Exploring Mandatory Reports of Mistreatment in Sweden’s Social Services

Abstract

Background: In Sweden, adult protection in Social Services is regulated in the Social Services Act, as an obligation for staff working in Social Services to report a mistreatment within their services. The intention of the regulation is to protect service recipients at risk, improve services, and enable staff to report mistreatments without risk of reprisals. The aim of this article is twofold: to describe what is reported as mistreatment by staff, and to compare types of mistreatment, assessment of severity and measures across the different Social Service’s areas. Method: All reports written by staff and investigated by a designated official in one of the largest regions in Sweden during one year (n = 1105) were collected and coded quantitatively. Results: Most reports were in eldercare and disability services. The main types of mistreatments were approved services incorrectly performed or not carried out, theft and ill-treatment. In Child protection services matters of legal certainty dominated such as delays in assessing cases of child abuse. The most common measure was to reinforce routines and local policies. 14 percent (n =156) of all reports were deemed to be serious. There was a great discrepancy between the different municipalities in reporting and assessing severity of the incidents. Municipalities with high incidence of reports per 10 000 inhabitants also had fewer reports that were considered as serious incidents. The differences in reporting and assessing mistreatments in Social Services are discussed in relation to adverse event reporting in health care.