The cornerstone of unity

104 “MAD” JOKES
Low self-
esteem is one of mentally ill people’s main problems, so in the 1990s the Finnish Central Association 
for Mental Health organised a diverse project to strengthen the self-esteem of its members. One part of this was 
to collect jokes, anecdotes and stories about mentally ill people, mental hospitals and psychiatrists. 
Association members were the main collectors, but mental hospital staff members were also invited to 
participate. The amount of material collected surpassed all expectations. The mentally ill people themselves 
were very enthusiastic, and in carrying out their task they learned to laugh at themselves, which is seen as a 
very important precondition for rehabilitation. About 90% of the jokes were gathered by people in rehabilitation. 
There were around 850 jokes and anecdotes, of which the writer Kalevi Kalemaa used 400 to compile a book 
called Can you fish in the toilet bowl? The book received a lot of publicity and sold as many as 30,000 copies, 
which is quite a high number in the Finnish context. When the book was published, Kalemaa and the 
association’s executive director Jussi Särkelä organised highly successful comedy events in different mental 
health associations across Finland. 
Mary returned a toilet bowl brush she had bought two days ago to the shop. 
– What’s wrong with it? asked the salesperson. 
– There might not be anything wrong with it at all, said Mary,
but paper is much more convenient. 
Although the feedback about collecting the jokes was mainly positive, there was also some resistance, e.g. 

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from some mentally ill people who, understandably, were unable to accept jokes being made about such a 
serious issue. The most sensitive people, however, were mentally ill people’s families, which can be explained 
by the fact that mental illness is a great burden on close relatives too. Another reason is that close relatives are 
often asked to carry more responsibility for the patient’s welfare than they would have to if social services were 
better able to meet their needs with regards to care and rehabilitation. 
The collecting of mental hospital jokes did not end with the book, but was spontaneously continued by some 
mentally ill people. One of the main hopes of the Finnish Central Association for Mental Health was realised in 
that the activity became decentralised and took place in local mental health associations. Now there are more 
than 20 000 members in about 150 local mental health associations. 
The improved self-esteem and empowerment of mentally ill people and the knowledge they gained about the 
important role that the association plays have had the effect of making the central association’s strategies and 
policies more and more clearly influenced by the needs and wishes of grassroots members. 
Jussi Särkelä 
– non-fiction writer,
former CEO of Finnish Central Association for Mental Health