. The KELA subsidy for individuals is called a “rehabilitation allowance” and is currently 57,60 Euro for individual therapy, and is available only to working age people. Usually 45 – 50 minute sessions with a psychotherapist cost between 80 and 120 Euro. To get the KELA subsidy you must of course be eligible for KELA-benefits within the Finnish system. If you are not, you can ask if there is another provider of psychotherapy services you could be referred to, for example through the local psychiatric services. For example, in the Helsinki region HUS psychiatric services refers some of their patients to psychotherapy and will pay for that service.
Psychotherapists in Finland come from a range of different therapeutic models, and also a range of different education backgrounds (e.g. nurse, priest, physiotherapist, doctor, etc…). Only some psychotherapists have also had training in psychology or psychiatry.
The other alternative to obtaining psychotherapy is to pay to see a psychologist/ psychotherapist privately. This method does not require a referral, waiting period or meetings with nurses or doctors. However there is no subsidy for the sessions. Depending on the issue you bring to therapy and the therapeutic style, you may require between 6 and 40 sessions. Generally speaking, psychoanalytic psychotherapists often have more of an emphasis on long treatments and Cognitive Behavioural or Solution-Focused psychotherapists promote shorter-term psychotherapy. When you are seeking a psychotherapist or psychologist, you should check whether the person is registered in Finland or their own country or both. Many foreign psychotherapists are unable to qualify in Finland as a psychotherapist but have registration in their own countries to conduct therapy like Cognitive Behavioural Therapy or Family Therapy. Using a service like Minduu helps to find the right person. Remember to select language when you search for the therapist.
In case of mild mental health difficulties
If you are experiencing work stress, or difficulties adjusting to life in Finland or a new life situation such as getting married or having a baby, you may want to seek some support and guidance. Again, you can contact psychologists or psychotherapists privately to make an appointment.
Often workplaces in Finland will have so-called “occupational psychology” services, which are sessions with psychologists to talk about these kinds of issues. Many workplaces will offer employees 5 or 10 sessions with an occupational psychologist in the workplace health station or by the workplace health company.
I hope that this summary provides some guidance for your situation.