Did you know?

Did you know that here in Helsinki was held Norddiakoni Intensive course – “Mental health and Wellbeing – focus on homeless and underprivileged populations” on 21.-26.4.2016? Well in case you did not, I will tell you about it.

There were participants from Finland, Norway and Sweden, students and teachers. What all the participants had in common was that they all took care of other people and their wellbeing.  I took part on it 23.–24.4.2016. It was rather interesting. Topics of the seminar were social inclusion, loneliness, mental health and undocumented immigrants and overall what we should, could and would do to those issues?

Students and teachers were discussing after the presentations of the various measures that should be done. How to activate people who feels loneliness or hopelessness in their life and those who suffer from poverty and unemployment. How to help those who live with the help of social benefits from year to year. How to help people who have stopped trying. Not to forget the people who have been forced to leave their country against their will, leaving everything behind just to find themselves in a country, with their high expectations of life and yet their new home country might only have a little to offer. In the worst case, they might not even have a legal permission to be in the country. They would have to live their lives without rights in welfare state.

What kind of activities do we need? What do we do? Because all the people have the right to be a member of our society.

All of the intensive course presentations were global, thought worthy and demanding subject’s activity. For example think about loneliness, homelessness, undocumented immigrants, poverty and hopelessness. Even though the topics covered the underprivileged of the society, not a single subject seemed hopeless. I personally followed the presentations with great interest. I got the feeling that we should come up with something right now, so that we can minimize people´s worries and make the world better place to live.  We must and we can do something to help each other. I suggest that we start the change from ourselves; our attitudes and how we face the people. We should take care of people and to be interested in other people’s wellbeing like we are with our children and loved ones.

Päivi Rissanen, who has been mental health patient for 27 years gave a presentation that brought hope and reassurance that nothing is impossible. Päivi´s survival is quite incredible. Her presentation condensed the whole aim and understanding of the intensive course. Having been a mental health patient for 27 years and now being Ph.D. Päivi told us that we need discussions and debates as well as interaction between people, respect for others, trust, caring and understanding. Rissanen´s survival story is quite touching and sweet. She took the help of a nurse, who saw her as herself as an individual rather than a mental patient. I love that Päivi shared her story with the rest of us. Hope is what we should all remember, isn’t it?

Change the attitude – Join me 

Who am I?

Marja Walldén-Hirvonen, student

Degree Program in promoting the social exclusion of health and well-being. Masters degree (YAMK), Diaconia University of Applied Sciences, Helsinki, Finland

My learning experiences during the course

This weekend course was named "Mental health and wellbeing - focus on homeless and underprivileged populations". It was part of my Master Degree -studies.

I think this course was very interesting and important. The preventive work is very important when we want to promote people's wellbeing in the society. I think the big problem is that the service system is very diffuse and bureaucratic. For people with mental health problems or people with a bad ability to function it can cause more stress and more problems. Päivi Rissanen told about her own experiences of suffering mental health problems and how she finally was rehabilitated. That lecture was very touching. It made me think about the role of the society and individuals in rehabilitation process.

The lectures were spoken in English, so I had a good opportunity to improve my vocabulary. Some articles in English were quite difficult but group work gave a possibility to learn from other students and get help from them.

I think one of the most interesting parts of the course was visiting Lehmustupa housing unit. We could meet the residents and workers there. They told us about their experiences and answered our questions, it was very interesting.

Who am I?

Saara Harju, 28

Master Degree -student

Promotion of the health and wellbeing of people in danger of marginalization (90 ECTS)

Diaconia University of Applied Sciences, Helsinki Finland

Seminar reflections

Jemima Heinonen from the Global Clinic gave a presentation about the paperless healthcare they provide. Global Clinic is run by volunteers, who provide both health and dental care.

Global Clinic is open to everyone, regardless of person's nationality or theirmigration status. Help is given for free, anonymously and in strict confidence.The audience were interested to know the reasons why patients in generalgravitate to the clinic. Audience also wanted Heinonen to explain to them why only about 3% of the patients were seeking help due to psychiatric reasons. According to Heinonen, there are plenty of reasons why patients seeking for psychiatric help cover such a small percentage of the whole patient base. One of the reasons is the fact that in many countries and cultures mental health disorders are a taboo and such problems are not talked about openly. Also, currently Finland does not have a institution or a hospital for these patients. The Global Clinic is looking for cooperation partner which the Clinic could consult in need. An other problem is the language barrier. The clinic is run by volunteers and so is the interpretation. The majority of the patients at the moment are from Romania and Bulgaria. Heinonen says that even though they do often  recognise the patients with psychiatric needs or problems, the treatment of those patients os difficult and it has limits.

The Global Clinic accepts donations from individuals and corporations, but do not receive grants from the state. The clinic has a patient registry, even though it is very primitive and on a slow computer. The patients are not asked about their ethnic background, only the very essentials; e.g, age, gender, diagnosis. The most touching and interesting lecturer of the weekend was Päivi Rissanen. Rissanen has done her doctoral thesis on how the patient him/herself experiences psychiatric illness and the treatment of it. Rissanen told that she herself was 40 times in a psychiatric hospital for treatment. She herself was first diagnosed with a borderline personality disorder andschizophrenia. Later, this diagnosis was discarded and Rissanen was given a new diagnoses: dissociative disorder. 

Rissanen explained how no one wanted to be her personal nurse, because she was considered so difficult for treatment. Eventually she got a new personal nurse, who had not previously taken care of her. Rissanen shared that her rehabilitation started when this new nurse asked her "Päivi, do you want to spend the rest of your life in a hospital?" Rissanen told that her motivation to get better awakened when she felt that her new nurse appreciated her. Rissanen told that finally she was given a change to tell herself how she wanted to be treated and rehabilitated.

Who am I?

My name is and I am Seija Kautto psychiatric nurse. I work in the closed ward that takes care of diseased psychosis patients. The majority of patients also have a substance abuse problem.

 

Mental health and Wellbeing- focus on homeless and underprivileged populations

It was an interesting weekend. Most touching and the best lecture was Päivi Rissanen. Finnish central association for mental health and rehabilitation model. She told of she's life as a patient of mental health problems. Päivi was for many years a patient in psychiatric hospitals. In 2015, he left for examination of the dissertation treatment.

Interesting was also a visit to Lehmustupa, Housing Services. We received information about their activities. Lehmustupa has 17 small bed-sitters, some of them being reserved for HIV-positive persons and AIDS-afflicted persons. Admission to Lehmustupa is via City of Helsinki's Social Department's unit dedicated to assisting the homeless.

Who am I? 

 

My name is Päivi Nikkilä. I am registered nurse and  I study Diaconia University of applied Sciences. Name of the education is: The promotion of health and wellbeing at risk of exclusion

Reflections after the conference days

It has been really great to participate to this conference, both listening to the speakers and sharing experiences with teachers and fellow students around the tables. 

One main experience is that the picture and challenges are pretty much the same in Finland as in Norway.

By listening to the different speakers and not least via group discussions I'm also reflecting that it is so much more into the picture related to mental health and well being among homeless and underprivileged groups than one first could think, much based on what is presented by the media. As I'm working in a psychiatric clinic for acute mental illnesses I see people coming there with a refugee background having a lot of difficult stories in their back pack which they have never been able to treat or talk about at an earlier stage. This because it is not focused when giving health support for instance in the refugee shelters. Of course it is easy to see that this is caused by capasity limits and also that this sort of illnesses is more time consuming (treatment over a long period). And however the result is that they quite often try to solve the problems and run away from them by using drugs and/or alcohol. This entailing that the community will have a lot heavier challenge and cost at a later stage and in the long run. I learned from the speaker with the topic Global Health Clinic that the statistics over their treatments only 3% is related to mental health - and this by the same reasons as mentioned above. By my question she confirmed the figures to be under reporting the real problem and needs. 

Furthermore I reflected during the group discussions yesterday (about the researches) that it is a lot about to motivate the locals around to take response and involve to help the immigrants/migrants to integrate into the community. I think that that the authorities never will be able to solve the challenges and issues as such only with supporting with resources (which are reduced under the challenging economic situation we are facing for the time being). 'Talkoo' is the answer to it - in Norwegian 'dugnad'.

It's a long way to go - and it's also about to remember that early and right treatment is like a Kinder Egg - a benefit to the migrant/refugee, a benefit to the community and a benefit to the budgets (one € in is 4 € saved..).

Resources:

The different speakers

Fellow students

Some from the researches (via the presentations)

Who am I:

Thank you for the days!

Jon Helge Løken

54 years old, but still young enough to be a student at

VID, Diakonhjemmet in Oslo.

Bachelor in nursing, 4th semester (out of 6)

FROM PLANS TO ACTION

"Service user involvement is one of the key challenges in Finnish mental health care." This argument by researcher, PhD Päivi Rissanen represents a problem and a call to action that concerns not only the Finnish mental health sector but also the health and social services sector as a whole, together with the diverse clientele that it serves.

By and large, the strengthening and advancement of service user involvement within the health and social services sector is viewed as an important means to prevent marginalization and poverty. For instance, the objective of improving service user involvement is stated in the Finnish government's objectives as well as in the parallel programs of the European Union. (Karjalainen & Raivio 2013, 12). An edited volume titled Osallisuus – oikeutta vai pakkoa (Service User Involvement - A Right or Compulsion) published by JAMK University of Applied Sciences is a collection of articles about service user involvement from a variety of perspectives ranging from an analysis of political programs to the experiences of young men within social service programs. To this end, studies in this collection present conflicting client experiences because some of them felt that they were coerced to participate whereas some of them viewed participation as an opportunity break the cycle of marginalization. In many political programs service user involvement is stated as an objective and an opportunity in fighting marginalization but unfortunately they often lack concrete steps towards its realization. (Era 2013, 141 - 142.)

On the website of National institute for Health and Welfare (THL) one can find definitions for service user involvement, examples for means to increase it and discussions about pertinent laws, policies and research in the field. (Terveyden ja hyvinvoinnin laitos i.a.) Also the Ministry of social affairs and health has a website about service user involvement, which outlines the Ministry's responsibilities in advancing it. (Sosiaali- ja terveysministeriö i.a.). Strengthening service user involvement is included in municipal substance abuse and mental health strategies, and for example, it is the topic of a chapter in a guide provided to municipalities for the preparation of substance abuse and mental health strategies (Laitila, Minna 2013, 5).

As a social and health care field professionals we should become familiar with laws, projects, initiatives and studies that concern service user involvement both at the national and international level. Consequently we can be prepared to bring current information to the grassroots and apply it practical decision making. We should work to support our clients' mental health through all levels (individual, community, structural) and participate in a variety of mental health forums together with our clients.  Through our own examples we can demonstrate the ways in which service user involvement can be improved, how to listen to clients, and engage them in the planning, development and preparation of different projects because involvement improves ownership, which in turn helps achieve better mental health. It's time to act.

REFERENCES

Era, Taina 2013. Osallisuus – oikeutta vai pakkoa? Jyväskylä: Jyväskylän ammattikorkeakoulu. Viitattu 25.4.2016. Saatavissa https://www.theseus.fi/bitstream/handle/10024/64153/JAMKJULKAISUJA1562013_web.pdf?sequence=1

Karjalainen, Jarno & Raivio, Helka 2013. Osallisuus ei ole keino tai väline, palvelut ovat! Osallisuuden rakentuminen 2010-luvun tavoite-ja toimintaohjelmissa. Teoksessa Era Taina (toim.) Osallisuus -oikeutta vai pakkoa? Jyväskylä: Jyväskylän ammattikorkeakoulu. Viitattu 25.4.2016. Saatavissa https://www.theseus.fi/bitstream/handle/10024/64153/JAMKJULKAISUJA1562013_web.pdf?sequence=1

Rissanen, Päivi 2016. Finnish Central Association for Mental Health and rehabilitation model. "Mental health and Wellbeing – focus on homeless and underprivileged populations" seminar 23.4.2016. Diakonia-ammattikorkeakoulu.

Sosiaali- ja terveysministeriö i.a. Osallisuuden edistäminen. Viitattu 25.4.2016. Saatavissa http://stm.fi/osallisuuden-edistaminen

http://stm.fi/en/promoting-participation

Terveyden ja hyvinvoinnin laitos i.a. Mielenterveyden edistäminen. Viitattu 25.4.2016. https://www.thl.fi/fi/web/mielenterveys/mielenterveyden-edistaminen

Terveyden ja hyvinvoinnin laitos i.a. Sosku kehittää sosiaalista kuntoutusta. Viitattu 25.4.2015. https://www.thl.fi/fi/tutkimus-ja-asiantuntijatyo/hankkeet-ja-ohjelmat/sosiaalisen-kuntoutuksen-valtakunnallinen-kehittamishanke-sosku

Terveyden ja hyvinvoinnin laitos i.a. Osallisuus. Viitattu 25.4.2016. https://www.thl.fi/fi/web/hyvinvointi-ja-terveyserot/eriarvoisuus/hyvinvointi/osallisuus

Who am I?

Marika Puurtinen, 42

Helsinki Deaconess Institute.Team leader of Kuninkaankallio housing service unit for homeless (Housing first principle). Nurse for mentally handicapped. Bachelor of social servicesDiaconia University of Applied Sciences. Master degree programme in social services (The promotion of health and wellbeing at risk of exlusion)

Attitudes towards homeless people and the mentally ill

Who am I? 

My name is Anders Nordsveen, I'm 36 years old and a nursing student at VID in Oslo, Norway. What I have been left with after the seminar and meeting people struggling with drug use is the prejudice that usually exists towards this group of people.

In the international code of ethics for nurses presented by International Council of Nurses it is written that everyone shall be met by acceptance and an open attitude, with no prejudice towards the person they are meeting. This is especially important when meeting people who are addicted to drugs and the homeless.This is important because the people in these groups have an expectation to be met by prejudice and bad attitudes towards themselves. This can again lead them to not using the healthcare options that are provided and can then lead to poor health. This is especially true when working in mental health.

Creating good relations between health care provider and the users is very important. The helper needs to have empathy and to be able to see the situation from the users point of view. This means that some times when working with the homeless or people addicted to drugs you have to go the extra mile to create and maintain a good relation. And in this way make it easier for the users to accept the help they need.

The most important thing I have learned from this course is to leave your prejudices at the door when working with the mentally ill, have an open mind, and that creating a good relation is the most important way to recovery.

Viewing of migrants as individuals with focus on social stigmatization

We are nurse students from UC Diakonissestiftelsen in Denmark. Our common interest in people with mental health issues is what brought us to Helsinki to participate in the intensive course Mental Health and Wellbeing - focus on homeless and underprivileged populations.

The course taught us about the importance of avoiding stigmatization in order to prevent migrants from getting excluded from society. Living in exile can have severe consequences for the quality of life and the mental as well as the physical health and wellbeing of migrants. Lack of knowledge and resources among migrants influence their ability to integrate and the consequences is a parallel society.

Seeing the individual

Many of the migrants have experienced great trauma in their home country and they are often in need of individual support from health care professionals, in which their personal background and individual needs is taken into consideration. The surrounding communities, however, might not provide individual care and rehabilitation suitable for for these people.   

If the migrants continue to live in exclusion, their mental and physical conditions are more likely to get worse. Immigrants will develop or worsen a severe mental illness which, if not taking care of, will affect both the individuals and the society. Intervening at an early state can help the migrants to integrate socially as well as getting a job and contributing to society.

A different approach

In Denmark a way of integrating immigrants in society is getting the them to work as soon as they arrive in Denmark. The vision is that by integration the migrants in danish workplaces, the social integration improved. The project is fairly new, but it seems to have a positive effect on social inclusion. However, the mental health situation is not taking care of, which is why we as students have a sceptical approach towards this way of integrating migrants. Inspired by the lecture given by Sakari Kainulainen and throughout the entire course, we have come to discuss this issue. We find that the mental health and wellbeing of migrants as well as homeless and other underprivileged is of great importance regarding integration. This must be approached alongside the social inclusion and integration in society, in order to secure positive and sustainable integration.

Who are we?

Mathias Støhrmann (25), Danmark, UC Diakonissestiftelsen,1st Nursing student

Sara Pais (24), Danmark, UC Diakonissestiftelsen, 2nd Nursing student

http://nyheder.tv2.dk/politik/2016-02-03-s-alle-flygtninge-og-migranter-skal-arbejde-fra-foerste-dag

http://nyheder.tv2.dk/2016-01-27-ekspert-flygtninge-kan-allerede-fordeles-efter-evner

http://nyheder.tv2.dk/2016-01-26-forslag-fra-kommunerne-flygtninge-skal-bo-hvor-de-kan-tage-job

http://nyheder.tv2.dk/2016-01-27-roede-kors-flygtninge-skal-sendes-til-kommuner-med-job

https://amnesty.dk/emner/flygtninge/flygtninge-i-danmark

https://www.information.dk/kultur/2015/09/migration

https://flygtning.dk/danmark/center-for-udsatte-flygtninge

Mgutshini T. 2012, Mental health. Greenfield M. Working with adults at risk from harm. Mcgrawhill - Open university press p. 65-85

Professionals fights for the underprivileged people

I participated to the seminar called Mental health and well-being- focus on homeless and underprivileged populations (22.4.-23.4.2016)§ that was hosted by my study place Diaconia University of Applied Sciences. What an interesting weekend!

On Saturday Sakari Kainulainen held a very interesting lecture about poverty in welfare state. Poverty isn't only about one's lack of money. It's also about lack of possibilities, interaction and knowledge on services. Poverty leads to risk of exclusion and professionals and civil helpers should focus on this group of people so they could gain back their status as a full member of the community. Everybody deserves to be accepted and helped to gain their full potential to be happy in their own terms. The key word for the client and professional relationship is TRUST.

PhD Päivi Rissanen gave a memorable presentation of her doctoral thesis that was about her own recovery path from severe mental illness towards happy and fulfilled life. Social and health professionals need to hear people to tell their stories and experiences in order to learn and develop new means to do their work and encounter people. Rissanen showed a map about the professional helper networks during her 27 years of mental illness. The map was very complicated and showed clearly how complex and fragmented the service network is in Finland and how much it takes of a person to cope in that bureaucratic system. The most important lesson about Rissanen's lecture to me was that it takes lots of patience, a functional professional network combined with peer groups and hope and dreams for rehabilitee to be able to recovery.

On Sunday we heard about the situation of refugees and made couple group works with the international students. It was a challenge to try to interact with a foreign language! It made me think that it would be useful to take a discussion course in English to improve ability to talk in with other students and professionals and especially with clients.

All in all the seminar was extremely interesting, useful and fun!

Who am I?  

Sanna Väisänen, age 44, works in municipal social office full time, studies the master's degree (The promotion of health and well-being at risk of exclusion) Diaconia University of Applied Sciences.

Thoughts on the seminar

For me was surprise that the biggest reason to get early pension are mental problems (Koponen 2016). After longterm unemployment is always more difficult to get back to work.  Usually you should have a medical diagnosi for having a rehabilitation. There may be problems with daily routines or lack of social skilss where you may need rehabilitation after long unemployment.

However the most important learning experience for me was that  safety and encouraging atmosphere helps you to survive even from the challenging situation (say it in English).

Who am I?

My name is Asta Eskelinen. I am 53 years old social counciler in city of Espoo. My job is to support my clients to figure out their issues involving longterm unemployment and health. I am studing in Diak Helsinki, on master level.