Jesper Ekelund, the director of psychiatry at the Hospital District of Helsinki and Uusimaa (HUS), moved into leadership roles from an established research career. In his career, he has focused on, among other things, imaging, the genetics of schizophrenia and research on information processing.
Jesper Ekelund, who began serving as the director of psychiatry at the Hospital District of Helsinki and Uusimaa (HUS) at the beginning of the year, has conducted diverse research in the field of psychiatry, including imaging, clinical trials and drug studies.
Ekelund graduated with a Licentiate of Medicine degree from the University of Helsinki, after which he focused on the genetics of schizophrenia as a doctoral researcher. His postdoctoral work took him to the United States, where he focused on brain imaging. Three years later, he returned to Finland and completed his specialist training in psychiatry. His research topics later expanded to include information processing during psychiatric disturbances.
In 2010 Ekelund was appointed to a professorship at the University of Helsinki, with an additional duty located in Vaasa. Gradually, his journey led him to leadership positions in the field.
“In 2017 I started working as director of psychiatry at the Hospital District of Southwest Finland, and then took up the same position at HUS at the beginning of this year,” Ekelund says.
Half of outpatient care in digital form at HUS
Ekelund praises the opportunities afforded by digitalisation in psychiatric care: efforts to develop the digital services of HUS’s psychiatric sector have been speedy, with half of outpatient care already provided over remote connections.
Digital care pathways have also advanced far, as has the monitoring of staff activity. Registering how patients have been treated also boosts the measurement of impact.
“Traditionally, talking therapy has been difficult to measure and define. We have created indicators, including fixed-term interventions. These indicators have helped us to better analyse our operations and their impact,” says Ekelund.
At HUS, the effect of the coronavirus pandemic has been apparent in the state of seriously ill patients. Ekelund says that particularly those with schizophrenia and other long-term conditions have suffered from the third sector lockdown. Many have ended up on the ward in an even poorer state due to illness combined with poor functional capacity.
A real risk of developing a mental illness is also present when a person becomes unemployed, for example, or goes bankrupt during the coronavirus period. Serious changes in people’s lives always pose a risk to mental health.
“In contrast, temporary external concerns don’t make healthy people ill. Things were slightly overdramatised, especially at the beginning of the pandemic,” Ekelund says.
Ekelund is worried about young people. Separating from your family of origin, finding your own identity and spending time with other young people are part of adolescence and young adulthood.
“The pandemic has been devastating for 15- to 20-year-olds. Spending a year or two isolated at home, and not being allowed to meet your peers as usual, is detrimental to this developmental stage,” he says.
Ekelund estimates that the coronavirus period may lead to a spike in mental disorders among young people later on.
“This is something professionals specialised in adolescent psychiatry are very worried about,” he notes.
Terminology associated with mental illness needs updating
Ekelund hopes to see psychiatric research provide answers to, for example, understanding the heterogeneity of depression. At the moment, depression as an everyday term describes both an emotional state and an actual disease. Misconceptions make it more difficult to determine the demand for psychiatric care. What is being treated when treating depressed patients?
“Can we define sub-groups for depression or anxiety, and, through that, different clinical pathways? It would be important to know who needs drug therapy, who needs psychotherapy and what is the most effective treatment for people with mild symptoms,” Ekelund says.
For a long time, the focus has been on prevention, which Ekelund believes has become an ideological mantra. He would like to see evidence of comprehensive clinical pathways, not only individual interventions.
“Scientific evidence of the cost-effectiveness of various methods as part of the overall treatment is actually insufficient. We need more research on how to use the resources available in a cost-effective way.”
“Psychiatry is at the heart of being human”
- Which researchers in neuroscience or psychiatry do you admire?
I want to start by mentioning Leena Palotie and Jouko Lönnqvist, my doctoral thesis supervisors. Kenneth Kendler, who examined my doctoral thesis, has significantly advanced psychiatry as a field. My opponent was Michael Owen who has a career in psychiatric genetics. During my postdoctoral period, I had the opportunity to meet one of the most pioneering researchers in the field of modern psychiatry, the Nobel laureate Eric Kandel. Through the Scandinavian College of Neuropsychopharmacology, I have also had the chance to meet Arvid Carlsson, another Nobel laureate known for his dopamine studies. He has revolutionised the entire field of psychiatry. Without him, there would be no modern psychiatry.
- 2. Why psychiatry?
Psychiatry is overwhelmingly the most interesting specialisation: it is at the heart of what being human means – psychiatry combines hard natural sciences with humanism and care. There is enormous demand for the field, and psychiatry concerns society as a whole. Moreover, the field requires diverse expertise: in addition to being familiar with pharmacology, neuroscience and brain function, you also have to be able to encounter human beings, identify with them and understand their experiences.
3. How do you recover after work?
Exercise is my number one way of relaxing. I clear my head daily in endurance training, such as running, cycling or swimming. Another passion of mine is sailing, which is a hobby for the whole family. I also participate in competitive sailing. I find it most relaxing when I have something to do.
Article written by Elina Kirvesniemi, University of Helsinki