Therapy guarantee and occupational health: Your rights in Finland

The therapy guarantee was talked about as a goal for years. For children and young people it became law: since 1 May 2025 anyone under 23 must be given brief psychotherapy in primary care, or a structured brief intervention, within 28 days of the need being identified, free of charge (Ministry of Social Affairs and Health).

There is no equivalent guarantee for adults. Adults fall under the general treatment guarantee, whose maximum waiting times were lengthened on 1 January 2025: for people aged 23 and over the first treatment appointment must be arranged in primary care within three months, and within 14 days for those under 23 (Ministry of Social Affairs and Health: Access to care). Urgent care must always be provided immediately.

This article covers what you are entitled to in Finland: the therapy guarantee, occupational health, Kela, and low-threshold services. A practical guide to invoking your rights.

The therapy guarantee: what it means and who it covers

The therapy guarantee applies to people under 23. Once a need has been identified in primary health or social care, treatment must start within 28 days unless a medical or treatment-related reason requires otherwise.

"Treatment" here means brief psychotherapy or a structured brief intervention: solution-focused brief therapy, interpersonal counselling (IPC) or CBT-based brief interventions, for example. It does not mean Kela's long-term rehabilitative psychotherapy, and the guarantee does not cover every mental health condition: it applies where a researched, structured method suitable for primary care exists. More complex situations are referred to specialist care.

The law binds the wellbeing services counties and the City of Helsinki, as well as student healthcare for higher education students (FSHS).

Implementation has been uneven between regions. According to government monitoring the guarantee has largely been met, but the data base remains incomplete because counties' recording practices and information systems are at different stages (Finnish Government 2026).

For an adult the guarantee confers no rights. An adult's routes to help are the general treatment guarantee, occupational health care, Kela's rehabilitative psychotherapy and low-threshold services. We cover those next.

How to invoke your right of access

The practice is the same whatever your age, but it requires initiative. Contact your own health centre (by phone, via an OmaKanta message or at an appointment) and raise the mental health issue. A nurse or doctor makes an assessment of the need for treatment. What matters is that the assessment and the identified need are recorded: the clock starts from that moment, not from when you first called.

So always ask for the assessment of treatment need to be entered in your patient records, and check the entry in OmaKanta. If treatment does not begin within the deadline — 28 days to brief therapy for under-23s, three months to a first treatment appointment for those aged 23 and over — ask for a written explanation of the delay. The wellbeing services county's patient ombudsman advises free of charge when a service is not delivered, and is worth contacting before filing a formal complaint.

If your condition clearly worsens while you wait, get in touch again: the urgency of care is reassessed, and urgent care may not be put in a queue.

If your problem is complex or requires long-term care, the doctor can write a referral directly to specialised psychiatric care and simultaneously guide you to apply for Kela rehabilitative psychotherapy.

Occupational health mental health services

Statutory occupational health covers at minimum preventive services. Most Finnish employers have also arranged medical services, including mental health.

What occupational health offers in practice:

GP appointments where mental health concerns can be discussed. Occupational health psychologist appointments for brief interventions. Writing the B-statement for Kela support if work capacity is affected. Sick leave when needed for recovery. Work capacity assessments when returning to work needs evaluation.

A brief intervention with an occupational health psychologist (usually 5–10 sessions) is often effective in early-stage depression, anxiety, or burnout. Long-term therapy is generally not provided through occupational health, but they help with the Kela application.

Kela rehabilitative psychotherapy

Kela reimburses rehabilitative psychotherapy for ages 16–67 with a diagnosed mental health condition requiring long-term therapy. The condition is that therapy supports work or study capacity.

Application process:

1. A B statement from a psychiatrist, after at least 3 months of appropriate care.
2. Application via Kela's e-service or paper form.
3. Kela's decision: processing time typically 2–4 weeks.
4. Finding a Kela-approved provider in the provider registry.
5. Starting therapy.

Reimbursement is €57.60 per session, with out-of-pocket costs typically €20–60 (depending on the therapist's price). Reimbursement covers up to 80 sessions per year and up to 200 sessions over three years.

Private insurance and therapy

Some private insurance includes mental health coverage, but it is often limited: a specific euro amount per year, a specific session count, or only certain diagnoses. Check your own insurance directly with your insurer.

Most health expense insurance does not cover long-term psychotherapy.

Low-threshold services

When you don't know where to start, low-threshold services are a good first step. Mieppi mental health points (Helsinki) and similar units in other wellbeing services counties offer service without referral or appointment. MIELI ry crisis centres operate around Finland.

Where to get help

Your own health centre: the therapy guarantee. Occupational health for working people. Mieppi or similar low-threshold services. Kela's provider registry (asiointi.kela.fi) to find rehabilitative psychotherapy. In acute crises, MIELI crisis line 09 2525 0111 or 112. The wellbeing services county patient ombudsman if service isn't realised.

Sources

• Ministry of Social Affairs and Health: Therapy guarantee for children and young people
• Ministry of Social Affairs and Health: Access to care (treatment guarantee)
• Ministry of Social Affairs and Health: Mental health is everyone's right
• THL: National Mental Health Strategy 2020–2030
• STM: Mental Health Services
• MIELI ry: Mental health services must be put in order

Where to find a therapist

You can look for a therapist in several places:

• Search services run by the Finnish Psychological Association (Psykologiliitto) and professional bodies.
• Kela's service provider search, if you are applying for rehabilitative psychotherapy (only Kela-approved therapists qualify for reimbursement).
• The Valitse Terapia service and other directories.
• Your own health centre, occupational health service or student health service (YTHS), which can refer you onward.

You can contact several therapists and see with whom the collaboration feels natural.