Deborah Finkel1,2, Pia H Bülow3,4, Monika Wilińska3, Magnus Jegermalm1,3,5, Cristina Joy Torgé1, Marie Ernsth Bravell1, Per Bülow3,6,7. 1. Institute for Gerontology, School of Health and Welfare, Jönköping University, Sweden. 2. Department of Psychology, Indiana University Southeast, USA. 3. Department of Social Work, School of Health and Welfare, Jönköping University, Sweden. 4. Department of Social Work, University of the Free State, South Africa. 5. Department of Social Work, Ersta Sköndal Bräcke University College, Sweden. 6. Regional Forensic Psychiatric Hospital, Vadstena, Sweden. 7. Psychiatric Clinic, Ryhov County Hospital, Region Jönköping County, Sweden.
Abstract
OBJECTIVES: As part of the process of de-institutionalization in the Swedish mental healthcare system, a reform was implemented in 1995, moving the responsibility for services and social support for people with severe mental illness (SMI) from the regional level to the municipalities. In many ways, older people with SMI were neglected in this changing landscape of psychiatric care. The aim of this study is to investigate functional levels, living conditions, need of support in daily life, and how these aspects changed over time for older people with SMI. METHODS: In this study we used data from surveys collected in 1996, 2001, 2006, and 2011 and data from national registers. A group of older adults with severe persistent mental illness (SMI-O:P) was identified and divided into those who experienced shorter stays (less than 3 years) in a mental hospital (N = 118) and longer stays (N = 117). RESULTS: After correcting for longitudinal changes with age, the longer-stay group was more likely than the shorter-stay group to experience functional difficulties and as a result, were more likely to have experienced 're-institutionalization' to another care setting, as opposed to living independently. CONCLUSIONS: The length of mental illness hospitalization has significant effects on the living conditions of older people with SMI and their ability to participate in social life.
OBJECTIVES: As part of the process of de-institutionalization in the Swedish mental healthcare system, a reform was implemented in 1995, moving the responsibility for services and social support for people with severe mental illness (SMI) from the regional level to the municipalities. In many ways, older people with SMI were neglected in this changing landscape of psychiatric care. The aim of this study is to investigate functional levels, living conditions, need of support in daily life, and how these aspects changed over time for older people with SMI. METHODS: In this study we used data from surveys collected in 1996, 2001, 2006, and 2011 and data from national registers. A group of older adults with severe persistent mental illness (SMI-O:P) was identified and divided into those who experienced shorter stays (less than 3 years) in a mental hospital (N = 118) and longer stays (N = 117). RESULTS: After correcting for longitudinal changes with age, the longer-stay group was more likely than the shorter-stay group to experience functional difficulties and as a result, were more likely to have experienced 're-institutionalization' to another care setting, as opposed to living independently. CONCLUSIONS: The length of mental illness hospitalization has significant effects on the living conditions of older people with SMI and their ability to participate in social life.
Authors: Pia H Bülow; Deborah Finkel; Monika Allgurin; Cristina Joy Torgé; Magnus Jegermalm; Marie Ernsth-Bravell; Per Bülow Journal: Int J Ment Health Syst Date: 2022-07-13