16.12.16
Lessons from Finland for NHS mental health
Source: NHE Nov/Dec 16
While many countries across Europe struggle to deal with a rising demand for mental health services, Finland is successfully improving service provision via a new online portal. Professor Grigori Joffe, medical director at Hospital District of Helsinki and Uusimaa (HUS) and a member of Mental Health Hub’s founding team, explains how the country’s digital approach can make therapy more accessible and affordable.
Finnish mental healthcare has taken a leap forwards with the launch of Mental Health Hub, a comprehensive range of mental health services that can be accessed through a single portal. By streamlining patient access to information and treatment, the hub is enabling our practitioners to address disorders at an early stage for better patient outcomes. Plus, in an age of growing demand for psychotherapy and health budgets being stretched even further, the hub aims to prevent mental healthcare costs spiralling out of control.
Offering patients online therapy, a local service finder, various sources of information, self-help programmes and guides for pre-clinical conditions, the hub gives immediate access to certain therapies with no waiting list, right across Finland. All services – for both patients and healthcare professionals – are now available in one place, with each patient receiving the same high-quality treatment and care.
Innovative features
At the heart of Mental Health Hub is a ‘symptom navigator’, which directs the public to appropriate local services based on the severity of their distress, but at the same time preventing any self-diagnostics. Separately, an automatic ‘psycho-educator’ provides reliable, common sense information on symptoms and disorders. For mental healthcare professionals, the hub also offers education, training, advice and consultation opportunities plus various tools for measuring mental health.
The portal is also currently offering patients computer-assisted cognitive behavioural online therapies for depression, alcohol misuse and a wide range of anxiety disorders, as well as a symptom control programme for bipolar disorder. A range of additional therapies is being developed, with bulimia therapy scheduled to go live in spring 2017.
Behind the scenes of the hub is a modular IT platform, designed to support the growth and expansion of the portal via diverse additional modules which include self-help, monitored peer group discussions; professional-guided, computer-assisted, internet-delivered cognitive behavioural therapy (iCBT); and consultations and professional training, to name a few.
Lessons learned
When we started the project almost 10 years ago, there was no national co-ordination of mental health service providers. But when we reached out to the relevant stakeholders from the public, private and third sectors, we were met with an incredibly high level of enthusiasm and they all wanted to become involved.
This open and inclusive dialogue was the primary, critical success factor of the project. From the government to private sector, what we quickly learned was that all parties need to collaborate – don’t be selfish, speak to anyone, and encourage co-operation for the benefit of everyone. And by maintaining the patient as the central focus at all times, the ethical nature of the project is guaranteed, which makes it straightforward for all parties to participate.
Another key learning was to start small and think rationally. We began by bringing together mental health and substance abuse professionals from our catchment area and involved patients in the early stages. This approach created a basis for the service paths and the first version of Mental Health Hub was born.
Results to date
Overall, the hub is helping to achieve better outcomes at less cost and the demand is finally being met. Now, primary healthcare practitioners are referring patients directly to the online therapies, which is improving the general mental health of the population with a minimal financial input. In a recent study by the Finnish National Institute for Health and Welfare, Mental Health Hub outperformed all other national eHealth services in terms of usefulness.
On the back of this success, we are developing the hub’s innovative platform model by applying it to other fields, such as social services. Live projects, in conjunction with regions across Finland, are already well underway.
Simultaneously, we are collaborating with other university hospital districts to build a government-funded, national ‘virtual hospital’ at HealthVillage.fi. Several hubs have already opened, including Weight Management Hub, Women’s Hub and Pain Relief Hub. By 2018 we will have launched a further 20, covering a wide range of specialist healthcare, patient groups and disorders.
Again, the objective is to make services more accessible and affordable and create a flexible platform that can be adapted to meet the needs of overseas healthcare providers. Working closely with the government’s Team Finland, we are seeking out international partnerships that will drive healthcare innovation across Europe and beyond.
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