Many states make use of personal identity numbers to govern people living in their territory and jurisdiction, but only a few rely on an all-purpose PIN used throughout the public and private sectors. This article examines the all-purpose PIN in Finland as a political technology that brings people to the sphere of public welfare services and subjects them to governance by public authorities and expert institutions. Drawing on documentary materials and interviews, it unpacks the history and uses of the PIN (...) as an elementary building block of the Nordic welfare state, and its emerging uses in the post-welfare data economy. The article suggests that, although the PIN is capable of individualizing, identifying, and addressing individuals, its most important and widely embraced feature is the extent to which it enables interoperability among public authorities, private businesses, and their data repositories. Interoperability, together with advances in computing and information technology, has made the PIN a facilitator of public administration, state knowledge production, and everyday life. More recently, in the post-welfare data economy, interoperability has rendered the PIN a national asset in all the Nordic countries, providing a great advantage to biomedical research, innovation business, and healthcare. (shrink)

The subject of this paper is the problematisation of depression in today’s mental health care. It is based on a study of the professional discussion on depression in Finland from the mid-1980s to the 1990s. The ways in which Finnish mental health experts define the object of depression treatment bring out an ambivalence that stems from the discrepancy between two parallel but incongruent notions of what depression is: the psychopharmacological and the psychotherapeutic. The analysis of the discussion demonstrates how clinical (...) and practical rationales of today’s mental health care are formed in the space between the two poles. Two tendencies of these rationales are also pointed out: first, the DSM paradigm of depressive illness inclines to become problematic and to dissolve in the actual practices. Second, they insinuate emphasis on antidepressant medication and overall neuropsychiatric approach in the treatment of depressive disorders, although in an ambivalent way. (shrink)

Repeating history? Public and community health nursing in AustraliaDespite the long history in Australia of public and community health nursing, it has never been regarded as important as hospital‐based nursing. Notwithstanding the establishment of nursing organisations in the very early years of the 20th century and subsequent efforts to develop the nursing workforce, public and community health nursing has been neglected in terms of policy, research into public health nursing practice and workforce development. Even in the present day, public and (...) community health nurses are marginalised from mainstream nursing interests and there is a lack of conceptualisation about the value of nursing’s contribution to the primary health sector. This sector is experiencing a new wave of reforms driven by a combination of managerialism and systems change for improved responses to address health inequalities. Because there is not a strong institutionalised professional policy and support base for public and community health nurses, they are vulnerable in these reforms to increased domination and appropriation of their practice by stronger professional interests. There is an urgent need for professionally organised support from mainstream nursing to ensure that public and community health nurses are positioned as a unified force in efforts to advance the health of the community. (shrink)

In current mental health care psychiatric conditions are defined as compilations of symptoms. These symptom-based disease categories have been severely criticised as contingent and boundless, facilitating the rise to epidemic proportions of such conditions as depression. In this article we look beyond symptoms and stress the role of epidemiology in explaining the current situation. By analysing the parallel development of cardiovascular disease and depression management in Finland, we argue, firstly, that current mental health care shares with the medicine of chronic (...) somatic conditions an attachment to risk factor epidemiology, which accentuates risk and prevention in disease management. However, secondly, due to the symptom-based definitions of psychiatric conditions, depression management cannot differentiate properly between symptoms, signs and risk factors such as, for example, cardiovascular medicine, but treats symptoms as signs or risk factors in contexts of treatment and prevention. Consequently, minor at-risk conditions have become difficult to separate from proper cases of depression. (shrink)