Changes in the utilization of psychiatric hospital facilities in Denmark by patients diagnosed with schizophrenia from 1970 through 2012: The advent of 'revolving door' patients.

OBJECTIVE: The Danish psychiatric system has gone through several structural changes in the last four decades. The deinstitutionalization of the mental healthcare system was implemented in Denmark in the late 1970s with the intention of increasing out-patient treatment. One of the aims in the reorganization was to treat the patient in the local environment rather than during long-term hospitalization. This study focuses on the changes in the utilization of hospital facilities. METHOD: Using register data from secondary healthcare treatment of patients diagnosed with schizophrenia in Denmark 1970-2012, we analysed the development in the use of hospital facilities. RESULTS: Our major finding was a 220% increase between 1970 and 2012 in the total number of hospital admissions due to schizophrenia each year, while at the same time the number of annual schizophrenia bed days was reduced by 76%. Furthermore, the readmission rate within a year after discharge with a diagnosis of schizophrenia reached 70% in 2012 compared to 51% in 1970. Finally, the total bed occupancy continued to rise over the four decades and has exceeded 100% in several years since 1999. CONCLUSION: The findings indicate that the reorganization of the Danish mental healthcare system has created a problem of 'revolving door' schizophrenia patients' who since the 1970s have been increasingly hospitalized but for shorter periods. Possible explanations of the findings are premature discharge of patients with schizophrenia due to lack of beds or/and that community psychiatry has not been providing adequate relapse prevention.

The development of social capital through football and running: studying an intervention program for inactive women.

This article examines the development of social capital through the use and dynamics of different types of stories ("I,""we" and "they") as described by Robert D. Putnam. The data come from a research project in which inactive women participated in a 16-week intervention program of physical exercise, either in the form of football or running. The study shows a positive development of social capital in the two different types of physical activity. The I-stories show themselves to be central to bonding within the two groups and bridging outside the groups (developing and/or creating networks). The study also points to the importance of the activity itself for internal bonding illustrated through we- and they-stories. Our data indicate that team sports, such as football, may have an advantage over individual sports in the development of social capital.