Sectorized psychiatry: Some characteristics of patient population after reorganisation

Abstract

The University Department of Psychiatry at the Haukeland General Hospital in Bergen, Norway, assumed 1976 the comprehensive responsibility for the mental health service in a geographically defined population in the county of Hordaland, Western Norway. The aims were to guarantee an all-round mental health service, in collaboration with the primary health and social services in geographical proximity to the patients' residence. Changes in demographic and clinical patterns and in the degree of collaboration with the primary health service in the community, were studied by comparing a three year period before, and after the reorganisation. The number of voluntary as well as compulsory admission increased considerably, while the average stay in hospital progressively decreased. Patients with psychotic states, andor heavy social problems, such as isolation and/or unemployment, increased in number. A decreased number of in- as well as out-patients was referred back to the primary health service. The necessary conditions for the fullfillment of the aims of comprehensive mental health care seem to lie both in adequate psychiatric resources for treatment and rehabilitation in the catchment area and in an effective collaboration with the primary health service. Fred Holsten är docent vid Psykiatrisk Institutt, Haukeland sykehus, Universitetet i Bergen och Giacomo d'Elia är professor i psykiatri, Psykiatriska institutionen, Universitetet i Linköping. Under åre, 1978–1981 har han varit professor i psykiatri, Psykiatrisk Institutt, Haukeland sykehus, Bergen.