We had the honour of interviewing Sami Pirkola, Professor of Social Psychiatry at the University of Tampere, who chaired an expert group in creating the Finnish mental health strategy for 2020-2030. Sami is also a guitarist in the band Juliet Jones’ Heart since the eighties. In this article, we explore the mental health strategy his team worked on and Sami’s professional views based on our interview.
Quotations from the Finnish Mental Health Strategy 2020-2030
The Finnish Mental Health Strategy treats mental health as a phenomenon that affects every person and needs to be addressed across society. Mental health is therefore fundamentally a positive resource, which is primarily intended to be maintained and supported. Society should therefore invest in those things that prevent mental disorders from developing, rather than focusing solely on treating mental disorders. This is also what we at Creativity Squads do, by helping people to find the means and direction for a meaningful life. To start the interview, I will present a sample of Finland’s mental health strategy 2020-2030. Sami describes the strategy as a guideline on which each Finnish government can base its own mental health programme. His interview starts halfway through the article.
“Mental health has become increasingly important in society. This is the result of major societal changes: technological development has accelerated, people are moving to cities and from one country to another, and values and lifestyles have become more diverse. In the workplace education and continuous learning have become increasingly important, and more and more people are working in jobs where high cognitive load and stress are commonplace. In a changing environment, good mental health is an increasingly important asset for individuals. It supports a balanced life and creates the conditions to function as part of diverse communities. Between different sectors of life there is a possibility and even the need to make choices. That makes mental flexibility, adaptability, learning new things and the ability to make independent decisions increasingly necessary.”
The key elements of the strategy are
- Mental health as capital
- Mental health of children and young people
- Mental health rights
- Adequate and comprehensive services
- Mental health management
What is mental health as a capital?
“Mental health is one of the most important things in a person’s life. It affects all aspects of health, well-being, relationships, learning, work and life in general. Good mental health strengthens trust, reciprocity and a sense of belonging in society.”
“From an individual perspective, maintaining strong mental health involves mental health knowledge and skills. Mental health literacy refers to knowledge and understanding of mental health as a resource and a health issue, the protective and risk factors for mental health, and ways to strengthen mental health. Mental health literacy includes identifying and understanding attitudes and perceptions related to mental health.”
“Mental health skills are emotional, awareness and interpersonal skills, the resilience to cope with life crises, the ability to regulate stress and strain and to form meaningful relationships with other people. They also include the ability to control and regulate impulses that could lead to harmful substance use or other forms of harmful life-dominating behaviour. Mental health skills also include skills for everyday living, recognizing the psychological resources in oneself and others and using them to build a balance between work, study, rest and leisure. Talking about mental health and its deterioration is part of mental health skills, as is the ability to assess when one’s own resources are not enough and when professional help is needed.”
Through the measures identified in the strategy, these results can be achieved, for example, through objectives closely linked to life planning exercises such as Self-Hack.
– “Increasing mental health knowledge and skills in early childhood education and care, schools, and educational institutions, both through projects and curriculum development. (Mental Health Capital)
– Increasing mental health knowledge and skills through training and projects in the workplace, at points of change in working life and in management. The well-being of staff at work is the most important asset of organisations, and mental health is a key part of this. Improving ways of identifying stress and fatigue among staff. Prepare a programme of measures for good mental health and working life. (Mental health capital)
– Strengthening the development of mental health skills and good self-esteem in adolescents by raising awareness of the good practice, investing in training in mental health skills and influencing the culture in early childhood, primary and secondary education. (Child and adolescent mental health)
The implementation of this policy requires a systematic use of skills, management and inter-agency cooperation. In sport-terms: the whole team – from the people in the communities in the third sector to those involved in medical specialist care – must be brought together to work in the same direction (Appropriate and comprehensive services).”
Sources:
Sami Pirkola’s summary of the topic (FIN) https://stm.fi/documents/1271139/12804033/SamiPirkola_mielenterveysstrategia_11.2.2020.pdf/afe8528b-7e22-fe90-6334-c04a8fd00453/SamiPirkola_mielenterveysstrategia_11.2.2020.pdf?t=1583244275000
A wider publication by the Ministry of Social Affairs and Health. (FIN)
https://julkaisut.valtioneuvosto.fi/bitstream/handle/10024/162053/STM_2020_6.pdf?sequence=4&isAllowed=y
Interview with Sami Pirkola, Professor of Social Psychiatry
In preparing the strategy, Sami has highlighted service system studies that describe members of his profession, such as clinical psychiatrists, psychologists and psychotherapists, as part of a mental health service package. This way of thinking recognises that mental health itself is not just a service provided by a trained professional, but a complex whole, influenced by multiple actors in an individual’s life. A simple example is a collaboration between clinical professionals and, for example, student counsellors in relation to a student. One of the most recent priorities Sami identifies is the attachment of communities to people’s lives, for example as part of mental health rehabilitation. In this case, clinical therapy itself does not only fill gaps in mental health but as part of a service, the package helps the individual towards a meaningful life, which is often achieved through communities, for example.
As one example of a new kind of community, Sami recently participated in a group called Hundred Days of Autumn, which used the internet to share and constructively comment on nature photos taken by its members each autumn day. The online community inspired and invigorated the group members and led to many life changes, such as a deepening hobby and even a marriage between the group members after the autumn days had already ended. Sami is also considering how communities like this could be better embedded in mental health services or, more directly, in people’s lives. From Sami’s point of view, there is a great need for social innovation in society today, as community-based care solutions, at least for mental health professionals, are relatively undeveloped, although their potential has already been proven.
With this interest in the topic, Sami took a preliminary look at the Self-Hack career workbook and gave feedback from his own psychiatric perspective. The My Life Story-Map exercise stood out clearly, showing the course of one’s life up to this point through different aspects of life. Narrative creation and storytelling have been identified as effective tools in mental health treatment. Sami also provided constructive feedback, particularly on the presentation of the individual exercises. From a clinical perspective, it is important that the researched data on the purpose and effectiveness of the exercise is revealed. In general, he said that the book is credible, for example, because of references from Stanford University.
Sami sees problems of credibility in social mental health discussions. With self-help books being popular and treatment methods based on different beliefs fighting against the academic thinking he represents. In psychiatry, often over a hundred years of experience, research and scientific reporting have gone into developing a treatment. At the same time, many assumptions have been disproved by evidence. Some practitioners, for one reason or another, ignore the research and publish their treatment guidelines without any guarantee that they will work. If anything positive is to be taken from this, Sami says they may inspire someone to pay attention to their mental health conditions, in the hope that harmful practices will be corrected, like harmful gym instruction.
This is a big challenge for the success of Finland’s mental health strategy. How to bring together clinical mental health professionals, mental health educators and trainers, and those involved in mental health such as education, workplaces and communities so that the issue can be discussed in a common language. For example, Sami would like his colleagues to drop some medical jargon and use a language that is easier to follow by everybody. To support the discussion, it would be great to have a metric for developing social value, as social innovation and multi-stakeholder participation in mental health initiatives make it very important to be able to see how new approaches are working.
Summing up the interview, Sami mentions that improving mental health is a complex process. Good mental health is linked to a balanced and enjoyable life. It is therefore contradictory to ‘cure’ a person without trying to create change in their life, with its potential problems. Therefore, mental health work is fundamentally about finding, enabling and strengthening a good and satisfying life for each individual.