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Finland’s two state forensic psychiatric hospitals report they are operating at full capacity, with doctors warning of a sharp rise in severely mentally ill individuals entering treatment only after committing serious crimes.
Niuvanniemi Hospital in Kuopio and Vanha Vaasa Hospital in Ostrobothnia say more patients are now arriving with no recent history of adequate psychiatric care. In many cases, individuals would have needed more intensive outpatient or inpatient treatment earlier, doctors said.
“This impression is now very strong,” said Allan Seppänen, chief physician at Niuvanniemi.
His counterpart at Vanha Vaasa, Pirjo Takala, agreed, stating that patients are increasingly being admitted only after their conditions have reached crisis point.
Forensic psychiatric hospitals are intended as a last resort, reserved for individuals who are both severely ill and legally considered dangerous. In practice, many patients who arrive at these institutions have already required years of psychiatric support. Last year, the average treatment time at Niuvanniemi was eight years.
Seppänen and Takala stress that basic and specialised psychiatric care in local health systems should prevent such outcomes. But both say these preventive systems are now failing in too many cases.
This year, hospitals have also seen a notable rise in court-ordered mental state examinations. By July, around 100 suspects were waiting for such evaluations, already exceeding annual totals from the past three years, when 80 to 90 assessments were completed per year.
Doctors say the growing caseload is partly due to the continued reduction in general psychiatric hospital capacity. Between 2015 and 2021, the number of psychiatric beds in Finland was cut by more than 40 percent, according to the Finnish Institute for Health and Welfare (THL).
Seppänen said the system had placed too much faith in community-based care. “Psychiatric inpatient care has almost been stigmatised. There was this belief that an ideal system would be built mainly on outpatient care, but those expectations have not been met.”
Takala noted that even when patients are admitted to hospital, treatment periods are often too short to identify or address root causes. At the same time, current outpatient systems demand more initiative and responsibility from patients, something that may be unrealistic for those suffering from serious mental illness.
Seppänen warned that the consequences are now visible across the forensic system. Both Niuvanniemi and Vanha Vaasa are full, and in Vaasa, patients have had to be admitted beyond official bed capacity.
Waiting times for forensic mental state evaluations have also stretched to several months, an unusual situation for the institutions.
“There is pressure on regional systems to cut costs,” Seppänen said. “But expanding long-term forensic care is not a sensible direction. It would be more economically viable to strengthen early-stage mental health services in the regions.”
Veteran criminal defence lawyer Kari Eriksson has observed a similar trend. Speaking to Yle earlier this month, Eriksson said he is seeing more defendants whose crimes appear linked to untreated mental illness. He warned of a possible increase in unpredictable violence against strangers.
Seppänen and Takala both described Eriksson’s concerns as valid and called for broader national discussion.
“Psychiatry, and especially forensic psychiatry, cannot solve this alone,” said Takala. “We need a wider rethink of how we deal with this issue in Finland.”
HT
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Source: www.helsinkitimes.fi
