Mental health and substance abuse services for young people in wellbeing services counties – Service availability, accessibility and coordination

The audit focused on the functioning of mental health and substance abuse services for young people at the primary level as well as in specialised medical care, student welfare and social welfare services. The functioning was assessed from the viewpoints of availability, accessibility and service coordination.

Mental health disorders among young people have increased in the 2020s. Young people’s mental health and substance abuse problems have long-term impacts and significantly increase exclusion from education and the labour market. The direct and indirect costs of mental health disorders in Finland are up to over EUR 10 billion a year.

Ensuring equality in social welfare and health care services throughout the country is a statutory obligation. The audit found that the differences in the content and scale of primary level mental health and substance abuse services for young people are large. There are major differences and also shortcomings particularly in substance abuse services for young people. In youth psychiatry services delivered as specialised medical care, the differences in costs, numbers of visits per patient, delays in accessing treatment, role and occupancy rate of inpatient care, and use of outsourced services are considerable.

There are also significant variations in the age limits for mental health and substance abuse services for young people between the wellbeing services counties. The age limits are rarely based on a medical view of youth. The Ministry of Social Affairs and Health and the wellbeing services counties, the City of Helsinki and the HUS Group should ensure that the service range and age limits will be regionally more consistent in the future.

The wellbeing services counties incur significant costs from outsourced services. According to the wellbeing services counties, turnover of service providers means that treatments are disjointed and continuity of care is jeopardised. Especially in youth psychiatry services delivered as specialised medical care, quality is sometimes experienced as low compared to the costs, and the work is found ineffective. Where outsourced services are used, the Ministry of Social Affairs and Health and the wellbeing services counties, the City of Helsinki and the HUS Group should ensure continuity of care as well as the quality and cost-effectiveness of the services.