Therapy guarantee helps facilitate full-time higher education studies
COMMENT
The Student Union of the University of Helsinki’s comment on the government’s draft proposal for changes in social and healthcare legislation to implement a therapy guarantee for children and young people, submitted on 14 June 2024.
The Student Union of the University of Helsinki is grateful for the opportunity to comment on the draft proposal for changes in social and healthcare legislation to implement a therapy guarantee for children and young people. HYY considers the therapy guarantee a crucial improvement to the status of young people and students in particular as well as a key element in helping facilitate full-time higher education studies. HYY considers having free services and restricting the waiting time to one month to be excellent measures to take. However, HYY believes the draft includes significant flaws, including the age limit of 23 years and the restricted selection of services and procedures.
Does the proposed legislation fulfil the goal of improving the availability of early mental health support and treatment for children and young people in primary services?
No, it does not. The proposed legislation should be amended in the following ways. HYY considers restricting the therapy guarantee through the remarkably low age of 23 years to be problematic. The age limit of 23 years mentioned in the proposal does not correspond to the group of people under 29 years of age referred to in the Youth Act. Allowing access to services to only those aged 23 years or under, as set out in the proposal, leaves 75% of students covered by the FSHS’s srevices outside the therapy guarantee. HYY believes this means that the entry on the equal access of children and young people to psychotherapy services included in Prime Minister Orpo’s government programme would not be fulfilled.
HYY also suggests that all students covered by student healthcare services for higher education students would be entitled to receive services included in the therapy guarantee. Only an extremely small group of students manages to complete a master’s degree by the age of 23 (in 2023, around 150 students completed a master’s degree by the age of 23). This means that students turning 23 years old would get changes to their mental health care pathways in an already complex mental health service network.
HYY believes that there are significant challenges involved in restricting the therapy guarantee to only a few service methods instead of providing all students requiring help with treatment that serves them as well as possible.
When implementing the therapy guarantee, particular attention should be paid to sufficiently fast access to treatment and removing obstacles to receiving treatment to ensure that unreasonable waiting times do not make students’ situation worse and further increase the need for treatment. From the perspective of higher education students, the main purpose of the therapy guarantee is to facilitate a balanced, good student life that enables students to focus on their work, that is, studying.
As a possible solution, HYY would consider amending the act on healthcare for students in higher education in such a way that the services included in the therapy guarantee and the allocation of resources for them could be included in the services of the Finnish Student Health Service. However, this would make it crucial to allocate sufficient additional resources for the FSHS.
Are the provisions on psychosocial interventions covered by the guarantee in Section 53 of the Health Care Act and Section 10 a of the act on healthcare for students in higher education sufficient for application?
No, they are not. The provisions should be amended in the following way. The proposal restricts interventions for higher education students under 23 years of age to either short-term psychotherapy that is part of primary health care or psychosocial treatment derived from psychotherapy, carried out in specific form and limited time. HYY hopes that the proposal would allow service providers to choose a treatment method and pathway that serve each student as well as possible. Treatment methods and services that are as proportionate as possible will allow students to reap the biggest possible benefit from the therapy guarantee. HYY considers using resources as efficiently as possible to be key to ensure the success of the therapy guarantee. This, in turn, requires students to have access to services that suit their needs as well as possible.
Is the maximum time for starting psychosocial treatment covered by the guarantee defined in Section 53 of the Health Care Act and Section 10 a of the act on healthcare for students in higher education sufficient for application?
It is not sufficient. The provisions should be amended in the following way. Timely access to treatment is crucial in mental health services and the potential prevention of an increase in the need for treatment. For this reason, HYY considers defining a maximum time for starting treatment justified in the case of the assessment of the need for treatment, too. The assessment of the need for treatment falling under the three-month waiting time set in the treatment time guarantee would allow for extremely long waiting times for challenges related to mental health. Long waiting times have been shown to increase the need for treatment and the resources needed for it.
The government’s decision in spring 2024 to extend the treatment time guarantee in primary health care from 14 days to 3 months will affect the maximum time available for arranging the first treatment for non-urgent care in primary health care. Should this change take effect, would you consider it to require changes to the legislation on the therapy guarantee?
HYY considers the three-month waiting time for the assessment of the need for treatment set in the treatment time guarantee to be too long in matters related to mental health. In matters related to mental health, HYY considers such a long waiting time to get to the initial assessment of the treatment process to be a risk that may increase the need for treatment among young people as well as further hinder their study progress. The initial assessment must be carried out in such a way that young people and students covered by the therapy guarantee would get directed to suitable treatment as soon as possible.
Other comments on the government’s draft proposal:
HYY supports the goals of the therapy guarantee in the promotion of the wellbeing of young people. However, HYY believes that its implementation includes significant flaws in terms of the low age limit and the possible restricted service selection. HYY believes that everyone aged 29 years or under as well as all higher education students should be entitled to services included in the therapy guarantee that are as proportionate and suitable to their needs as possible and that these services should be available within a reasonable waiting time.
Further information
Teemu Virtanen
Specialist in social policy
teemu.virtanen@hyy.fi
