Dr. Maria Vuorilehto, 4.3.2016 Seminars 2015-2016 for asylum seeker and refugee health care professionals

1. Mental Health Services in Finnish
Health Centers
Maria Vuorilehto M.D.
Specialist in General Practice and Psychiatry

2. 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

3. 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

4. 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

5. 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,

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. THANK YOU FOR YOUR ATTENTION