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1. National strategy(ies)

2. Improving the mental health of young people

National strategy(ies)

Mental health work is based on the Health Care Act and the Mental Health Act. According to the recently updated legislation (2021), the health and social services counties must provide mental health services and their quality and availability must be adapted to needs. The Future Health and Social Services Centres programme, which is a part of Finland's health and social services reform, gives the guidelines for the development of the structures of healthcare services. In the future it is planned to collect all the social and healthcare services under the same roof, but all the counties can make individual decisions regarding their own services. The development work is supported by funding from the Ministry of Social Affairs and Health, during the years 2020–2023.  

Currently the municipalities are responsible for providing mental health services. The Health Care Act sets the statutory care guarantee, which includes maximum limits for waiting times. As regards mental health services for children and young people, an assessment of the need for treatment must commence within three weeks of hospital or other specialised medical care unit receiving physician’s referral. In situations where the assessment of the need for treatment requires consultation with a specialist, the assessment and any required tests must be carried out within six weeks. According to the Act, any treatment of a person who is under the age of 23 year old and is deemed necessary on the basis of the assessment of the need for treatment must begin within three months from when the need for treatment was ascertained, taking into consideration the urgency of the case, unless otherwise required on medical, therapeutic or other comparable grounds.   

The Ministry of Social Affairs and Health is responsible for planning, coordinating and monitoring national mental health work. The goal is to strengthen mental health and to reduce factors which undermine it. Additionally, the strategy for social and health policy of the Ministry of Social Affairs and Health emphasise the reform of the Mental Health Act as well. Other objectives of the Ministry are improving the availability of mental health and services for substance users, continuing to implement the development plan on mental health and services for substance abusers and instilling practices concerning depression prevention and preventing work incapacity due to depression.  

The Finnish Government published The National Mental Health Strategy and Programme for Suicide Prevention 2020–2030 in 2020. The strategy has five priority areas: mental health as capital, mental health of children and young people, mental health rights, services and mental health management. The strategy provides guidelines for decision-making and for targeting activities and resources. The objectives of the strategy will first be implemented by increasing the availability of preventive services and therapies at the basic level and by improving the cooperation structures necessary for maintaining these services. Other measures aim to improve employment-oriented mental health services, raise the level of mental health competence in municipalities and step up suicide prevention efforts.

Currently the legislation regarding the arrangement of mental health and substance abuse services is under statute drafting. The aim is to move from the regulation of so-called “voluntary mental health and substance abuse services” from the Mental Health and Substance Abuse Act to the Social Care Act and the Health Care Act. At the same time, the aim is to improve the availability, accessibility, effectiveness and overall quality of the services in question. Changes in the legislation are intended to enter into force 1.1.2023.   

In addition, MIELI Mental Health Finland has established the national centre for preventing suicide. The centre works in Helsinki and Kuopio, and it gives support to the people who have themselves  tried to attempt suicide, and to their close ones. 

Improving the mental health of young people

Promoting the mental health of young people is an important part of youth policy.  

As mentioned above (see: Youth Wiki/Finland: 7.2 Health and Well-Being: Administration and governance), one of the youth work centres of expertise, a consortium which consists of the Into – Association for Outreach Youth Work and Workshop Activities, EHYT Finnish Association for Substance Abuse Prevention, MIELI Mental Health Finland and Juvenia Youth Research and Development Centre, focuses on these issues. The consortium unites the organisations’ expertise and knowledge in mental health work and substance abuse prevention. It aims to increase national expertise in the field of mental health promotion and preventive work. The consortium offers education to youth workers, produces material for professionals and emphasises a resource-oriented approach.   

As mentioned above, municipalities are primarily responsible for organising health services and these services should cover mental health as well as physical health. Physical examinations in school and school healthcare are not limited to only checking a young person’s physical health. An examination by a child or youth psychiatrist to determine young people’s mental health status must be made available if necessary. For example, a young person has the right to discuss their life situation with a psychologist seven days at latest after they have requested the meeting. If the issue is urgent, the meeting must be organised on the same or following day. The statutory care guarantee regulates maximum waiting times in public healthcare.  

One of the priority areas of The National Mental Health Strategy and Programme for Suicide Prevention 2020–2030 by The Finnish Government is the mental health of children and young people. According to Finnish Institute for Health and Welfare, the mental health of children and young people is supported when society:   

• creates secure conditions for family-life and in other formative environments also during societal change  
• ensures that each child has equal opportunities for self-esteem, mental health skills, learning and feelings of achievements  
• gives each child equal opportunities for engaging in safe recreational activities which promotes their development  
• safeguards the rights of vulnerable children and young people and those in challenging life circumstances   
• reduces childhood poverty in families   
• reduces social exclusion of children and young people.  

Mental health promotion for children and young people is linked to the National Strategy for Children, which was published in February 2021. The purpose of the National Strategy for Children is to create a child and family friendly vision for Finland which extends over several administrative sectors and over several governmental periods. According to the strategy, “social welfare and healthcare services will be extensively linked to education services and different services, activities and communities that promote wellbeing and health.” The aim is also to improve “the prerequisites of the third sector to support children and families, complementing the service system”.  

Public health-care services provide the website called mentalhub.fi for young people facing mental problems. The website enables self-evaluation and lists places where young people can get help. The content is currently available in Finnish, but the English version is coming soon. However, the website highlights that self-evaluation is suggestive only and cannot replace a physician’s evaluation.  As mentioned, municipalities are primarily responsible for organising services, including 24-hour social service in urgent crises. Implementation may vary: in Helsinki, this can be counselling over the phone or 1-5 meetings. A psychiatric emergency service is available for all individuals over 16-year olds.  

Besides these statutory services, the Ministy of Social Affairs and Health and Ministry of Education and Culture support various youth and health organisations, which are working for the better mental health of children and young people.  

Youth Mental Health Association – Yeesi was founded in 2011 by young people themselves. The organisation is Finland’s first national Mental Health Association for young people. The members of the organisation have an opportunity to enhance the mental well-being of their generation. The aim of the organisation is to increase the awareness amongst youth of the importance of taking care of their own mental well-being. Yeesi wants to “give opportunities to any 13–29 year olds, to enhance and learn how to cherish their own mental well-being, and to help others look after theirs”. Their main channel of communication is social media where young people can also engage in the activities. 

Sekasin Collective is a collaboration coordinated by MIELI Mental Health Finland, The Finnish Red Cross, the Finnish Federation of Settlement Houses (FFSH) and SOS-Lapsikylä (SOS Children’s Villages), which provides a mental health chat-service for young people aged 12–29. The key objectives of the service are to promote the mental well-being of young people, to help them in various crises and to prevent negative causes of mental health issues. Sekasin-chat is operated by the afore-mentioned co-operators, other actors and organisations on the field, and additionally a large number of educated volunteers. Young people are able to talk in the chat every day of the year and they have 45 minutes at a time to talk with the professionals. In 2019 the chat service reached 21 000 young people and it was contacted 136 000 times.  

Besides chat-service, Sekasin Collective also operates Discord-based Sekasin Gaming, which is Finland's largest professionally moderated online youth space and community on Discord. The service is targeted especially for those young people, who are hard to reach by traditional means, marginalised or at risk of marginalisation. The server offers the opportunity to chat anonymously with nearly 14,000 other Finnish young people via voice and text channels 24/7. In 2019, approximately 25,000 young people visited the server in total, and more than 2 million messages were exchanged between members on the server.  

Many non-governmental organisations have phone and chat services especially for young people. As in Sekasin-chat, educated volunteers, youth workers and other professionals reply to the messages and phone calls of children and young people, and most of the services are open several days a week. Save the Children Finland also has a WhatsApp chat service, where young people are able to get longer-lasting support from the volunteers and professionals. For more information, visit:  

• Eating Disorder Association SYLI ry: SYLI –chat for young people, who want to talk about their worries and thoughts considering eating, sports and body image (in Finnish) 
• Family Federation of Finland: Et ole yksin –chat (“You’re not alone” chat for for athletes and those working in the sports sector, in Finnish)  
• Family Federation of Finland: Seksuaalineuvontachat (Sexual Counceling Chat for young people under 20 years, in Finnish)  
• Family Federation of Finland: Poikien puhelin (Boys’ phone line for boys and young men, in Finnish)  
• Federation of Mother and child homes and Shelters: Chat (in Finnish)  
• Finnish Student Health Service: SelfChat for assessing the need for mental health treatment, for university students
• Mannerheim League for Child Welfare: Chat and phone line for children and young people (in Finnish)  
• Maria Akatemia: Keijun varjo –chat (“Shadow of the fairy” chat for girls and women over 15 years, who use violence towards others or are afraid to do so, in Finnish)  
• Nuorten palvelu ry: Outreach youth work chat in WhatsApp and Discord (in Finnish) 
• Save the Children Finland: Netari-chat & Netari WhatsApp (in Finnish)

Zekki is an online service created by Diaconia University of Applied Sciences, MIELI Mental Health Finland, Takuusäätiö (Guarantee Foundation), Martha Organisation, Family Federation of Finland, Finnish Youth Housing Association NAL, Save the Children Finland, Nuorten ystävät ry (Friends of Young People), Mannerheim League for Child Welfare, Vamos by The Deaconess Foundation, Youth Mental Health Association – Yeesi, HelsinkiMissio, and EHYT Finnish Association for Substance Abuse Prevention, which was chosen as best European Social Innovation by European Innovation Council in 2021. Zekki is based on the 3X10D® life situation assessment tool, research and professional knowledge, and it is designed for the young people aged 15–25. With 10 quick quiz questions the respondent can self-assess their own life situation and get guidance and the contact information of service providers during difficult life situations, such as social, health-related or money-related problems.

MIELI Mental Health Finland organises also intensive courses and peer support groups for young people and young adults who are in need of support. Groups are tailored according to young people’s needs: there are different groups for young people whose family members have a drinking problem, who have experienced relatives’ or friends’ suicide or who need support in their transition to working life, etc. A crisis line is available in urgent situations. In Helsinki, Kuopio and Seinäjoki there are SOS crisis centres, which offer conversational therapy meetings without a physician’s referral and are free-of-charge.

The Finnish Red Cross provides emergency youth shelters for young people who are between the age of 12 and 21. Emergency youth shelters offer conversational therapy or a temporary overnight bed if needed, and they are located in Espoo, Helsinki, Vantaa, Tampere and Turku. Young people can also call to seek advice if needed, and online support is available twice a week. The services at the shelter are free of charge for young people.