People with intellectual disabilities seek emergency care in Oulu due to lack of support services

People with intellectual disabilities in northern Finland are increasingly turning to emergency rooms for help with loneliness and insecurity, as support services fail to meet their needs, reports Finnish public broadcaster Yle.

The North Ostrobothnia wellbeing services county has observed a growing number of cases where individuals with intellectual disabilities—some exhibiting aggressive behaviour—arrive at emergency departments because they have nowhere else to turn. Emergency services, however, are not equipped to provide the long-term social or psychological support these individuals require.

Jarmo Körkkö, chief physician at OYS Konsti, a specialised rehabilitation unit in Oulu, confirms the trend has persisted for some time, placing strain on healthcare staff. “We know who the frequent callers are,” Körkkö said, noting that while some receive social and healthcare services, the support often proves inadequate for their complex needs.

A key factor behind the issue is the reduction of institutional care for people with disabilities, a shift Körkkö describes as a major societal change. “There was a time when institutional care allowed for better management of these cases within specialised units,” he explained. Now, with fewer long-term care options, emergency services bear the brunt of unmet needs—particularly outside regular hours, when even specialised units like OYS Konsti, designed to handle crises, operate with limited capacity. Currently, half of its 30 beds are occupied by long-term residents, and the unit does not admit new patients overnight.

In some cases, individuals with behavioural challenges are temporarily placed in psychiatric acute wards, though these units are not tailored to their specific needs.

Tanja Salisma, a long-time legal expert at the Finnish Association on Intellectual and Developmental Disabilities, questions whether existing services are sufficient. “When someone repeatedly seeks help from emergency rooms due to loneliness, it raises concerns about whether their daily support is adequate,” she said. The association has received similar reports from the North Ostrobothnia region, where cuts to local health stations and emergency networks have left Oulu as the sole 24/7 emergency care provider in the area.

Salisma attributes the problem partly to strict interpretations of the upcoming 2025 Disability Services Act, which has made it harder for people with mild intellectual disabilities to access necessary services. “Many are directed toward general social welfare services, which either don’t exist in sufficient quantity or don’t match their needs,” she said. Even services guaranteed under disability legislation are increasingly difficult to obtain.

To mitigate the strain on emergency services, North Ostrobothnia has introduced a five-person mobile team that can be dispatched to assist individuals in their homes. Körkkö notes that psychiatric referrals have declined as tailored solutions are developed in collaboration with other agencies. Additionally, a new facility near OYS Konsti, currently under construction, will provide expanded housing services.

Salisma argues that community-based care, when properly resourced, could address both short-term crises and long-term housing needs. She emphasises the importance of accessible daytime activities, social inclusion programmes, and adequate psychiatric support to combat loneliness. “The gaps lie in high-quality community services—housing support, crisis intervention, and meaningful daily routines,” she said.