April 2018

Towards an Independent Life

In Sähäkkä, a series of housing units in the cities of Ylivieska, Oulainen and Jyväskylä, young people and young adults with mental problems are rehabilitated in order to live independently. The Oulainen unit rehabilitates 15-17 year olds and in Ylivieska and Jyväskylä the rehabilitation is for 18-29 year olds. In the Jyväskylä unit, which opened in September 2017, there will also be a rehabilitation program for minors. The goal is clear.

– Our goal is to rehabilitate the young person/young adult back to the environment in which he/she grew up, says Anu Vuolukka, branch manager of Sähäkkä.

Sähäkkä's first housing unit was founded in 2006 and two new units were opened this year. The clientele comes from all over Finland to all of the units and currently negotiations on expanding the business are undergoing.


The use of Raisoft's program for psychiatric out-patient treatment, interRAI CMH, began as a pilot project in Sähäkkä already in 2009 and soon the test use of a new program, interRAI ChYMH-DD (Child and Youth Mental Health – Development Disorder), particularly designed for children and young people with mental health issues, is being launched.

– We were lacking an objective measuring tool that assesses and measures the effects of our work. In the field of mental health work the effectiveness and the achieved results are often called for. The interRAI-assessment tools help us show that we actually meet these expectations.

Proving effectiveness and demanding results are things Anu Vuolukka roots for. In her Master's thesis on leadership, done for the University of Lapland, Vuolukka has studied the principles of tendering procedures in the social services and health care sectors.

– In the tendering procedure there may well be requirements for effectiveness of the service but the service producers are very rarely asked to use any kind of measuring tools to follow up the results. At the end of the day your only assessment tool is your gut feeling. Both the tenderers and the service providers should commit to follow up the effects. Only then you'll know where you put your money.


In Sähäkkä the interRAI assessment tool has been used in a diverse way already for eight years. Every time a new person is admitted to Sähäkkä an interRAI-assessment is done to assess, among other things, functional ability. RAI gives a clear picture and helps set the goals.

– When you go from one rehabilitation level to another in our four-stage program a new interRAI assessment is done and one last one is made when the rehabilitation program is finished. The interRAI-assessment is a great tool for follow-ups. It confirms the staff members´ observations, affirms that the rehabilitation is on the right track and exposes weaknesses, if some areas need more attention, Vuolukka says and underlines that the interRAI-assessment can also motivate a young person to move on.

– Those young people who come to Sähäkkä go through very difficult times in their lives and there are moments when everything seems to go wrong. In those moments interRAI can be of help when we study the results together with the young person and see the real progress that has been made. The person sees the development with his/her own eyes and this motivates to go on, towards an independent life or towards returning home.


Even if you have used interRAI for a long time you can always learn something new. In early September 2017 Vuolukka participated in a VIP-event in Tampere, hosted by Raisoft. At this event Vuolukka had another RAI-light bulb moment.

– I am so excited when I noticed that interRAI works as a conversation opener on more levels than I had ever noticed before. The results of RAI-assessments work as conversation tools for the whole network of professionals within the mental health field. Before I used to think that the results are beneficial mostly on an individual or organizational level.

– Sähäkkä is not the most inexpensive service producer and often we get the question how do we justify the content of our service and is everything actually needed? Wouldn't housing be sufficient? After having gathered eight years of interRAI-assessment material I can show for instance that 40% of those who come to us have cognitive impairment. This is why we provide cognitive rehabilitation. The assessment also shows that these young people suffer from considerable amount of pain. When a person suffers from a mental disorder feelings and emotions are often felt physically due to psychosomatic processes. If you are not aware of this you might seek help for various pain issues at the local medical center and unnecessary tests are done as the reasons lie elsewhere.


Anu Vuolukka believes that the new customized interRAI-system designed for children and young people with mental health problems will provide more possibilities in including and utilizing the support network.

– The new interRAI challenges us to better utilize the young person's support network and it is included in the assessment. Some of the assessment questions are about early childhood for instance. If one part of the RAI assessment is of particular importance for the person but the assessment is not his/her own care taker's special field we hand it over to someone else who has that expertise. In doing so we utilize the multi-professionalism within our own organization to the fullest. In the future I hope to see more co-operation over organizational boundaries.

Anu Vuolukka has noticed that during the recent years society has started to recognize and acknowledge mental symptoms earlier and better than for instance a couple of years ago.

– The situation has changed. You can tell that from the fact that the average age of the people who come to our units has dropped. The symptoms are recognized better. I have noticed that Sähäkkä´s goal to rehabilitate a young person/young adult back to the environment in which he/she grew up sometimes raises question, especially in the field of Child Protective Services. We never think that the young ones who come to us will automatically stay in our care until they are of legal age. If the knots are undone earlier, the person can return to his/her environment at any point. But that doesn't mean that we wouldn't commit of taking care of the person also after being released.

– I believe in general that we need more people in child protective services who have specialized in different areas. Our unit in Oulainen was opened in April and already now we have 15 to 17 year olds in queue. Obviously not every child within Child protective services needs mental rehabilitation, but those who do need it don't benefit of being tossed from institutions to wards with the hope that they will make it.