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After the Asylum? The New Institutional Landscape.

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Area of Science:

  • Mental Health Services Research
  • Social Psychiatry
  • Public Health Policy

Background:

  • Significant transformations in mental healthcare services for individuals with severe mental health issues have occurred over recent decades.
  • Key terms describing these changes include deinstitutionalization, transinstitutionalization, and dehospitalization.
  • The study examines the evolving institutional landscape following the closure of mental hospitals within a welfare society context.

Purpose of the Study:

  • To collect data on the changes in the institutional landscape for individuals with severe mental health problems.
  • To analyze the impact of deinstitutionalization and evolving service models.
  • To understand the role of various agencies in the care of individuals with psychosis.

Main Methods:

  • Data collected from local and national registers for 1355 individuals diagnosed with psychosis in Stockholm (2004-2008).
  • Included data on interventions from social welfare, psychiatric care, and prisons.
  • Also collected data on cause of death and socio-economic status.

Main Results:

  • Psychiatric in-patient care and prisons have become marginalized service providers.
  • Open care interventions reached a large number of individuals.
  • Social welfare agencies are increasingly central to the service network.

Conclusions:

  • The traditional large mental institutions have been replaced by a network of smaller, 'micro-institutions'.
  • These new structures provide both assistance and forms of control.
  • The findings highlight a significant shift in the delivery and management of mental health services.