The Finnish therapy navigator – Digital support system for introducing stepped care in Finland

Abstract

Introduction: The need to improve quick access to effective psychological treatments is urgent. Success requires effective tools<br/>for identifying what kind of therapies an individual is likely to benefit from and managing a comprehensive therapy offering<br/>that matches an individual’s needs. First-line therapies initiative (Terapiat etulinjaan–toimintamalli) is a national initiative<br/>started 2020 in Finland. It aims to help Finnish regions in building locally sustainable stepped care systems and providing<br/>the support services needed. One key service of First-line therapies initiative is the Finnish therapy navigator (FTN). The<br/>FTN is a digital tool to help assess individual needs for psychosocial treatments and to build a regionally sustainable stepped<br/>care treatment offering, as part of the national reform of social and health services. This paper describes the development,<br/>content, implementation and feasibility of the FTN. Materials and Methods: The system was piloted in six regions in<br/>Finland between October 2021 and May 2022, with a catchment area of around 600 000. The feasibility data was collected<br/>from professionals (n = 48) using the system at 1 and 4 months after implementation, and from the anonymous FTN<br/>responses (n = 2630). Results: Professionals estimated the FTN had a positive impact on their work, quality of assessment<br/>and notes, and patient experience at 1 month after starting to use the FTN. Satisfaction scores improved further at 4<br/>months, and 93% of users wanted to keep FTN as a permanent tool. The mean time patients used to fill the FTN was<br/>24 minutes; 75% of clinical interviews lasted under 30 minutes. The FTN provides important data on treatment seekers.<br/>In our sample 57% of respondents scored between 10-19 points on PHQ-9 and 59% between 5-14 on GAD-7, suggesting<br/>mild-to-moderate depressive and anxiety symptoms. 28% reported no previous psychosocial treatments and 33% previous<br/>treatments shorter than 6 months. Thus, it seems that a significant proportion of treatment seekers in Finland could<br/>benefit from readily available, short-term, evidence-based psychosocial treatments that the First-line therapies initiative<br/>supports. Conclusions: FTN is a feasible tool for first assessment of mental health issues in primary care. Implemented<br/>and localized using the manualized co-creation process results in very high user satisfaction and acceptability of the<br/>system. The FTN provides important real-time data on mental health treatment seekers to support service development<br/>and planning. The First-line therapies model that includes introducing FTN in combination with regionally adapted care<br/>pathway development, education in short evidence-based psychological interventions and increase in use of digital support<br/>systems appears a feasible way to build regionally sustainable stepped systems.