Psychiatric Care In Sweden Research Articles

Psychiatric care as seen by the attempted suicide patient.

Psychiatric care as seen by the attempted suicide patient This study highlights the experiences of patients during in-patient psychiatric care in Sweden following a suicide attempt. Eighteen patients were interviewed as close to being discharged as possible. Each respondent was asked to narrate his/her experiences of the care received. An interview guide concerned the following areas: admission to the hospital, feelings and reactions, and positive as well as negative experiences during the hospital stay. The interviews were transcribed verbatim and a qualitative content analysis concerning the meanings, intuitions, consequences and the context of the data was performed. Three central categories were identified: being a psychiatric patient, patients' perceptions of the caregivers and the care provided, as well as important aspects of the psychiatric care received. The importance of being well cared for and receiving understanding and confirmation was emphasized. Lack of confirmation may have contributed in some cases to a feeling of being burdensome, demands for discharge or even another suicide attempt. Verbal contacts with the staff were seen as essential for the process of healing and for the desire to go on living.

Factors Influencing Job Satisfaction Among Swedish Occupational Therapists in Psychiatric Care

This study examined job satisfaction among occupational therapists in Swedish psychiatric care, and investigated how clinical supervision, organizational aspects and demographic characteristics contributed to job satisfaction. We received 332 returned questionnaires, corresponding to a response rate of 66.9%. Job satisfaction factors that emerged were: general satisfaction with work, communication and co-operation among team members, managerial feedback, the patients' influence on care and the relatives' influence on care. The respondents rated their general satisfaction, co-operation and communication as high. They were least satisfied with the relatives' influence on care. We found few relationships between other factors and job satisfaction, but, for example, satisfaction with the patients' influence on care was higher among occupational therapists working in outpatient care than among those working in hospital wards. Furthermore, having supervision was positively associated with co-operation and communication. This study revealed a fairly satisfactory situation, possibly thanks to social support, advantageous care-planning strategies and supervision. However, managerial staff must be aware that measures need to be taken continuously to counteract detrimental forces. The study pointed to a need for further research that relates occupational therapists' job satisfaction with issues such as support, control and individual need for growth.

Practice Models in Swedish Psychiatric Occupational Therapy

In clinical settings, occupational therapists need models both from their own field, occupational therapy, and from other fields in order to offer the clients adequate treatment. It is unknown which theoretical approaches and practice models influence Swedish occupational therapists' daily work. In this study a questionnaire (n=334) was used to investigate approaches and models used in Swedish psychiatric care service and in psychiatric occupational therapy service. The results showed that the psychosocial approach influenced both psychiatric care and psychiatric occupational therapy most. The most frequently used practice model was the Model of Human Occupation. However, 75% of the respondents did not identify theoretical thinking based on models from their own field behind their actions. Many practitioners seemed to use knowledge developed by other disciplines more often. Years of clinical experience in the profession or education did not seem to have any impact on the ability to identify the practice models that were used. The results indicate that education in occupational therapy must emphasize knowledge in its own field more than has been done up to now.

Compulsory psychiatric care in Sweden 1979-1993. Prevalence of committed patients, discharge rates and area variation.

The prevalence of committed patients in mental health care from seven different inventories between 1979 and 1993 and rates of discharge from compulsory psychiatric care during 1984, 1988 and between 1 July 1992 and 30 June 1993 were studied by using statistics from the Swedish National Board of Health and Welfare. Changes over time and area variation in prevalence and discharge rates were analysed in relation to mental commitment law reform, urbanization, number of psychiatric beds and locus of short-term psychiatric care. The prevalence of committed patients in psychiatric in-patient care and the discharge rates from compulsory psychiatric care rapidly decreased during the periods studied. Legal reforms in 1983 and 1992, which led to a strengthened legal influence on compulsory care procedures, were followed by further reductions in the use of compulsory psychiatric care. The reductions were found not only among patients with psychotic conditions, but also among patients given other diagnoses. The proportion of committed patients in relation to the total number of in-patients increased during the latter half of the 1980s. Area variations in the 26 counties (or corresponding health administrative areas) were significant and increased after the new legislation in 1992. The three large city areas had higher psychiatric bed rates and also higher compulsory care rates than other areas in the country. In the counties outside the large city areas, no connection was found between number of beds and prevalence of committed patients, and no relation was found between locus of care and rates of compulsory psychiatric care.

The impact on occupational therapists of the reorganisation of psychiatric care in Sweden

AbstractThe present study focuses on the on‐going reorganisation of psychiatric care in a major county council in Sweden. The aim of this study is to describe the impact of these changes from the perspective of one group of occupational therapists. Data were collected by a mailed questionnaire. Results showed an acceptance of the current policies towards restructuring psychiatric care, especially on the focus on alternative living and work/occupational facilities. Strong criticism was raised concerning the lack of trans‐institutional facilities. Loneliness and isohtion were seen as a main problem of the patients. Strong doubts were raised concerning independent living as the best alternative for most of the patients. The new professional role in community psychiatric care has brought the occupational therapist closer to die individual patient. Feelings of shortcomings and frustration in this group of occupational therapists regarding the reorganisation of psychiatric care were linked to the insufficiency of community support facilities designed to meet these new challenges.

Management of suicide attempters in psychiatric care in Sweden:Evaluation of a questionnaire to psychiatric care providers

A questionnaire sent to psychiatric care providers in Sweden contained questions on the management of suicide attempters. Routines for admission, psychiatric consultation for suicide risk assessment, and follow-up after discharge were focused on. Participation was satisfactory: 89 of 111 (80%) questionnaires were answered. In two of three districts, specific routines for the management of suicidal patients had been included in written memoranda. In 73% of the districts, all patients referred to the somatic emergency ward were assessed by a physician from the department of psychiatry; in 61% of these, however, the physician was not always a specialized psychiatrist. Rating scales for assessment of suicide risk were used in 22% of the districts. Special follow-up approaches after suicide attempts were rarely available, nor was there any registration of suicide attempts. Nevertheless, almost all psychiatric care providers had a very positive attitude towards a continuous effort to develop better routines.

The Development of Psychiatric Care in Sweden

It is unlikely that any other branch of Western medicine is going through radical changes in its organizational structure comparable with those in psychiatry. In fact, whereas the second half of the 19th century will be remembered as the epoch that saw the rapid expansion of the hospital the second half of the 20th century will probably go down in history as the period when a reverse movement, from the hospital back to the community, took place. The pace of this movement of restructuring mental health care has been so rapid in recent decades in most countries as to make it difficult to collect

Sjukhusvård ay psykiskt långtidssjuka på väg att upphöra: En beskrivning av den aktuella utvecklingen inom ett svenskt landstingsområde, Västmanland

Psychiatric care in Sweden is presently undergoing the same rapid change that is going on in other countries. In some parts of Sweden the change will mean that the former state mental hospitals will be closed down completely, because all short-term care will be located to the general hospitals and extended out-patient care, using new care alternatives, will be responsible for the long-term mentally ill. The situation for the county of Vastmanland is described in detail. Here, care in mental hospitals will be completely discontinued by the end of1987. Compulsory care is decreasing and it is estimated that total care in psychiatric institutions will be less than 1 place per 1 000 inhabitants within a few years. At the same time the number of out-patient visits and visits to day care centres situated in the local communities is increasing continually. The results of patient surveys are presented. A survey carried out by the primary health care authorities and the social services documents the existence of me...

Psychiatric Care in a Sparsely Populated Area in Northern Sweden

The organization of psychiatric care in Sweden has much in common with that in other Western countries. During the second half of the 19th century, a number of mental hospitals, covering quite large areas, were built. Mental patients at small general hospitals who were not well enough to go home after six weeks of treatment were sent to the regional mental hospitals. In northern Sweden the first mental hospital was built in 1845, in Harnosand; others were opened in Pitea, in 1893, and in ostersund, in 1915. Until 1967 the mental hospitals were run by the state, but they have since been taken over by the county councils; all of Sweden's psychiatric care has become the responsibility of the county councils, which has made more comprehensive care possible. Since the 1930s, especially since World War II, psychiatric clinics have been established at some of the larger general hospitals.

The Swedish Medical Association's basic programme regarding psychiatric care in Sweden

The essential purposes of the basic programme for psychiatric care drawn up by the Swedish Medical Association are as follows. In principle, a necessary condition for the courses which should be chosen when carrying out these measures is a coordinated mental health service, divided into the care of acute and chronic cases and including rehabilitation and treatment of the disabled, in the same way as has been found rational in somatic medical care, with the modifications made necessary by reason of the special nature of the psychiatric discipline. Finally, the basic programme confirms that a speedy modernization of the mental health services in Sweden, in order to render them more effective, is an urgent necessity and must be commenced immediately. The work of carrying out this programme must, however, be distributed over a number of years.