HUS found solutions for access to psychotherapy and developed a system for brief therapy

Access to psychotherapy has been almost impossible. People with mild to moderate depression, insomnia, anxiety or crisis are the ones most commonly in need of therapy.

Psychosocial treatments need to be targeted correctly

In recent decades, mental health treatments have focused on the long-term therapies: more than 60,000 people aged 15–64 years are currently receiving long-term psychotherapy supported by Kela and the number of patients has quadrupled in 10 years. However, there is a considerably larger number of people in need of psychotherapy, which is why the queues for psychotherapy have grown, and in the end, access to therapy has become almost impossible.

The low-intensity psychosocial treatment forms and the psychosocial treatment forms offered by primary healthcare have previously been lacking in Finland, and this has played a part in the crisis in mental health services we are experiencing.

Brief therapy is an effective treatment

The most common psychological problems for Finns are mild to moderate depression, insomnia, anxiety, or various crises. Both international studies and studies conducted at HUS have shown that short-term cognitive therapy is often sufficient treatment for these issues. However, many who would benefit from brief therapy now remain untreated. In addition, there have been no low-intensity therapies in primary healthcare, although the front-line brief therapy is cognitive short-term therapy that has been shown to be effective.

The patient is referred to a beneficial form of therapy

HUS has tried to resolve the problem by coordinating, among other things, the Terapiat etulinjaan front-line therapies initiative with government funding since 2020. The new initiative model includes digital mental health services for citizens and professionals, therapy training, rapid treatment referral, staggered treatment model, and a national network of competence centers operating with the new model. The use of the model is advancing throughout the country, as its results have been excellent and access to treatment has been accelerated.

The Terapiat etulinjaan front-line therapies initiative is based on national co-development, research conducted at HUS, and international research data. The model also produces more data to assist in the investigation of the effectiveness and cost-effectiveness of the therapy forms. 

Investment in treatment referrals and low-threshold therapies have provided benefits

The Terapiat etulinjaan front-line therapies initiative has studied, developed and implemented, for example, different solutions that facilitate the availability and effectiveness of psychotherapy. For example, the referral to treatment has been improved with the Therapy Navigator and service vouchers. In addition, evidence-based low-threshold therapies have been increased. These include guided self-care, front-line brief therapy, online therapy, and early psychotherapy. With the new solutions, access to treatment has become faster and more than half of the patients do not need further treatment.

The Therapy Navigator guides people in finding an effective form of therapy

A person seeking help fills out an anonymous web survey in the Therapy Navigator on symptoms, background information and treatment wishes, and they can contact the primary healthcare in their area if they wish. The results will help professionals trained in the Terapiat etulinjaan front-line therapies initiative to identify individuals who will benefit from psychosocial treatments that begin quickly.

The use of the Therapy Navigator has shortened access to low-threshold services from two months to less than two weeks. More than 90% of professionals involved in the piloting for the Therapy Navigator want to see it in permanent use.

Service voucher for faster access to treatment

The process is also accelerated by a service voucher. The patient will receive a list of therapists specializing in the method deemed most appropriate for the patient. The therapists have been selected from around 500 psychotherapists providing services to HUS.

In 2022, 50% of patients started psychotherapy on a service voucher in the HUS area in less than six weeks, compared to 30% in 2020.

Front-line brief therapy and guided self-care help the patient

In addition, the Terapiat etulinjaan front-line therapies initiative trained and established a network that can help train thousands of healthcare professionals to provide these low-intensity therapies, guided self-care, and front-line brief therapy.

This year, a 1,000 therapists will complete training to provide services in primary healthcare. Slightly more than 50% of patients are adequately treated by these therapists and do not require any further treatment.

Online therapy is effective and efficient treatment

There is a lot of scientific evidence for online therapy and the cognitive therapy it utilizes. The Mielenterveystalo online service (Mental Health Hub) now has 12 online therapy programs, all of which are evidence-based therapies and most of which are based on cognitive therapy.

In 2022, 17,000 online therapy referrals were made in the HUS region for mild to moderate issues. In 2016, a total of 2,100 referrals were made for online therapy. For example, in 91% of patients who received online therapy for insomnia, the symptoms were alleviated, and in 34%, the insomnia had been cured.

The development work has been based on HUS research projects, which have investigated the availability of various psychosocial methods, i.e. how patients can access psychosocial treatments. Quality monitoring ensures their safety and prevents adverse events. In addition, their effectiveness has been investigated, with use of indicators, such as reduced symptoms and need for support and improved functional capacity.