title: The closure of a mental hospital in Sweden. 5 years of transition to district-based long-term care.
abstract: A political decision to decentralize psychiatric care in a county of Sweden was made in October 1984. This will lead to the closure of the county's only large psychiatric hospital. Short-term psychiatric care will be provided by three smaller hospitals in the county, while long-term care in hospital will cease completely and be replaced by district-based psychiatric services. All patients (n = 199) in the large hospital's long-term unit were studied over 5 years of the transition period. The results showed that 42% of patients were discharged during the period, mainly to other institutions. Only 8 patients were provided with alternative types of care, such as group homes. Sixty-eight per cent of all patients died, most of them before being discharged (80% of the organically demented patients and 51% of the others). The mortality rate for patients with severely impaired activities of daily living (ADL functioning) was 92% for those who were also organically demented and 84% for the others. The patients who survived the 5-year period were mainly (80%) nondemented patients with relatively well-preserved ADL functioning, but with behavioural disturbances.
authors.affiliation: Department of Psychiatry and Neurochemistry, University of Göteborg, Mölndal Hospital, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Dencker
authors.forename: G
authors.initials: G
authors.lastname: Långström
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D003688:Deinstitutionalization; D003704:Dementia / Q000175:diagnosis; D005260:Female; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis / Q000534:rehabilitation*; D008875:Middle Aged; D009735:Nursing Homes; D011569:Psychiatric Status Rating Scales; D013548:Sweden