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The forensic psychiatric clinics in Sweden are overcrowded. Archive image from the forensic psychiatric unit in Huddinge.
1 / 2Photo: Jessica Gow/TT
The forensic psychiatric clinics in Sweden are full. Not everyone who is sentenced to care gets a place and some are now out on the loose.
– It has escalated enormously in the last two years, says Pähr Forsberg at the regional clinic in Vadstena.
Nationally, the occupancy of forensic psychologists is 108 percent, according to the latest figures from SKR. The region with the lowest occupancy is 98 percent, the highest is a region with 144 percent.
Pähr Forsberg, director of operations at the regional clinic in Vadstena, which has 86 care places but 93 inpatients, believes that the numbers do not show how bad it actually is.
– The numbers only show which patients we managed to get in and that we are stretched to the limit. It does not show all the patients who should have been here.
In addition to caring for convicted persons, forensic psychiatry’s mission includes, if necessary, caring for arrested and detained persons as well as assisting adult psychiatry with particularly demanding patients. Forensic psychiatry in Östergötland cannot handle any of these tasks. And it has been like that for several years now, says Forsberg.
Full everywhere
In the past, regions have been able to solve place shortages by buying places in other parts of the country. Now it’s full everywhere.
– I think it’s been nine months since I even tried to call and get a place, I know, there are no places, he says.
A serious consequence is that forensic psychiatry is forced to place patients with general psychiatry. This means fewer places for those who are in need of care but who have not been convicted of a crime, says Susanne Andersson, chief medical officer at the forensic psychiatric clinic Karsudden outside Katrineholm.
– If it doesn’t calm down, it will become a very serious problem, mainly based on the impoverishment of general psychiatric care, she says.
– In my years, I have never seen such a coating as we have today, when I look across the country.
Pähr Forsberg also says that the situation is unprecedented.
– It has escalated enormously in the last two years.
The lack of places is mainly due to the sharp increase in the length of care. We don’t know for sure what this is due to, the matter must be investigated by SKR.
Convicted at large
Today, Östergötland is judged to lack 38 care places to cope with the task. The consequence is that you have twelve convicted persons who are either in custody or are at large awaiting trial.
The person who has been free the longest would have started their treatment in April 2023, says Forsberg.
– I am saddened that we have people who are seriously ill who do not receive the care they are entitled to. Then, of course, it would be terrible if they committed renewed crimes because we failed to fulfill the social protection mission. It’s a scary thought.
FACT Forensic psychiatric care
Anyone who suffers from a serious mental disorder and commits a crime should not be sentenced to prison, but to forensic psychiatric care. For most people who are sentenced to forensic psychiatric care, a so-called special discharge examination (SUP) is also decided.
SUP means that the administrative court, not the chief medical officer, decides when a patient is discharged. In those cases, the court must make an overall assessment of the person’s situation, where particular consideration is given to the risk of recidivism.
In 2023, forensic psychiatric care was the main sanction in 331 verdicts, of which 51 were against women and 280 against men. Compared to 2014, the number of verdicts with forensic psychiatric care as the main penalty has increased by 27 percent.
At the same time as more people have been sentenced to forensic psychiatric care, the length of care has increased over several years.
In 2023, roughly 2,000 people were cared for in forensic psychiatric inpatient care.
Source: Brå, SKR
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