Forensic psychiatrist Kaisa Roiha emphasizes mental health care in Finland

In critical situations, a decision must sometimes be made to ensure the safety of both the patient and others. A psychiatrist may order a patient into a seclusion room similar to a detention cell, or in extreme cases, even restrain them to a bed with thick leather straps. Kaisa Roiha, a psychiatrist, calmly explains to the patient what will happen and why, maintaining her composure even if the patient becomes agitated. She reflects, “I could easily find myself in a similar situation as a patient.”

In Finland, there are only about 50 forensic psychiatrists like Roiha, who cares for the most dangerous and challenging psychiatric patients. Most of these individuals are treated at state-run hospitals, but Roiha’s workplace, North Karelian Central Hospital’s Unit 26, stands out as few regions have their own forensic psychiatric department.

Forensic psychiatric patients are, in layman’s terms, under involuntary treatment, often following serious violent crimes for which they have been deemed not guilty by reason of insanity. Instead of prison, they face years of treatment in a secure setting. Roiha notes that for some, being hospitalized is a relief, providing a sense of safety amid chaos. Typically, treatment lasts 6-7 years, but can vary significantly.

Roiha emphasizes the importance of understanding the complexities of human behavior, seeking a balance between necessary medical intervention and the potential abuse of power by healthcare professionals. Recognizing the stigma associated with her patients, she aims to remove the barriers that prevent them from seeking help, reflecting on her own childhood experiences with trauma and how they shape her practice.

She believes it is crucial to foster relationships that help prevent potential violent situations. Recently, a patient who previously displayed aggression voluntarily sought treatment again, showcasing the effectiveness of trust-based care approaches.