Friday, May 09, 2014

Tell Me About Sweden

I've been delving into a recently published study from Sweden that was mentioned here in the Wall Street Journal. The study looked at the effects of psychiatric medication compliance on violent crime. It's interesting and intriguing but I have to say I'm struggling to see how or if this may be applicable to people in the United States. Thus, this blog post. I know from Google analytics that we've had almost 5000 page views from readers in Sweden this month alone. I know that many of our blog readers are patients. Please, tell me about your mental health care system. From the paper I know that your legal system is very different from ours: you essentially have no insanity defense. It appears that the only time mental state issues come into consideration is at sentencing. This means we really can't know how many of those violent crimes actually were due to psychiatric symptoms.

But beyond that fact, I'd like to know how the community response to mental health issues may be different and about differences in the system of care.

Some questions, off the top of my head:
-Are there mobile treatment teams that respond on site to patients in crisis?
-What is the emergency evaluation process, how long does it take, does it work?
-If there is an emergency response, how often do patients get taken to a hospital vs some other alternative?
-What are the involuntary medication laws like? How often is this pursued? How often ordered vs not?
-Are outpatient services integrated with substance abuse treatment and medical care?
-How long does it take to get into outpatient treatment?
-Is there legal enforcement for outpatient treatment? What does it look like? How often is it sought?
-Are there pretrial diversion programs for mentally ill people who get arrested and charged with crimes?
-Any thing else you'd like to tell me?

Don't be limited by my questions. I have trouble believing that a single intervention like medication should have such a significant impact on crime. Disclaimer: this is probably going to be my next Clinical Psychiatry News column, so you may be quoted.


Anonymous Liz said...

i'm so interested now to hear this as well. great questions!

Anonymous said...


Tell us more about neighboring Finland, which is seeing an 80 percent full-recovery rate for "schizophrenia", without drugs:℠/


Anonymous said...

In fairness, with very limited use of psychiatric drugs.