Psychiatric Care and Social Support for People with Long-Term Mental Illness in Sweden

Brinck, U

doi:10.1177/002076409404000403

Cited by 4 publications

(6 citation statements)

References 19 publications

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“…Despite these weaknesses, this study provides evidence on changes in the psychiatric inpatient utilization, as a possible result of the ongoing psychiatric reform programme in line with the recent developments in several European countries (Mangen, 1987;Tansella et al 1987; Thornicroft & Bebbington, 1989;De Salvia & Barbato, 1993;Brink, 1994;Bock, 1994;Madianos, 1994). However it seems that the existing number of community based alternatives to inpatient psychiatric care are still inadequate to diminish admissions in public mental hospitals and to accommodate the remaining long-stay psychiatric patients in the community.…”

Section: Discussionmentioning

confidence: 66%

Utilization of Psychiatric Inpatient Care in Greece: a Nationwide Study (1984-1996)

Madianos

Zacharakis²,

Tsitsa³

2000

Int J Soc Psychiatry

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This report examines the trends in the utilization of psychiatric inpatient care for the period 1984-1996, when the implementation of the psychiatric reform programme was initiated in Greece. Admissions in public mental hospitals declined by 7.2%. However discharges have been increased by 30.6% with a parallel decrease of the length of stay by 53.7% followed by an increase in discharges of patients diagnosed as suffering from schizophrenia and affective psychoses by 61.1% and 123.8% respectively. In the private sector a remarkable reduction in both admissions and discharges was noticed. Admissions in psychiatric departments of general hospitals for the same years have been increased by 1054.1%. It seems that the recent deinstitutionalization process resulted in increasing trends in the discharges of patients suffering from psychoses. Additionally, a substantial increase in the number of extramural psychiatric services and rehabilitation places between 1994-1996 was observed. The demand for the mental health care services expressed as the urbanization index was found to be related with mental health professionals and the extramural units ratios. The higher degree of urbanism is, the greater the number of extramural services exist. The models explained variance reached 50.6%.

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Section: Discussionmentioning

confidence: 66%

Utilization of Psychiatric Inpatient Care in Greece: a Nationwide Study (1984-1996)

Madianos

Zacharakis²,

Tsitsa³

2000

Int J Soc Psychiatry

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“…In 1992, a parliamentary commission was tasked with investigating access to services by the long-term, severely mentally ill, and its findings formed the basis for the subsequent 1995 reform (Arvidsson and Ericson, 2005: 187; Brinck, 1994: 265; Stefansson and Hansson, 2001: 83). 4 The commission concluded, among other things, that greater measures should be taken to rehabilitate the mentally ill and reintegrating them into society and the job market.…”

Section: The 1995 Psychiatry Reformmentioning

confidence: 99%

“…4 The commission concluded, among other things, that greater measures should be taken to rehabilitate the mentally ill and reintegrating them into society and the job market. Following from this, the Social Insurance Agency ( Försäkringskassan ) and local municipalities were given greater responsibilities than previously in terms of preparing mentally ill patients for a return to work, through various job-training and social rehabilitation programmes (Brinck, 1994: 265–6; Stefansson and Hansson, 2001: 82–4). Once begun in earnest, deinstitutionalisation was rapid and sweeping.…”

Section: The 1995 Psychiatry Reformmentioning

confidence: 99%

“…In the late 1960s, there had been approximately 33,000 psychiatric beds in Sweden, servicing a population of 7.5 million. At the start of the 21st century there were around 5000 beds left, in a population of just under 9 million (Arvidsson and Ericson, 2005: 186–7; Brinck, 1994: 258–61).…”

Section: The 1995 Psychiatry Reformmentioning

confidence: 99%

“…In the decade leading up to the 1995 Swedish psychiatry reform, the number of psychiatric inpatients diagnosed with personality disorders grew by 30% (Brinck, 1994: 261). This development can perhaps in part be attributed to the publication of the third edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980, which gave personality disorders a much more prominent place than in previous editions, and introduced BPD as a formal diagnosis for the first time.…”

Section: Borderline Personality Disorder Suicidality and The Creatimentioning

confidence: 99%

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Teaching ‘small and helpless’ women how to live: Dialectical Behaviour Therapy in Sweden, ca 1995–2005

Jansson

2018

History of the Human Sciences

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In 1995, a Swedish pilot study of Dialectical Behaviour Therapy (DBT) was launched to investigate its therapeutic efficacy and cost-effectiveness as treatment for Borderline Personality Disorder (BPD) in suicidal women. In the same year, a sweeping reform of psychiatric care commenced, dramatically reducing the number of beds by the end of the decade. The psychiatry reform was presented as an important factor prompting the need for a community-based treatment for Borderline patients. This article suggests that the introduction of DBT in Sweden, and its relationship to the reform, can only be adequately explained with reference to the wider political shift occurring at the time, whereby the Swedish welfare state and its guiding ethos of egalitarianism were abandoned in favour of a neoliberal ‘choice revolution’. With the new liberalism, hard work and individual responsibility replaced the idea of a Swedish ‘people’s home’, a nationwide community and social support network. This language was reflected in DBT, which sought to teach patients the ‘skills’ necessary ‘to create a life worth living’. In this context, therapy was constituted as a form of ‘work’ that the patient had to undertake to improve. Moreover, DBT rejected the prevailing view of Borderline patients as ‘manipulative’ and ‘aggressive’, suggesting instead that they were ‘helpless’, ‘weak’ and unable to regulate their emotions. This new Borderline persona fit neatly into the new liberal discourse: she could be taught to become a rational and independent person able to cope in a society that valued individual responsibility over social support.

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Managed Care in Europe

Sternai-Saraceno

1999

Manage or Perish?

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Psychiatric Care and Social Support for People with Long-Term Mental Illness in Sweden

Cited by 4 publications

References 19 publications

Utilization of Psychiatric Inpatient Care in Greece: a Nationwide Study (1984-1996)

Utilization of Psychiatric Inpatient Care in Greece: a Nationwide Study (1984-1996)

Teaching ‘small and helpless’ women how to live: Dialectical Behaviour Therapy in Sweden, ca 1995–2005

Managed Care in Europe

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