If you are looking into psychedelic-assisted treatment in Finland — for yourself or for someone close to you — the country in July 2026 offers exactly one reimbursed route, and it is a study in Finnish design: the strictest entry criteria in the Nordics attached to the most flexible delivery model in Europe. Everything else — psilocybin, MDMA, private ketamine infusions — is either research-only or effectively absent. This guide covers who qualifies, how the paperwork actually works, what it costs, and what to realistically expect; you can begin orienting yourself with our eligibility check.
TL;DR Esketamine nasal spray (Spravato) has been reimbursed by Kela since August 2023 under restricted entitlements 3062 (basic) and 1539 (special, 100 per cent). The bar is high: adults with treatment-resistant depression on an ongoing SSRI or SNRI, a MADRS score of at least 31 at the start, and no response to at least three different antidepressant treatments with attached psychotherapy or other psychosocial care — one of the three being a combination treatment. A psychiatrist's B-statement carries the application. The distinctive part is delivery: the patient buys the reimbursed spray at a pharmacy and self-administers it under supervision at a healthcare unit, which allows treatment in outpatient and private settings. Psilocybin and MDMA remain research-only, with no Finnish trial recruiting in July 2026.
At a glance
| Route | Substance | Status in Finland | Who qualifies | Cost |
|---|---|---|---|---|
| Kela-reimbursed esketamine | Esketamine (Spravato) | Reimbursed since August 2023 (codes 3062 and 1539); running | Adults with TRD on SSRI/SNRI, MADRS at least 31, at least three failed treatments incl. psychotherapy, one a combination; psychiatrist's B-statement | Basic reimbursement covers 40 per cent of the medicine; special reimbursement 100 per cent; treatment-visit fees depend on the setting |
| Off-label ketamine | Racemic ketamine | Legal anaesthetic; occasional off-label psychiatric use in hospital settings | Treating department's clinical decision | Within public care where used; no established private infusion market |
| Psilocybin therapy | Psilocybin | Research only; no trial recruiting | — | — |
| MDMA therapy | MDMA | Research only; no Finnish trial exists | — | — |
| Clinical trials | Esketamine, ketamine, psilocybin | Ten trials tracked, none currently active | Study-specific criteria | Free |
Kela-reimbursed esketamine: the strictest gate, the most flexible door
Finland reimburses Spravato through Kela, the national social insurance institution, under two restricted entitlements introduced from August 2023: code 3062, a restricted basic reimbursement covering 40 per cent of the medicine's price, and code 1539, a restricted special reimbursement covering 100 per cent for patients whose severe mental disorder is demonstrated as in entitlement 112 (Kela 3062, Kela 1539).
The medical criteria are precise, and they are the strictest published in Europe. Reimbursement is granted for treatment-resistant depression in adults, used in combination with an SSRI or SNRI antidepressant, when:
- the Montgomery–Åsberg depression scale (MADRS) score is at least 31 — a severe episode — at the start of esketamine treatment, and
- at least three different antidepressant treatments, with attached psychotherapy or another psychosocial treatment, have failed to produce a response — and one of the three must have been a combination: two antidepressants, an antidepressant plus an antipsychotic, or an antidepressant plus lithium.
Compare that with Germany's two failed antidepressants and you see the design: Finland reimburses late, but then pays properly. Note the detail most patients miss — psychotherapy or psychosocial treatment attached to the medication attempts is itself part of the requirement, not an optional extra.
The B-statement is the application. The entitlement is granted on the basis of a physician's B-statement (lääkärinlausunto B) written by a specialist psychiatric unit or a psychiatrist, describing the illness, every prior treatment and its outcome, and a treatment plan consistent with good clinical practice. The entitlement is time-limited — at most one year at a time — and continuation is granted only if the MADRS total score has at least halved from the starting point (while remaining 13 or above; below that, the treatment goal is considered reached).
The pharmacy-dispensing model. Here is what makes Finland genuinely unusual. In most of Europe, Spravato is a hospital-dispensed medicine, which chains treatment to hospital sites. In Finland the reimbursed spray is dispensed at a pharmacy to the patient, who brings it to a healthcare unit and self-administers it there under supervision, with the standard post-dose observation. That single administrative choice lets supervised treatment happen in outpatient psychiatric clinics — including private ones — rather than only in hospitals. If you use a private clinic, Kela reimburses the medicine on the same terms; the clinic's own visit fees are yours to pay, so ask for a written per-visit price before starting.
How to start. The route runs through a psychiatrist — via referral from your health centre or occupational health, or directly in the private sector. Bring a complete written treatment history: medications, doses, durations, outcomes, psychotherapy episodes. Under criteria this specific, the documentation decides the case; the Europe-wide reimbursement map shows how Finland's bar compares with every neighbour.
Off-label ketamine: an anaesthetic, occasionally a psychiatric tool
Racemic ketamine is an established anaesthetic in Finland and is occasionally used off-label in psychiatric settings — typically in hospital care, in emergency contexts, or alongside ECT services, at the treating department's discretion. What Finland does not have, honestly stated, is an established private ketamine-infusion market of the kind found in Oslo, London or Berlin: no Finnish infusion clinic is currently listed in our catalog, and we know of no published price list to point to. If a hospital psychiatrist judges ketamine appropriate in your case, it happens within public care; it is not a service you can book.
Psilocybin: research only
Psilocybin is scheduled as a narcotic in Finland with no medical-access route — no compassionate-use programme, no authorised clinics, no reimbursement. The research picture is honest but thin: a multicentre Phase 2 trial of psilocybin-assisted psychotherapy for alcohol use disorder that included Finland was terminated, and an earlier Turku-based psilocybin and depression study dates to 2018 with no active successor. As of July 2026, no Finnish psilocybin trial is recruiting (Blossom's Finland report tracks ten trials, none active). The University of Turku remains a centre of Finnish psychedelic research, so new studies are plausible — watch the registries. Until then, the realistic options are trial sites elsewhere in Europe; our trials guide explains how to search and what participation involves. Anyone offering psilocybin therapy commercially in Finland today is operating illegally.
MDMA: research only
MDMA is a controlled narcotic in Finland with no medical route and, unlike its Nordic neighbours, no Finnish MDMA trial history at all — Blossom's Finland tracking shows esketamine, ketamine and psilocybin studies, not MDMA. Nothing is recruiting, and no framework outside research exists. If MDMA-assisted therapy matters to you, trial sites elsewhere in Europe are the only legal option, and commercial offers inside Finland are illegal.
Clinical trials in Finland
Finland has real research infrastructure — Helsinki University Central Hospital and the University of Turku have both run psychedelic and esketamine studies, and Finnish sites took part in the international esketamine Phase 3 programme (ESCAPE-TRD, SUSTAIN-3) — but the current moment is a lull: of the ten trials Blossom tracks for Finland, none is active or recruiting as of July 2026. That can change quickly, and trial participation remains free and legal when it does. See the trials guide for how phases, placebo and consent work, and search ClinicalTrials.gov for current Finnish listings before assuming the door is closed.
What to expect in treatment
The reimbursed route has a well-defined rhythm. First comes the specialist assessment: a psychiatrist reviews your history against the Kela criteria, administers the MADRS, checks cardiovascular health and current medicines, and — if the criteria are met — writes the B-statement and applies for the entitlement. Once granted, you fill the prescription at a pharmacy with reimbursement applied at the counter.
On a treatment day, you bring the spray to the clinic and self-administer it under staff supervision, then stay for roughly two hours of observation while blood pressure and heart rate are monitored. A detached, dreamlike feeling, dizziness or nausea, and a temporary blood-pressure rise are expected effects that settle as the drug clears. You must not drive for the rest of the day, so arrange a ride. Induction is typically twice weekly, tapering to weekly and then less frequent dosing based on measured response — and in Finland the measurement is not rhetorical: your MADRS trajectory literally determines whether the entitlement is renewed after a year. The oral antidepressant continues throughout, and ongoing psychiatric follow-up is part of the plan, not an accessory to it.
Risks and who should not start
Esketamine treatment is generally well tolerated under supervision, but it is not for everyone — which is exactly what the assessment is for. Common, transient effects include dissociation, dizziness, nausea, sedation and a short-lived rise in blood pressure. Treatment may be inappropriate, or require particular caution and specialist evaluation, when any of the following apply:
- Uncontrolled hypertension or significant cardiovascular disease, including aneurysmal vascular disease or a history of intracerebral haemorrhage, because of the temporary blood-pressure rise.
- A history of psychosis — psychotic depression and primary psychotic disorders are screened out.
- Substance-use concerns, particularly patterns of compulsive use; esketamine is a controlled medicine and clinics assess this before starting.
- Severe liver disease or other serious unstable somatic illness.
- Pregnancy or breastfeeding.
- Acute suicidality requiring emergency care — in a crisis, call 112 or contact your nearest psychiatric emergency service first.
A responsible provider screens for all of these before the first dose. To see who is listed in Finland, browse our catalog.
Frequently asked questions
Do I qualify for Kela reimbursement of Spravato?
The published criteria: you are an adult with treatment-resistant depression, taking an SSRI or SNRI, with a MADRS score of at least 31 at the start of treatment, and at least three different antidepressant treatments with attached psychotherapy or psychosocial care have failed — one of them a combination treatment (two antidepressants, antidepressant plus antipsychotic, or antidepressant plus lithium). A psychiatrist's B-statement documents all of this. If you are unsure, the assessment appointment exists precisely to establish it.
What is a B-statement and who writes it?
A lääkärinlausunto B is the detailed medical certificate Finnish physicians use for benefit and reimbursement applications. For entitlements 3062 and 1539 it must come from a specialist psychiatric unit or a psychiatrist and must describe the illness, prior treatments and outcomes, and a proper treatment plan. Kela decides on the entitlement based on it.
What is the difference between codes 3062 and 1539?
Code 3062 is restricted basic reimbursement — 40 per cent of the medicine's price. Code 1539 is restricted special reimbursement — 100 per cent — for patients whose severe mental disorder is additionally demonstrated as required for entitlement 112. The medical criteria for esketamine itself are the same under both.
Can I be treated at a private clinic?
Yes — this is the point of Finland's pharmacy-dispensing model. The reimbursed spray is dispensed to you at a pharmacy and administered under supervision at a healthcare unit, which can be an outpatient or private psychiatric clinic. Kela's reimbursement covers the medicine either way; the private clinic's visit fees are self-paid, so request a written price per treatment visit before starting.
Is the entitlement permanent?
No. It is granted for the period required by the treatment plan, at most one year at a time. Continuation requires that your MADRS total score has dropped by at least half from the starting point while remaining at 13 or above — measured response is built into the funding.
Can I get psilocybin, MDMA or ketamine infusions in Finland?
Psilocybin and MDMA: only in research, and no Finnish trial is recruiting as of July 2026. Ketamine infusions: occasionally used off-label inside hospital psychiatry at the treating team's discretion, but there is no bookable private infusion market in Finland. For all three, trial sites elsewhere in Europe are the realistic alternative.
Sources
- Kela: entitlement 3062 — esketamine, restricted basic reimbursement (criteria)
- Kela: entitlement 1539 — esketamine, restricted special reimbursement (criteria)
- Blossom: Finland country report
- Blossom: Medical access in Finland
- Reimbursement Pathways for Psychedelic Therapies in Europe — Magnetar Access and Blossom (2025)
- Psychedelic Alpha: Worldwide psychedelic laws tracker
- EMA: Spravato (esketamine) EPAR
- ClinicalTrials.gov: studies in Finland (search)
This guide is for general information only and is not medical advice, a diagnosis, or a recommendation of any treatment. Reimbursement criteria and trial recruitment change; always verify current requirements with Kela, your clinic, or a licensed clinician who knows your history. If you are in crisis, call 112 or contact a crisis line immediately.
This guide awaits review by a licensed medical professional.