At the beginning of October, almost 1,500 psychotherapists from different parts of Finland described to HS the difficulty of getting psychotherapy. Many problems of the current system emerged, for which HS is now presenting solutions.
HS told at the beginning of October about the difficulty of accessing individual psychotherapy. There are not enough individual therapists offering rehabilitation psychotherapy reimbursed by Kela, and you may have to wait months for help.
Information about the situation was collected through a survey, which was answered by almost 1,500 psychotherapists from different parts of Finland.
HS presents five ways in which the problems of the psychotherapy system could be solved.
Read more: Psychotherapy has drifted into complete chaos, 1,500 psychotherapists tell HS
At the beginning of October, HS told about the problems of the psychotherapy system.
1. More resources
Public half’s service system is not working, because there are not enough resources. For example, there are too few employees in primary health care and psychiatric outpatient care.
“Certainly one big factor is also the fact that for years there have been too few psychiatrists in relation to the tasks,” says the chairman of the management group of psychotherapist training at the University of Helsinki Jari Lahti.
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“Sending the patient to rehabilitation psychotherapy became attractive.”
The attending physician prepares a B-statement for the patient, i.e. an explanation of the patient’s illness. It is needed as an attachment, for example, when the patient seeks support for psychotherapy. In addition, the doctor tries to find help for the patient where services are available.
The psychotherapy reimbursed by Kela as a matter of discretion became legal in 2011. It laid the groundwork for more and more people to receive support for psychotherapy.
“Previously, there were not enough funds. It was a message to the service system, that you should be careful about who you send for treatment. With the change, sending the patient to rehabilitation psychotherapy became attractive.”
The current situation would be improved by increasing the number of skilled professionals. In addition, according to Lahti, it is essential to take care that, for example, quick low-threshold psychological interventions also utilize the expertise of psychologists and psychiatric nurses.
2. Help earlier
Because getting treatment for mental health disorders is difficult and slow, many people simply can’t bring themselves to start seeking help.
“In no way is this about the patient’s fault. He just goes with the flow in the system.”
It is, of course, a problem that patients in very poor condition and in difficult situations are referred to psychotherapy, which is primarily designed to treat moderate problems, says Lahti.
In difficult situations, it would be better for the patient to receive more treatment than just psychotherapy once a week.
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The lack of school psychologists is a real problem
“In the large service system of the public side, it is possible to receive, for example, social care or ward care at the same time.”
According to Lahti, the division of the current system should be corrected, that is, a stronger connection between the systems should be created. In this way, the patient could get help from the public sector if needed.
For a long time, experts have been criticizing the backward problem-solving model prevailing in Finland. Executive director of Mieli ry Sari Aalto-Matturi told HS in May that investing in timely treatment for mental health disorders would pay for itself over the years.
The situation could be improved with earlier help and prevention. For example, the lack of school psychologists is a real problem, says Lahti.
3. More different levels of care
Problems the escalation is partly explained by the fact that there is a gap between light discussion help and robust psychotherapy.
“It would make sense for the public sector to have access to lighter treatment, such as short psychological interventions, more quickly,” says Lahti.
Other forms of treatment must also be available because Kela’s rehabilitation psychotherapy is focused on improving work ability and the system is thus not open to everyone.
One solution to the problem would be offered by the Terapiatakuu citizens’ initiative run by Mielenterveyspool. The mental health pool is a network of 34 mental health professionals.
The aim of the initiative is to guarantee everyone quick access to therapeutic psychotherapy or other psychosocial treatment after the first visit to the health center. According to the mental health pool, rehabilitation psychotherapy as a system would remain unchanged, but better access to early help might reduce the need for it.
However, the government left in May the therapy guarantee in all silence, out of the treatment guarantee presentation.
Fact
Kela supports going to psychotherapy
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Rehabilitation psychotherapy for adults supported by Kela can be individual, group, family or couple psychotherapy.
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Kela grants support for one year and a maximum of three years at a time.
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Psychotherapy supported by Kela can be given by a therapist whose training has been approved by Valvira. Psychotherapist is a title-protected professional title.
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Psychotherapist training is further training, which many people pay for themselves. Applicants for psychotherapy training must have a suitable degree and, on top of that, two years of work experience in mental health services or similar tasks.
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There are different forms of psychotherapy, and the client has the opportunity to choose the one that suits him.
Sources: Kela, Valvira, Mental Health Pool, University of Helsinki
4. More different forms of treatment
Coil adult rehabilitation psychotherapy supported by can be individual therapy but also group, family or couple psychotherapy. It has also been stated in the Therapy Guarantee initiative that early help could be family or group therapy in addition to individual therapy.
Different treatment models complement each other and are intended for different patients and different situations.
However, many seek individual therapy. Why?
According to Lahti, it’s more about what the patients themselves want.
“If it’s a delicate or fragile situation, the patient’s wish often leans towards individual therapy.”
However, Lahti emphasizes that other forms of therapy have their place and that their confrontation is pointless.
The situation could be improved by making sure that patients know all the options. For example, group therapy is well suited for treating anxiety or an unstable personality. Group therapy is also used successfully in the Student Health Care Foundation.
5. More therapists
Educated the number of therapists is simply not enough for the current system.
“I feel like we didn’t understand development ten years ago. Over the past few years, there has been an awakening to the fact that it is necessary to increase the amount of training.”
Lahti says that the University of Helsinki plans to increase training places next fall. The intention is that next autumn you could start your studies with around 170–180 instead of the normal hundred.
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“Over the last few years, there has been an awakening to the fact that it is necessary to increase the amount of training.”
The free psychotherapist training run by Mielenterveyspool would be one possible solution. At the moment continuing education can cost up to 60,000 euros. At the beginning of May, the parliament approved the proposal contained in the citizen’s initiative on the initiation of legislative work aimed at making psychotherapist training free of charge.
The Association of Psychologists has presented a two-step model as a solution to the shortage of therapists. In the model, the basic level education would provide the skills for short interventions, and the upper level would correspond to the current psychotherapist education.
Psychologists who have completed a basic degree and whose degree includes studies would automatically receive a short intervention qualification. Other suitable professional groups could complete a short additional or supplementary training. The model would also lower the price of higher education.
Lahti thinks the union’s proposal is good. In his opinion, it is also important to listen to students in the field and their wishes when developing the model.
“It is important that the psychotherapist has faith in himself and in the method he uses. It has been established that in terms of the success of the treatment, it is essential that the Therapist feels that his own training is beneficial.”
The story has also used Mielenterveyspool’s materials as a source.
Read more: Psychotherapy has drifted into complete chaos, 1,500 psychotherapists tell HS
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