Severely and persistently mentally ill—A changing group. Ten years after the 1995 Swedish mental health care reform

Abstract

Aim: A mental health care reform was implemented in Sweden in 1995. The target group of the reform was persons considered severely and persistently mentally ill (SMI). The aim of this article was to study changes in the target group 10 years after the reform, i.e. changes in the group of persons defined as SMI. Methods: Inventories of persons considered SMI were made in a municipality of Sweden in 1995/96, 2000/2001 and 2006 based on the same definition. The invented persons were interviewed. The same interview procedures, questionnaires and need assessments were used on all three occasions. The results were based on comparing the new groups considered SMI in 2000/2001 and 2006. Results: In 2006, the group of persons considered SMI was younger. Fewer persons with a diagnosis of schizophrenia and more persons with a diagnosis of mood disorders or addictive problems were included. Problems concerning relations and physical health were more evident. A greater part had all their income from social security in 2006, and fewer persons were occupied in some kind of salaried employment, full-time or half-time, regular or sheltered. Conclusion: The target group of the reform had changed and other groups of persons were considered SMI in 2006. These new groups require other strategies of care.