History

Founding of the hospital

According to a Parliamentary decision ratified by the Czar of Russia in 1877-1878, a combined curative institution organised as a settlement or a farming system shall be established in the vicinity of the town of Kuopio to meet the country’s psychiatric treatment needs. To that end, the search for a suitable location for the new institution was commenced, during which the nearby farms of Savisaari and Fagernäs (denoting Niuvanniemi in Swedish) as well as the cape of Haapaniemi, owned by Kuopio, were considered.

The most important reasons for choosing Niuvanniemi as the hospital site were, in addition to the possibility of land purchase, its advantageous location, peacefulness and impressive natural beauty. Equally important must have been the new railway, which in 1889 was extended to Kuopio, as it enabled patients to be transported from other parts of the country. Construction work of the hospital began in 1881 and concluded in 1884, with a total of 120 beds, 60 for men and 60 for women, and all the necessary administration, housekeeping and maintenance facilities. The Niuvanniemi Hospital was opened on 1 February 1885.

Patients

The growth in the number of criminally insane patients at Niuvanniemi was slow during the first decades of the 20th century, but the pace picked up in the 1930s. After the war the hospital was appointed its special task as the main place of treatment for criminally insane patients in Finland.

The following table illustrates the increase in the number of criminally insane patients since the end of the 1930s.

The number of criminally insane patients at the Niuvanniemi Hospital in 1939–1967.

Year	Male	Female	Total
1939	109	12	121
1948	111	2	113
1959	220	38	258
1967	343	61	404

Staff

When the Niuvanniemi hospital began operations on 1 February 1885, its staff consisted of the following posts:

• 1 chief physician
• 1 foreman (senior male nurse)
• 1 matron (senior female nurse)
• 7 male nurses
• 5 female nurses

The following posts were allocated for housekeeping, maintenance and other staff:

• 1 housekeeper
• 1 priest
• 1 cook
• 1 female baker
• 3 maids
• 4 farm hands
• 1 carpenter
• 1 firewatcher
• 1 heater (until spring)

When the hospital started operating in its extended form in 1894, the maximum number of patients at the hospital was 310, and its staff consisted of 23 male nurses and 19 female nurses. This meant that the men’s wards had 1 nurse to 6 patients, and the women’s wards 1 nurse to 8 patients.

The impacts of social developments were reflected in the hospital’s classification of mental patients. The patients were firstly divided into the gentry and the commoners, and further classified according to their wealth. This unequal treatment was for instance manifested in hospital charges, which depended on the patient’s own, or his or her proxy’s, wealth or willingness to pay certain daily fee.

The level of the daily treatment fee guaranteed that even during their hospital stay each patient would be able to retain the standard of living to which s/he was used, although there only few patients who could afford the highest fees. The range varied from free beds to 4 Marks per day.

The everincreasing range of psychopharmaceuticals and expanding experience in their use improved treatment results in particular for schizophrenic and depressive disorders throughout the 1970s and also the 1980s. They enabled a new level of psychotherapy and occupational therapy, further enhancing the overall treatment results. The development of retirement benefits and social welfare also helped people previously disabled by their illness to successfully cope with life outside the hospital. All this together lead to a rapid decrease in treatment times, also curbing the growth in patient numbers. Whereas in 1955–59 approximately half of the patients admitted to the hospital as criminally insane patients could only be discharged after 10 years of treatment, in 1970-71 this figure fell to three and a half years, continuing to further decline throughout the 1980s. The following table indicates the distinct reduction in patient numbers from 1975 onwards.

Number of patients at year-end by genders in 1969–1984.

Year	Male	Female	Total
1969	346	60	406
1975	393	50	443
1980	358	44	402
1984	347	35	382

In the 1980s the Finnish Government began targeting the Niuvanniemi Hospital with in-vestment efforts: the hospital was allocated the posts of second psychologist and second social worker in 1982, a research post of a Chief Forensic Psychiatrist (research) in 1983 (transferred from the Mustasaari Hospital), and a further post of Chief Forensic Psychiatrist in 1985. The long-term plans for a new therapy building project also reached a positive conclusion, when the inauguration of the new building with a floor space of 3126 square metres was celebrated during the 100th anniversary jubilee of the Hospital on 26 September 1985.

Society’s increased support proved decisive for the hospital’s new development policy: the goal to become a hospital specialised in forensic psychiatry and eventually a University Clinic, for which Niuvanniemi had good prospects thanks to its special task as a state mental hospital as defined in the Mental Health Act Section 12, its extensiveness, and the vicinity of the University of Eastern Finland and the Kuopio University Hospital.

Long-term efforts for the establishment of a chairship finally lead to results when in 1983 Finland’s first professorship in forensic psychiatry was established at the University of Kuopio, for which post Docent and Medical Director Panu Hakola was appointed at invitation. The Niuvanniemi Hospital has also functioned as the Forensic Psychiatric Clinic of the University of Kuopio since 1 September 1983.
Today Niuvanniemi is the second oldest psychiatric institution in Finland, after the Lapinlahti Hospital (currently operating under the Helsinki University Central Hospital). Its over 100 years of history are beautifully reflected in the hospital buildings, protected by the National Board of Antiquities, whose original appearance has been successfully preserved during renovations while observing the needs of evolving psychiatry and technology.

Source: Malmivuori J. Niuvanniemen sairaalan historia 1885–1985. (The history of the Niuvanniemi Hospital). A publication of the University of Kuopio. Kuopio 1985.