University of Helsinki
What are the rationales that have underpinned Finnish mental health policies and how has it affected what the core problems are perceived to be? This is discussed in a new doctoral dissertation by CEACG- researcher and group coordinator Anna Alanko. Alanko defends her dissertation on Friday the 22 September.
Mental health policies will inevitably involve views on what mental health is as a phenomenon and the characteristics of the people suffering from the problems. In line with a foucauldian tradition of how subjects materialize from discourse over history but also by applying the CEACG-founder Pekka Sulkunen’s thought on autonomy, Alanko shows in her dissertation how such rationales have changed during the period 1964-2016.
If you would be asked to describe the main rationales that have governed mental health policies in just one sentence, what would you answer?
– Throughout the analysed period the most important aims have always been to minimize psychiatric hospital treatment, to increase outpatient care, and to increase the possibilities to participate in work and to increase equality between mental health care service users and other citizens, says Alanko.
How, then, do you think that this materializes in groups of people who suffer from the problems?
– The psychiatric hospital care has indeed been reduced, but there is evidence of a so called transintitutionalisation as the number of people living in unintensive residential care facilities due to mental health problems is high. The outpatient care has also increased, but due to a phenomenon which I refer to as the expansion of mental health care, there is a very wide group using and demanding the services explains Alanko
An important contribution of the dissertation is that it is able to show that the emphasis is today targeted to those whose mental health and working ability are to be promoted, not to those most in need:
– Simultaneously with the aims of increasing the possibility to work, the number of people retired early due to mental health reasons has grown. The early retirement has frequently been addressed as a problem, but recently not a general problem, but as a problem only among those with close connections to the labour market, creating a potential for cream skimming. For these reasons it seems that what has materialised the least are a striving for equality, explains Alanko.
Alanko unfolds historical developments and trends in praxis that have affected the ways in which mental health is articulated as a political question. Alanko argues that the recent rationales in mental health policy are in sharp contrast with many welfare state principles.
Through its new insights Alanko’s dissertation constitutes a valuable contribution to research on mental health policies and governmentality studies. She is not only a skillful social scientist, but also a highly appreciated and dear colleague in the CEACG-group
Anna Alanko defends her dissertation “Improving mental health care: Finnish mental health rationale in the era of dehospitalization” on 22 September, at 12 noon, at the University of Helsinki main building, hall 12. Dr Tuukka Tammi will serve as opponent.