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Psychoanalytic psychotherapy is one of the most commonly practiced psychotherapy orientations in Finland. It has secured continuity in the recently renewed university-based educational programs for training psychotherapists, although the proportion of psychoanalytic therapists in relation to other orientations has been decreasing during the past decade. Psychodynamic psychotherapy is reasonably well acknowledged in the Finnish Current Care Guidelines as one option in the treatment of the most common mental disorders, due to recent advances in effectiveness research. There is funding provided by the national insurance system for patients attending long-term rehabilitative psychotherapy. It has been shown to be effective and allows access to up to 3-year long psychotherapy for persons who need help for improving their lowered ability to work or to progress in their studies. However, greater focus on evidence-based short-term treatment models and more strained competition of the public mental health-care resources are expected. In order to survive the struggle, proponents of psychoanalytic psychotherapy need to be active in securing high quality of service delivery and in helping the health care system and political decision makers to recognize the value of our approach. As an example, we present experiences of a successful implementation of the Mentalization-Based Treatment. A viable future of psychoanalytic psychotherapy is highly dependent of continuing high-quality, clinically relevant research and psychotherapist training, as well as organizational cooperation in these areas and in health policy issues.