Finland forensic psychiatric hospitals are reporting full capacity, with doctors warning that severely mentally ill individuals are entering care only after committing serious crimes.
Niuvanniemi Hospital in Kuopio and Vanha Vaasa Hospital in Ostrobothnia say an increasing number of patients arrive without recent psychiatric treatment. Many would have benefited from intensive outpatient or inpatient care earlier, doctors explained.
“This trend is now very strong,” said Allan Seppänen, chief physician at Niuvanniemi. His counterpart, Pirjo Takala, confirmed that patients are often admitted only when their condition has reached a crisis.
Forensic psychiatric hospitals are intended as a last resort, for individuals who are both severely ill and considered legally dangerous. In reality, many patients arriving have already needed years of psychiatric support. Last year, the average treatment period at Niuvanniemi was eight years.
Doctors emphasize that basic and specialized psychiatric care in local health systems should prevent these outcomes. Yet both note that preventive systems are failing in too many cases.
Hospitals have also seen an increase in court-ordered mental state examinations. By July, about 100 suspects were awaiting evaluation, exceeding annual totals from the past three years, when only 80 to 90 assessments were completed each year.
Experts link the growing caseload partly to a long-term reduction in psychiatric hospital capacity. Between 2015 and 2021, Finland reduced psychiatric beds by more than 40 percent, according to the Finnish Institute for Health and Welfare (THL).
Seppänen said reliance on community-based care has not met expectations. “Psychiatric inpatient care has almost been stigmatised. There was a belief that outpatient care could handle most needs, but this has not worked.”
Takala added that even admitted patients often have treatment periods too short to address underlying causes. Outpatient care demands high initiative from patients, which can be unrealistic for those with severe mental illness.
Both hospitals are at full capacity, and Vanha Vaasa has admitted patients beyond official bed limits. Waiting times for forensic mental evaluations have stretched to several months, an unusual situation for these institutions.
“There is pressure on regional systems to cut costs,” said Seppänen. “Expanding long-term forensic care is not efficient. Strengthening early mental health services would be more effective.”
Veteran criminal defence lawyer Kari Eriksson has observed a similar pattern. He noted more defendants whose crimes appear linked to untreated mental illness, warning of possible increases in unpredictable violence.
Seppänen and Takala consider Eriksson’s concerns valid. They call for a national discussion on improving mental health support.
“Psychiatry, especially forensic psychiatry, cannot solve this alone,” Takala said. “We need a broader rethink of how we handle mental health in Finland.”
