Opinion: Sweden’s healthcare system lets down victims of sexual violence

The #MeToo movement should have inspired political suggestions for improved care of mental health problems as a result of sexual violence and honour-based violence, but despite the fact it’s an election year, the initiatives have been lacking, writes a group of campaigners for better treatment of victims of sexual violence.

Opinion: Sweden's healthcare system lets down victims of sexual violence
Representatives of many of the 'MeToo' petitions, with former equality minister Åsa Regnér. Photo: Magnus Hjalmarson Neideman / SvD / TT

That’s why we want to highlight the question of healthcare and create a dialogue between the #MeToo movement and politicians.

Petitions like #bortabrahemmavärst ('Away is good, at home is worst' – relating to sexual violence at home), #intedinhora ('Not your whore' – relating to sexual violence against people in prostitution), #underytan ('Under the surface' – victims of honour-related violence), #utanskyddsnät ('Without a safety net' – sexual violence against those suffering from substance abuse or other social problems) and #vårdensomsvek ('Care that let us down' – women subjected to sexual trauma and harassment by health professionals) testify of traumatized people who received substandard care and, in the worst cases, were subject to assault and violations from healthcare staff.

In the petition #omniberättarlyssnarvi (if you talk, we’ll listen), 1,299 psychologists attested to their patients’ and clients’ vulnerability – at least 39,500 narratives of assault in total.

Talking about assault is still closely linked with shame. Many don’t talk about what they experienced, and healthcare professionals are often bad at asking. But the biggest problem is that access to effective treatment is lacking.

OPINION: Here's how we can prevent a backlash to the #MeToo movement in Sweden

Without treatment, there’s a significant risk of long-term mental health problems, for example post traumatic stress disorder (PTSD), depression and anxiety – with reduced quality of life and, in the worst instances, suicidal tendencies, as a result. There’s also a higher risk of suffering from physical health problems, substance abuse, or long-term sickness requiring time off work.

One of seven suggestions for political measures put forward by the coordinators of the #MeToo petitions is about increased efforts when it comes to treatment. In Almedalen, Equality Minister Lena Hallengren and the Moderate Party’s equality spokesperson Jessica Polfjärd showed engagement in the issue, but throughout the entire election campaign, we’ve not had any proposals of concrete investment.

Approximately just five percent of patients with mental health issues receive psychological assessment and treatment, according to national guidelines. Those who seek treatment after assault are rejected or have to wait much too long, despite the fact there are effective psychological treatments.

Would we accept so few getting the right care for any physical condition? Imagine that only five percent received care for cervical cancer. That would never be accepted.

In the case of cervical cancer, the healthcare sector has received resources to work with information campaigns, screenings at a national level, and extensive routines so that as many people as possible get treatment at an early stage.

When hundreds of thousands attested to harassment and abuse, we listened – but it’s not enough just to listen. There’s a need for concrete efforts and special measures for the relevant group.

We want to see a healthcare sector that works proactively and uses outreach to identify people early on who are developing mental health problems as a result of sexual assault. It should be as obvious to screen for this as it is to carry out smear tests for those at a risk of cervical cancer.

Sex-workers, people with substance dependencies, and those who are at risk of honour-related violence seek care less frequently. Therefore, they should be asked about any vulnerability through contact with the social services and other facilities, and they should be helped to receive further care as needed.

Care must be scaled based on the number of those affected. A large increase of psychological treatment requires primary care as well as specialist care, both for children and adults.

Within the #MeToo movements there is important knowledge both from the perspective of patients and those treating them. Within #omniberättarlyssnarvi (If you talk, we’ll listen), there is psychological expertise in trauma and care development, which are completely necessary in the work that needs to happen.

We are now inviting the responsible politicians (including Minister for Social Affairs Annika Strandhäll and the social policy spokesperson for the Moderates, Camilla Waltersson Grönvall) to a meeting in August. That’s when we will sit down together and discuss the solutions which give the best possibility of change.

Article by the undersigned, originally published in Swedish in Aftonbladet and translated into English for The Local by Catherine Edwards. Read the original version here.

#omniberättarlyssnarvi ('If you talk, we'll listen')
Amanda Simonsson
Charlotte Ulfsparre
Kristina Bondjers
Maria Bragesjö
Erica Mattelin
Johanna Ekdahl
Kerstin Bergh Johannesson
Maria Sandgren
Sveriges Kliniska Psykologers Förening
Olof Molander
Gustav Jonsson

#allmänhandling ('Public records)
Ingrid Mårtensson

#bortabrahemmavärst ('Away is bad, at home is worse')
Hanna Kaiser Barnes
Karin Tennemar

#ickegodkänt ('Not approved')
Ulrika Konstig
Anna Hermelin

#intedinhora ('Not your whore')

#lättaankar ('Cast anchor')
Cajsa Fransson
Frida Wigur
Linda Svenson

Anna Velander Gisslén

#nödvärn ('Self defence')
Kerstin Dejemyr

#sistabriefen ('The last brief')
Elin Ahldén
Maja Stridsberg
Mimmi Sköldberg

#slutvillkorat ('Final terms')
Denise Cresso

#underytan ('Under the surface')
Galaxia Elias

#utanskyddsnät ('Without a safety net')
Birgitta Johnsson
Lotten Sunna

#virivermurarna ('We tear down walls')
Katarina Risberg
Malin Isaksson
Mia Blomberg

#vårdensomsvek ('Care that let us down')
Natalia Valiente Vecchio

Coordinators for the #MeToo petitions
Emmy Lilliehorn
Elin Andersson

Member comments

Log in here to leave a comment.
Become a Member to leave a comment.
For members


Gothenburg: is the dream of a new city turning into a nightmare? 

Sweden’s second city is the site of Scandinavia’s largest urban development project. But there is rising concern that the costs outweigh the benefits, says David Crouch

Gothenburg: is the dream of a new city turning into a nightmare? 

Last week, residents in the area of Fågelsången (birdsong), a quiet street at the very heart of Sweden’s second city, woke up to read the following news: “Explosions at Fågelsången: On August 8, week 32, we start blasting around Fågelsången and are expected to be done by week 40. When blasting, for safety reasons, no one is allowed to go out, open their windows or be within the blasting area. We will work weekdays 7am to 5pm.” 

Blasting deep holes in the granite – along with sprawling roadworks – has been the reality for central Gothenburgers for the past four years, as a vast rail tunnel is being dug to link the current terminus with other parts of the city and enable smoother connections with other routes. The aim is to triple rail passenger numbers and eliminate traffic jams on the main road through the city, at a cost of 20 billion crowns (€1.9 billion).

This railway, known as Västlänken (the West Link), is not the only big construction project in the city centre. It is just the largest element in a gigantic scheme to revive the docks area along the river, which was destroyed by a global shipping crisis in the 1970s. The great rusting cranes opposite the opera house and the disused Eriksberg gantry are an important aspect of Gothenburg’s skyline and self-image. The areas on the north bank were also home to many recent immigrants and a byword for poverty. The city’s mayor famously, and shamefully, referred to it as “the Gaza strip”.

So in 2012 the city launched an ambitious plan. Christened Älvstaden, the RiverCity, municipal investment aimed to build an attractive, modern waterfront while creating tens of thousands of homes and jobs. It is by far the Nordic region’s biggest urban regeneration project. A YouTube video commissioned by the city authorities a few years later neatly sums up both the breathtaking scope of this vision and the exciting / brutal (choose your own adjective here) nature of the transformation it would bring: 

The RiverCity revolved around two flagship projects: a new bridge over the river, the Hisingsbron (Hisingen Bridge), combined with major new office developments right in the centre; and Karlatornet, Sweden’s tallest skyscraper, which would literally tower over Gothenburg like a beacon of modernity in a city that traditionally has had strict rules against high-rise buildings. 

Add to all this a proposed high-speed rail link with Stockholm, and you have a recipe for quite spectacular urban upheaval involving billions of tons of steel and concrete. Visit Gothenburg today and much of the city seems to have been turned into a building site. There is a forest of cranes, while smart new office blocks puncture the skyline – a genuine metamorphosis is under way.

But many Gothenburgers are either uneasy or downright unhappy. The RiverCity is a vanity project to gentrify the docklands, they say. Karlatornet’s 73 stories of luxury apartments will be a scar on the landscape and a symbol of Gothenburg’s new love affair with finance and real estate, a slap in the face for the city’s proud industrial values. Västlänken is a vit elefant, a costly project that will deliver questionable benefits, many believe.  

Opposition to Västlänken was such that a new political party, the Democrats, took 17 percent of the vote in 2018 with its headline demand to stop the project immediately. This caused a revolution in local politics, overturning decades of Social Democrat rule. 

And now the gloss on these big-ticket construction projects is starting to fade. Karlatornet was the first to run into trouble. For most of 2020 building work was at a standstill, raising the threat that this flagship of regeneration would be nothing more than an unfinished stump, after American financiers pulled out of the project. The new Hisingen Bridge is open to traffic, but its construction was fraught with setbacks and the final cost to the taxpayer is still unknown. “There has been an awareness from the start that this was a high-risk project,” one of the project’s bosses said ominously this spring.

RiverCity is more than two billion kronor over budget, and facing accusations of mismanagement that evoke Gothenburg’s old nickname of Muteborg, or Bribetown, after a proliferation of municipal companies in the 1970s led to conflicts of interest, with politicians sitting on company boards. Opponents of the scheme argue that in any case it is unlikely to solve any of the city’s fundamental problems, such as the ethnic segregation that has created immigrant ghettos in outlying suburbs.  

In May, Swedish newspaper Dagens Nyheter published leaked minutes from Västlänken management meetings in which one of the main contractors on the project said it would be delivered billions over budget and four years later than its official 2026 deadline – in other words, four more years of earth-shattering explosions, roadblocks and associated upheaval. With local elections only months away, the Democrats have taken out advertisements on billboards and in local media demanding that top politicians tell the truth about what is going on. For opponents of the scheme, this is exactly what they have warned of all along

Next June, Gothenburg will officially celebrate its 400th anniversary, postponed from 2021 because of the pandemic. Visitors will experience a city on the move, with pristine new motorways and sparkling office blocks. So for Gothenburg’s urban planners, there is light at the end of the development tunnel. In the case of Västlänken, however, they will be hoping that the light is indeed that of an oncoming train. 

David Crouch has lived in Gothenburg for nine years. He is the author of Almost Perfekt: How Sweden Works and What Can We Learn From It, a freelance journalist and lecturer in journalism at Gothenburg University.