Stöd till personer med psykisk funktionsnedsättning
– etablering av ett nytt verksamhetsfält
Establishment of community mental health services in Sweden
Care and support for people with psychiatric disabilities has been subject to significant changes during recent decades. Institution-based forms of care have been replaced by policies focused on inclusion and participation in society, and by a new field of community-oriented services. The formal responsibility for supporting the target group has largely shifted from mental health care to municipal social services. This article characterizes this new field of expertise, and discusses a number of current themes that seem to influence the extent to which policy-level objectives can be achieved. One theme is the establishment of a knowledge base regarding community-based services, in which local development work and academic research have sometimes enriched each other. Individual support towards employment is used as one example of a model developed through a combination of service innovation and research. Another theme concerns the concept of personal recovery, which has contributed to a new ideological orientation, where the lived experience of service users and issues of participation and involvement are emphasized. Furthermore, the problem of in-real-life implementation is discussed. A significant share of the current knowledge on effective service and support is never implemented in real practice, neither at a national nor a local organizational level. This ”treatment gap” should be considered as one of the primary challenges in community mental health services today. This article highlights a study where researchers sought to identify critical components for long-term establishment of evidence-based services. Finally, the field of community mental health services is portrayed as slowly establishing both organizational forms and a foundation of research- and experience-based knowledge.