Reduction in number of psychiatric hospital beds has not increased psychiatric outpatient services – Pressure reflected in sharp increase in need for assisted living services for people with mental health problems

The number of psychiatric hospital beds in Finland has been decreasing for several decades. However, psychiatric outpatient care has not increased in the same proportion to meet the demand, and this need has been covered by a sharp increase in assisted living services for people with mental health problems.

Researchers from the Research Unit of Clinical Neurosciences at the University of Oulu studied the use of assisted living services, psychiatric hospital services and outpatient services for people with mental health problems in Finland between 1996 and 2018. The study based on 23 years of data showed that assisted living services have increased while psychiatric hospital beds have been reduced.

The study also looked in more detail at the use of different levels of assisted living services during the years 2006–2018. The services examined were assisted living with 24/7 supervision, assisted living with part time supervision and supported accommodation. The study revealed that while the overall growth of assisted living services has slowed, the lightest form of assisted living, supported accommodation, has continued to grow.

The study also showed that the use of psychiatric outpatient care in specialised healthcare did not increase until the last 10 years, and its growth has been much slower than the decline in the number of ward beds and the growth in assisted living services.

The study data was collected from the Finnish Institute for Health and Welfare THL’s public Sotkanet indicator bank.

Are people living within the sphere of assisted living getting the rehabilitation and care they need?

Researchers say the problem with the current system is that it offers the same service to everyone, which ultimately leads to inappropriate service supply, with some mental health patients not getting the services they need at all. The fear is that the care and treatment of psychiatric patients is not happening as expected in the Finnish assisted living care system.

“It is of paramount importance to reflect on the progress of rehabilitation of people with mental disabilities across the system and to provide the services they need,” says Erfan Jahangiri, MD. “We also need more information on the health of residents in assisted living and the effectiveness of rehabilitation,” he stresses.

The study provides important information for decision-makers in the upcoming wellbeing services counties, and confirms long-standing concerns expressed also at grassroots level in society about the neglect and under-resourcing of services for people with mental health problems.

Publication details: Assisted living in relation to use of psychiatric inpatient and outpatient care – a 23-year time-trend analysis of national indicators from Finland. Psychiatria Fennica 2022;53:190-203. Link to study publication

Last updated: 17.11.2022