ABSTRACT
At the beginning of the twentieth century, psychiatry was seen by the state as an area for medical responsibility. In about 1900 the number of beds for psychiatric patients in Sweden was 4500: around the same as today’s number of psychiatric beds in relation to the population. Thousands of sick people waited for years to be given somewhere to go where they could be treated. Often they lived in miserable conditions in cellars or poorhouses. Around the turn of the twentieth century, a series of new psychiatric hospitals was built with room for up to 1000 or more patients in each. In the 1960s there were 34,000 places in mental hospitals (besides around 5000 for ‘retarded people’). This represents 0.5 per cent of the Swedish population, equal to the prevalence of schizophrenia (SOU 1958). Many more were on the waiting list. The effective exclusion of the psychically ill from the community has subsequently been strongly criticised, not least because of the chronic institutionalised state it can generate in patients. However, it is easy to be critical of this lack of outpatient care in retrospect. We must not forget the humanitarian ethos that lay behind the creation of such institutions, which addressed the needs of those who needed care but had been unable to get it.
