In recent years, Finnish public services have increasingly adopted new practices that are named “neuropsychiatric”. People working in various fields, such as education and social services, are offered an astonishing amount of courses and books on “neuropsychiatric issues” in educational contexts, aiming at better “recognition” of “neuropsychiatric traits” and dealing with challenges assumed to be connected to the “neuroatypicality” of the individual. Wellbeing services counties and municipalities are establishing neuropsychiatric teams, -coordinators, -helplines and -websites. Even work on criminal sanctions and homelessness have been offered a “neurodiversity” perspective through training projects. Experienced difficulties in different areas of life are viewed as an expression of unmanaged “neuropsychiatric traits”. 

The term neuropsychiatric is mostly used to refer to behaviors often associated with diagnostic categories of ADHD and autism. Adhering to critical theory, we view these concepts as social constructs instead of objective descriptions of facts. Despite the scientific processes involved in their development, these concepts are culturally produced and affected by societal values and structures and the biomedical paradigm of psychiatry. Psychomedical categories and the involved neurological explanations suffer from several logical fallacies and lack of empirical evidence to support their validity. No biomarkers of diagnostic constructs like ADHD or autism have been found (Timimi, 2015, 2020; te Meerman, Freedman & Batstra, 2022; Schleim, 2022; Rose, 2016). Thus, these constructs are based on circular reasoning, where the psychiatric label is used both as a reason and a consequence (e.g. “he has ADHD because he behaves that way, and he behaves that way because he has ADHD”) (Honkasilta & Koutsoklenis, 2022). As long as psychiatric constructs are empirically invalid, using them to explain our social world is just an interpretation based on an ideology.

However, such interpretations are applied even in policymaking. The current Finnish Government (2023, 36) states in its programme that it “will pay particular attention to services for children with neuropsychiatric symptoms (nepsy) and support for their parents, including quick diagnosis and quick access to help”. Who defines who is “a child with neuropsychiatric symptoms” and what kind of consequences does such a definition have? What is left unmentioned when the political focus is on the “neuropsychiatric symptoms”? This kind of discourse can be seen as an expression of therapization (e.g. Brunila, 2012), Instead of structural changes to reduce injustice or adverse circumstances, political acts are headed towards services that aim to foster the individuals’ resilience and capabilities to manage the adverse conditions of life. 

From a socio-constructivist and discursive perspective, policies are also productive. They do not address matters of fact that would be problematic per se, but problematize their objects based on value-laden assumptions and power structures (see Bacchi & Goodwin, 2016). Thus, problematizing is also a tool of governance.

The aim of this study is to critically examine the ways psychomedical categories and neurological explanations are being adopted as a part of Finnish welfare policy. We are concerned about whether policies that are based on such problematizations are the best way to help those in need and whether they can even promote harmful practices and thinking by creating assumptions of people’s essence and capabilities and shifting attention from politics and structures to the individual. Applying the WPR (What’s the problem represented to be?) approach (Bacchi and Goodwin, 2016), our research question is “What is the problem represented to be in policy texts referring to “neuropsychiatry”?”.

For the international audience, this study offers insights into the governmental implications of the global trend of psychiatrization in welfare policy and the WPR approach as a methodological tool to investigate the discursive and lived effects of this phenomenon.

We perform critical discourse analysis structured by the six questions of the WPR (What’s the problem represented to be?) approach (Bacchi & Goodwin, 2016, 20) presented below: 1: What’s the represented to be in a specific policy or policies? 2: What deep-seated presuppositions or assumptions (conceptual logics) underlie this representation of the “problem” (problem representation)? 3: How has this representation of the “problem” come about? 4: What is left unproblematic in this problem representation? Where are the silences? Can the “problem” be conceptualized differently? 5: What effects (discursive, subjectification, lived) are produced by this representation of the “problem”? 6: How and where has this representation of the “problem” been produced, disseminated and defended? How has it been and/or how can it be disrupted and replaced? Drawing from Foucault’s thinking and according to theoretical starting points of the WPR approach, we view discourses as knowledges that shape what is sayable and thinkable. By knowledges we do not refer to objective truths, but “unexamined ways of thinking” (Foucault, 1994, 456) that guide our understanding of the world and thus are also a form of power. We have analyzed two types of policy-related data: national parliamentary documents and local project plans, reports and other texts discussing local welfare service provision. The first set consists of parliamentary documents in the web search of the Finnish Parliament using the keyword “nepsy”, an abbreviation commonly used in Finnish for the word “neuropsychiatric”. 179 search results, forming a total of 55 documents, was found from years 2015–2024. The second data set consists of 20 documents produced mainly by Finnish municipalities and wellbeing services counties, and additionally a few by different projects. These documents are mostly project reports and -plans discussing local service provision around people or issues defined “neuropsychiatric”, mostly with children and young people in educational settings.

The overarching claim throughout the data was that we cannot fully achieve equity and wellbeing because there are “neuropsychiatric disorders” and “-traits”. Therefore, the problem – inability as a society to achieve our values – was in the “neuroatypical” individuals’ brain. “Unidentified” neuropsychiatric issues were seen to pose a risk to the society. The policy needed to alleviate this problem was firstly, to aim at better “identification” of neuropsychiatric disorders and traits, and secondly, offering enough right kind of help for the “neuroatypical” individuals. The problem representation originates, on one side, in the hypotheses and classifications of biomedical psychiatry. A central presupposition underlying this problem representation is that psychomedical categories and neural explanations are scientifically plausible and objective. No questioning towards biomedical psychiatry was present in the data. In policies focusing on “neuropsychiatric issues” people become subjects of screening for “neuroatypicality” and determinist claims on on how people assumed “neuroatypical” and “-typical” are. Especially in the documents discussing local service provision, the emphasis was on the need to train workers to “identify neuropsychiatric traits” and encouragement to view situations through the assumed atypicality of the individual and educate both the individual and other professionals on this perspective. As biomedical psychiatry is framed as a progressive form of knowledge, it may be seen superior to different kinds of understanding of mental distress that could be more acknowledging of their collective and political nature. This may negatively affect the way people and their suffering are encountered in welfare services. It may also lead to policies where resources are allocated according to an amount of people categorized “neuroatypical”, which further creates demand for these categories as a tool to negotiate support, instead of discussing, for example, forms of injustice, such as poverty or discrimination, and allocating resources to alleviate them.

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