The overall health of Finns has improved steadily over the past 20 years, and by international standards, Finland can be regarded as a healthy nation.¹ This is especially true of people with stable careers and families and people who have just reached retirement.² However, despite improvements in general health, the incidence of mental health disorders has increased markedly over the past ten years. In Finland, one adult in ten reports suffering from a mental health disorder. In clinical terms, mental health disorders are even more common: the incidence of psychiatric disorders is about 15%.³ Though the occurrence varies depending on the assessment criteria, at any given time, approximately 20 % of adults suffer from mental health problems. Disability related to mental health disorders has also been increasing since the early 1970s. At present, mental health disorders are the group of diseases which most frequently cause disability.⁴

Depression

 

The substantial increase in the occurrence of mental health disorders is due to the rising prevalence of depression and anxiety. The incidence of depression, in particular, has increased over the past ten years. According to a recent study, approximately 9 % of Finns had suffered from depression in the course of the previous year. Twenty-five per cent of them had been treated, and 13 % took medication for depression. Previous studies on depression have shown that, at any given time, 5 % of Finns are depressed.⁵ For women, the risk of depression is double, and they suffer from overexertion and fatigue more often than men. Dejection or depression, nervousness or tension, lack of stamina or fatigue also are more common in the lowest income groups. There is an increasing tendency among young adults to be at risk for depression. This may be related to tougher demands at work and in other areas of contemporary life.⁶

Causes of the increased incidence of mental health disorders

 

The growing numbers do not necessarily indicate an actual increase in the prevalence of mental health disorders. Several factors explain the increase, particularly of depression. First, the awareness of mental health problems has risen among doctors and patients, improving the likelihood of recognition. This is due partly to the availability of new antidepressants and their marketing in the Western world. Clinicians have become more skilled at recognising depression. For instance, people reporting chronic backache and fatigue may also obtain a secondary diagnosis of depression. The stigma traditionally associated with mental health problems is diminishing, and both physicians and service users are more freely discussing these issues. This, in turn, is reflected in the recorded increase in mental health disorders.^{7 8}

Second, changes in the diagnostic systems are partly responsible for the increase. A number of cases that would have been classified under the category of neuroses in the old system now fall under the category of affective disorders (i.e. major depression). At the same time the number of diagnosed neuroses has decreased.