Administrative Challenges in the Finnish Alcohol and Drug Treatment System

Abstract

This article examines the National Plan for Mental Health and Substance Use Work (the MIELI plan), published in Finland in 2009. We place the plan into a wider context of changes in Finnish social and health services and have also studied responses to the plan. The data is provided by national documents, complemented by an online enquiry and some journal articles as feedback material. The MIELI plan is implemented in conjunction with a municipal and service system reform in Finland. While the proposals of the plan clearly carry a potential for change in the treatment system, there are also great challenges. For instance, to what extent can this kind of plan influence reality? Can the proposals really change anything in the treatment system, or does the potential change emerge from elsewhere? Responses to the plan indicate that referral-free access to treatment, the principle of a single entry point and primary-level services in general were considered important proposals in the MIELI plan. At the other end of the scale, the implementation of the plan and its medical orientation were received less positively.