Few countries (if any) have experienced the abundance of material welfare Norway has had for the last decades. The report of the Organisation for Economic Co-operation and Development (OECD) for 2004 places Norway on the very top of the list of ‘best countries to live in’. One might therefore expect that mental disorders would not thrive in Norway, but this is not so.
Norway is a constitutional monarchy: its parliament decides new laws; a government with a parliamentary basis executes political decisions; and the judicial system interprets and enforces the laws.
The total population is about 4.5 million, approximately 1 million of whom are under 18 years of age. The population is concentrated around the major cities in the southern part of the country, Oslo, Bergen and Stavanger; large areas of the country feature only small towns and villages and a scattered population. This creates challenges for the provision of an equal health service to all the country's inhabitants.
The predominant political ideology throughout the last 50 years has been based on social democratic ideas of equality in health and social services and education. Therefore most health services are in the public sector, in which hospital treatments are free and most out-patient services are financed by public means. Patients pay a small amount, not exceeding 150 euros per year. Over the last decade, the number of private services have increased, some of which are purchased by the public healthcare system. In the mental health services, this has given rise to private services for people with less severe disorders, who would otherwise fall outside the priorities of the public system.
History of mental healthcare
Norway passed a Law of the Treatment and Care of the Insane in 1848. It declared that the responsibility for the care of the insane was the government's. A Control Commission was established to inspect the asylums and the private residencies that lodged people with a mental illness, and it looked after patients’ legal rights. The law stated that isolation and restraint should be kept to a minimum.
This law underwent only minor amendment until it was replaced by the 1961 Law on Mental Healthcare. The major change was that the new law introduced the possibility of admission for observation when there was doubt about the mental state of the patient, that is, whether the patient suffered from a psychosis.