STRUCTURAL-CHANGES AND THEIR CONSEQUENCES IN A NATURAL PSYCHIATRIC SECTOR - GOTLAND 1976-1981

  • 1 January 1983
    • journal article
    • research article
    • Vol. 6  (1) , 29-42
Abstract
In recent years discussions about the development of psychiatric care, internationally and in Scandinavia, have focused on principles of opening and sectorizing, sometimes at the cost of existing differentiated and effective psychiatric in-patient care-programs. During the last 6 yr a process of strengthening and opening psychiatric care was started on the Swedish island of Gotland (55,000 inhabitants), based on an existing mental hospital, utilizing the existing personnel, maintaining existing effective structures of institutional care and developing new ones in out-patient care. Principles of subspecialized psychiatric inpatient treatment were combined with ideas of sectorization, accessibility and openess. Apparently, it is possible to reach positive results, optimizing and opening up an existing institution, using a basic psychodynamic, synoptic and eclectic ideology, offering differentiated treatment programs and without the immediate use of sectorizing principles. Sectorization and accessibility without qualified treatment programs of in-patient care may not be a sufficient solution to all the problems found in psychiatric organizations. The positive results achieved probably have the naturally sectorized character of the island of Gotland as a presupposition. Principles of sectorization and differentiation seem in psychiatry not to be contrary but complementary. It seems to be legitimate, possible and effective to start a process of psychiatric evolution transforming an existing old-fashioned mental hospital.

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