De-institutionalisation and trans-institutionalisation - changing trends of inpatient care in Norwegian mental health institutions 1950-2007
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
BACKGROUND: Over the last decades mental health services in most industrialised countries have been characterised by de-institutionalisation and different kinds of redistribution of patients. This article will examine the historical trends in Norway over the period 1950-2007, identify the patterns of change in service settings and discuss why the mental health services have been dramatically transformed in less than sixty years. METHODS: The presentation of the trends in the Norwegian mental health services and the outline of the major changes in the patterns of inpatient care over the period 1950-2007 is founded on five indicators: The average inpatient population, the number of discharges during a year, the average length of stay, the number of beds or places, and the occupancy rate (average inpatient population/beds). Data are reported by institutional setting. Multiple sources of data are used. In some cases it has been necessary to interpolate data due to missing data. RESULTS: New categories of institutions were established and closed during the 57 years period. De-hospitalisation started in Norway in the early 1970s, de-institutionalisation in general 15 years later. Six distinct periods are identified: The asylum period (-1955), institutionalisation and trans-institutionalisation (1955-65), stabilisation and onset of de-hospitalisation (1965-75), de-hospitalisation (1975-87), from nursing homes to community-based services (1988-98), and the national mental health program (1999-2007). There has been a significant reduction in the number of beds and in the average in-patient population. The average length of stay in institutions has been continuously reduced since 1955. The number of patients actually treated in psychiatric institutions has increased significantly. Accessibility, quality of care and treatment for most patients has improved during the period. The mental health system in Norway has recently been evaluated as better than the systems in USA, England and Canada. CONCLUSIONS: De-institutionalisation means fewer beds but not fewer patients treated, neither in institutions in general nor in psychiatric hospitals. The periods represent different kinds of de-, trans-, and even re-institutionalisation. Expansion of the welfare state, increased professional focus on active treatment and increased focus on patients' preferences are the factors that best explain de-institutionalisation in Norway.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it