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Interpersonal counselling curbs rampant depression in Espoo schools

Schools using interpersonal counselling (IPC) report positive results, but experts say Finland's mental health epidemic is still ongoing.

Iltarusko, ihminen puiston penkillä.
Depression is all too common among Finnish youth. Image: Ismo Pekkarinen / AOP

Recent initiatives have found that mild and moderate depression in teenagers can be treated successfully in school.

All schools in Espoo now feature interpersonal counselling (IPC) as part of their basic student health care for grades 7-9. The move follows a 2016-17 pilot programme that trained 60 student care workers in the international method.

Teachers and counsellors report clear, encouraging improvements in symptoms of depression among schoolchildren who undergo the six-step IPC guidance routine. The method emphasises that the way depression affects personal relationships is directly related to how the relationships themselves can trigger mental issues, creating a vicious circle.

"This model offers early support as well as preventative care," says director Merja von Schantz from the city of Espoo's teaching services. "The principle is that we have to try everything in our power to aid struggling students before they're sent elsewhere for possible continued treatment."

Early this year the number of youth admissions to specialised psychiatric care fell in Vantaa (three percent), Espoo (nine percent) as well as Helsinki (16 percent) over one year. However, the situation is still far from ideal, say health care professionals.

Local services lagging

While the capital region may be looking at a small uptick in teenage mental health, the situation remains grim in Finland as a whole. Specialised psychiatric care admission figures have been climbing across the country for years.

Klaus Ranta, director of youth psychiatry at the Capital Region Health Care District (HYKS), says the biggest issue is that services aren't brought close enough to those who need it.

"Localised mental health services are extremely underdeveloped in Finland," he says. "The attitude seems to be that specialist care can account for all mental health work. In reality, a child who enters the system at that stage is in a very bad way and has already suffered from symptoms of depression for a long time."

Further statistics corroborate Ranta's views: in the Uusimaa region, one-tenth of youth aged 13-17 are already using specialist psychiatric services. In Helsinki that amounts to some 6,500 teens in treatment last year.

Adults may have access to nurses or psychologists at public or work health centres, but such services do not necessarily even exist for teenagers.

Resources scant

Even with the successes in Espoo, scheduling issues continue to plague proper care for students facing symptoms such as fatigue, sleeping problems, discrimination, class absences and disputes at home or in school.

"Weekly meetings can be difficult to organise for students and counsellors alike," von Schantz says. "Most of our care workers are on call at multiple schools."

Reaching teens at their own schools is easier than it is in public health care, as school is where they spend much of their time and teaching institutions already gather data from youngsters through regular questionnaires.

When asked, students themselves say they would most like to receive mental health guidance in school, not outside of it.

"Surveys that measure mood and performance provide a backbone for the effective tracking of depression," adds school curator Arja Heinonen. "Such care can also provide a substantial basis for further psychiatric care, which can otherwise be very hard to come by."

The IPC method will next be piloted in Vantaa schools, while Espoo considers extending the service to secondary education as well.

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