The closure of a mental hospital in Sweden

5 years of transition to district-based long-term care
  • Karina Dencker
  • Göran Långström
Original Articles


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.

Key words

ADL Deinstitutionalization Elderly Mental hospital Mortality 


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Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • Karina Dencker
    • 1
  • Göran Långström
    • 1
  1. 1.Department of Psychiatry and NeurochemistryUniversity of Göteborg, Mölndal HospitalMölndalSweden

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