OECD Observer
Finland’s mental health challenge

At some point in just about everyone’s life, we are affected by poor mental health.­ In the EU an estimated 1 in every 6 people experience a mental health problem. In Finland, which has the highest estimated incidence of mental disorders in the EU, close to 1 in 5 are affected. Mental illness has a high economic cost–the cost of treatment, social security programmes, lower employment and lost productivity add up to a total average of 4% of GDP in EU countries. In Finland it is higher still: an estimated 5.3% of GDP in 2016.

What is mental health?

When we talk about good mental health, we mean someone who can cope with the normal ups and downs of life, work productively, and contribute to their community. On the flip side, mental illness is the loss of mental health, and of that ability to cope. In Finland, like in other EU countries, the most common mental disorders are anxiety and depressive disorders, which affect 4% and 6% of Finns, respectively. Drug and alcohol use disorders also affect 4% of the Finnish population–well above the EU28 average of 2.4%. These illnesses, along with conditions such as bipolar disorder or schizophrenia, which typically affect a smaller number of people–around 1-2% of the population–can affect people for only a short time, like a couple of weeks or months, but can also affect their whole life.

Mental illness affects absolutely everyone, rich and poor, male and female, young and old. However, some population groups are particularly vulnerable to mental ill-health. For instance, the two most common mental disorders–anxiety and depressive disorders affecting, respectively, 5.4% and 4.5% of the EU population–are more common among women. Conversely, drug and alcohol disorders, which are the third most common mental disorder and affect 11 million people in the EU, are twice as likely to affect men. Socioeconomic status also plays a part. In Finland, men in the lowest income group are nearly five times more likely than men in the highest income group to report chronic depression.

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In 2015, every 6 minutes someone died from mental illness-related events or suicide in EU countries. In the same year, roughly 9 young people between the ages of 15 and 24 died each day from suicide in EU countries. In fact, suicide is an area on which Finland has had remarkable success, thanks to a concerted policy effort over the past 30 years. Starting in the 1980s, Finland embarked on a series of national suicide strategies. The government established crisis phone lines, and gave the media guidance about how to report on suicide by recommending, for example, that information on the method of suicide not be included in news stories. Lastly, the government focused on improving treatment for mental illness. These efforts helped bring down Finland’s overall suicide rate by over 50%.

Preventing and treating mental illness

One reason for this success is that, rather than focusing only on preventing suicide, Finland chose instead to broadly improve its mental healthcare. The government focused on drivers of suicide, like depression, poor access to mental healthcare, substance and alcohol abuse, and access to lethal means. Finland also set up an online Mental Health Hub, which provides therapies such as cognitive behavioural therapies for low-threshold disorders, for the whole of Finland.

With suicide rates particularly high among men, policies reached out to vulnerable young men with campaigns like “Time out! Back on track” (Aikalisä! Elämä raitelleen). Has this strategy had any effect? Interestingly, between 1986 and 2016, antidepressant consumption–an admittedly crude measure of mental health treatment rate–increased 13-fold, with much of the increase in the first 20 years. Consumption has stabilised over the past decade or so.

Despite this progress, about 750 Finns still die every year from suicide. The gap in mortality rate between the general population and those diagnosed with a mental disorder, of which suicide is one driver, is significant. Finland has established a new National Mental Health Strategy, which includes €300,000 for suicide prevention, but there is room for more investment in mental health, if only to further reduce the high costs of these illnesses.

The good news is that more people are talking about mental health in OECD countries. This is a major step forward in reducing the stigma around mental illness, and helping people get the support and treatment they need and deserve. But more work needs to be done in Finland and the rest of the OECD to prevent the onset of mental illness, improve the lives of those living with mental ill-health, and prevent premature mortality linked to mental disorders.

References and further reading

OECD/EU (2018), Health at a Glance: Europe 2018: State of Health in the EU Cycle, OECD Publishing, Paris/EU, Brussels, https://doi.org/10.1787/health_glance_eur-2018-en

OECD (2015), Fit Mind, Fit Job: From Evidence to Practice in Mental Health and Work, Mental Health and Work, OECD Publishing, Paris. https://doi.org/10.1787/9789264228283-en.

OECD (2014), Making Mental Health Count: The Social and Economic Costs of Neglecting Mental Health Care, OECD Health Policy Studies, OECD Publishing, Paris. https://doi.org/10.1787/9789264208445-en.

Patel V Saxena S Lund C Thornicroft G Baingana F et. al. (2018), “The Lancet Commission on global mental health and sustainable development”, The Lancet, 2018 vol: 392 (10157) pp: 1553-1598. https://doi.org/10.1016/S0140-6736(18)31612-X

Patana, P. (2014), "Mental Health Analysis Profiles (MhAPs): Finland", OECD Health Working Papers, No. 72, OECD Publishing, Paris, https://doi.org/10.1787/5jz1591p91vg-en.