Mellansjö school-home. Psychopathic children admitted 1928-1940, their social adaptation over 30 years: a longitudinal prospective follow-up.

The school-home for "psychopathic" children, Mellansjö, was founded in 1928. The initiator was Alice Hellström, a teacher and physician. She was a child psychiatric pioneer in Sweden. She had no formal education in child and adolescent psychiatry but with support from Professor of Paediatrics Isaac Jundell she received education in pediatrics and from Professor of Psychiatry Bror Gadelius she was trained in psychiatry. Hellström made a study trip to Europe where she visited child psychiatry clinics. She visited Summerhill in England and professors Aichhorn and Lazar in Austria. When Hellström opened the school-home she had been influenced by a number of factors, including the ideas behind the Swedish Child Welfare Law of 1924. She was also influenced by curative education and the psychoanalysis theory. She regretted that she lacked psychoanalytical training, however. Hellström was responsible for Mellansjö during the period 1928-56. Total admissions of 387 boys and 235 girls were recorded. Hellström planned a prospective longitudinal study with support from Jundell. Her intention was to describe the outcome of the children. She collected background and follow-up data from 1928 to 1968. She was unable to complete her project before she died in 1981 at the age of 95. The study has been completed with a consistent examination and follow-up of the 242 children treated between 1928 and 1940. This can help us to understand child psychiatric patients from the 1930s and obtain knowledge about their outcome. Such knowledge is important for understanding how evolution in society can activate child and adolescent psychiatry and how new forms of treatment have something to provide beyond those that already exist. The follow-up showed that 55% of the boys and 89% of the girls had an outcome without criminality and/or alcoholism in spite of difficult adjustment problems during childhood and were considered to be "psychopaths" in the 30s. However, 45% of the boys developed criminality and/or alcoholism despite early discovery and treatment. This group of boys is characterized by heredity for mental insanity, criminality or alcoholism, low social class, word-blindness and pilfering--a special hypothesis put forward in accordance with Hellström's own intentions. "Children who have a heredity of addictions, criminality and mental disease, a vulnerability revealed in behaviour problems and learning difficulties in the absence of mental retardation run a greater risk of developing addictions and criminality."(ABSTRACT TRUNCATED AT 400 WORDS)