Assuntos
Distinções e Prêmios , Psiquiatria , Finlândia , História do Século XX , Humanos , Psiquiatria/história , Sociedades MédicasRESUMO
This study reports the 10-year evaluation of the Finnish National Schizophrenia Project. The aims of the national project were achieved. The number of long-stay schizophrenic patients in psychiatric hospitals decreased by 63% between 1982 and 1992. Both the treatment of schizophrenic patients and the structure of mental health services have changed greatly in Finland. Psychosocial treatment methods in particular have developed. The major innovations of the Project are the acute psychosis teams now serving over 50% of the country, and social skills training programmes. The 10-year evaluation of the Finnish National Schizophrenia Project shows that it is possible to conduct successfully nation-wide projects to develop the treatment of schizophrenic patients and psychiatric practices across an entire country.
Assuntos
Programas Nacionais de Saúde/tendências , Admissão do Paciente/tendências , Esquizofrenia/reabilitação , Atividades Cotidianas/psicologia , Terapia Combinada , Estudos Transversais , Finlândia/epidemiologia , Seguimentos , Previsões , Humanos , Incidência , Assistência de Longa Duração/tendências , Equipe de Assistência ao Paciente/tendências , Avaliação de Programas e Projetos de Saúde , Esquizofrenia/epidemiologia , Esquizofrenia/etiologiaRESUMO
Admission to a close ward was analyzed at the Department of Psychiatry, University of Oulu using 888 patients and their 1861 assessment and treatment episodes. Of all referrals for involuntary assessment (n = 237, 12.7% of all episodes) a total of 44 (2.4%) used "questionable" juridical criteria: the final diagnosis was not psychosis. In the follow-up, the admission of the questionable patients was mainly considered a clinical necessity, and at least one third of them were diagnosed as being psychotic and 2 committed suicide. An elevated probability of belonging to the questionable group was seen among patients in their first treatment episode, with minimal professional education, female sex, short treatment time, or residence in a rural area. The result suggests that some inequality existed between women and men, less and more educated and residents of urban and rural areas. The results also reflect conflict between the ethics and clinical practice of involuntary commitment, and the phrasing of the law, especially its diagnostic limitation to psychotic states only.
