Before I tell you about what actually happenened, how I ended up in hospital and how my time there was, let me explain the Swedish system a bit. There are no mental hospitals in Sweden, unless you are talking about forensic psychiatry. There are facilities for mentally ill criminals who are too ill to be in prison. In some of these hospitals they also keep severe cases of the mentally ill, self-harmers, people who have tried to kill themselves too many times. It's kind of the final destination for the people the system has given up on. It's actually quite a disgrace that they keep self-harming women in the same facilities as schizophrenic murderers. There have been a lot of debates about that in Sweden this year because these young women are treated badly and as it all happens behind closed doors, no one really knows what's going on. So that's the only kind of "proper" mental hospitals there are in Sweden.
They closed down all asylums in the 1990s and let everyone who had been in there out. Yes, they released all mental patients at once from all mental hospitals. Crazy, eh? So since then there is polyclinic and inpatient care. At the polyclinic you meet therapists, doctors and nurses and it's basically built up like a GP's office. Well, apart from all the security, they have lots of codes and locked doors there. The receptionists are bhind glass. I guess some mental patients can get quite agressive so it's good to be precautionary. So that's where you get therapy and have meetings with psychiatrists. They are often huge places, where I go they have around 30 therapists and 10 psychiatrists. They have an emergency number, an emergency pschiatrist and an emergency team to come and visit you. They are only avaiable until 10 p.m.. Mind you, not all polyclinics have that. You go there voluntarily but I also know of people who are forced to attend therapy because they have antisocial personality disorder.
The contact you have with the professionals isn't really personal. I get therapy 45 minutes a week and meet a psychiatrist maybe once every six months. You don't get the number to your psychiatrist and you are only allowed to call your therapist when you are in crisis. They have many patients so they really don't have the time to put a lot of energy into one case. They have time-guidelines to follow, it's all quite capitalistic. Like, CBT is only 12 weeks, then you are supposed to be "cured". Another thing is that most of these polyclinics are owned by private companies now, not by the state. So it's really all about money and efficiency. That's something we have the right-wing government to thank for.
Then there is inpatient care. As there aren't any mental hospitals, the psych units are in normal hospitals. How many units there are is really based upon how big the hospital is and where in the country you are living. The hospital I've been at is the biggest one in the country and it's in Stockholm. So they have 9 units (I think). There is one for intensive care, two for general care, two for psychotic patients and two for affective patients (bipolar, manic). Each unit holds around 25 patients (I think officially there is only place for 20 but they try to "make place" by putting two beds into a one-bed room). The intense care is mostly for violent patients. There is one hospital in Stockholm who has a psychiatric emergency room which is huge and they are open 24/7. You always run into high addicts there which I find quite uncomfortable.
So how do you end up in inpatient care? The most common reason is that you have been sent there by your polyclinic. You will have to have met a psychiatrist who assessed you. They will fix a place for you if they feel there is a need for that. Then there is the ambulance but they always take you to the huge psych ER which means many hours of waiting with addicts and psychotic patients. And then there is the possibility to call a special crisis number. They will tell you to come in and get assessed by a psychiatrist. I have done that a few times. Well, I didn't call, my man did and they told me to come in. That's how I got admitted the first time ever.
And there's voluntary and involuntary treatment. Either you seek help or they section you. There are quite strong laws when it comes to sectioning but if you had been sectioned once, it is easier to section you again. Bascially, you have to have serious mental illness, you need to be a danger to yourself or others and you need to refuse to get admitted. I have always been at the inpatient care voluntarily. But it's not easy to get in in the first place. A depression won't do it. A panic attack won't do. You need to have hit rock bottom, you need to be a milimeter from suicide. Oh, and after a suicide attempt you always get sectioned.
So that's what the system looks like in Sweden. I just thought I'd explain all that before I'll tell the story of my last visit to the psych unit.
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