History

Founding of the hospital

According to a Parliamentary decision ratified by Czar Alexander II of Russia in 1877-1878, a combined curative institution organised as a settlement or a farming system was to be established in the vicinity of the town of Kuopio, in order 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 were considered.

The most important reasons for choosing Niuvanniemi as the hospital site were 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 for the hospital began in 1881 and concluded in 1884, with a total of 120 beds, 60 for men and 60 for women, in addition to the necessary administration, housekeeping and maintenance facilities. Niuvanniemi Hospital was finally opened on the 1^st of 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 Second World War the hospital was appointed its special task as the main place of treatment for forensic patients in Finland.

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

The number of forensic 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 Niuvanniemi Hospital began its operations on the 1^st of February 1885, its staff consisted of the following:

• 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 every 6 patients, and the women’s wards 1 nurse to every 8 patients.

The impact of social developments were reflected in the hospital’s classification of its patients. The patients were firstly divided into the gentry and the commoners, and further classified according to their wealth. This division manifested eg. in hospital charges, which depended on the patient’s own, or his or her proxy’s, wealth or willingness to pay a 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 which s/he was used to, although there were few patients who could afford the highest fees. The range varied from free beds to 4 Marks per day.

The ever increasing range of psychopharmaceuticals and expanding experience in their use improved treatment results in particular for schizophrenic and depressive disorders throughout the 1970s and 80s. They enabled a new level of psychotherapy and occupational therapy, further enhancing the overall treatment results. The development of 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 the length of treatment, also curbing the growth in patient numbers. Whereas in 1955–59 approximately half of the patients admitted to the hospital as “criminally insane” 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.

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 investing in Niuvanniemi Hospital: the hospital was allocated the posts of second psychologist and second social worker in 1982, a research post of a Chief Forensic Psychiatrist in 1983 (transferred from Mustasaari Hospital in Vaasa), and a further post of Chief Forensic Psychiatrist in 1985. The long-term plans for a new therapy-building 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 strategy. It was then able to reach its goal to become a hospital specialised in forensic psychiatry and eventually a university department, affiliated with the University of Eastern Finland. Its specific task as a state mental hospital was embedded in law, as defined in the Mental Health Act (Section 12). These developments culminated in 1983, when Finland’s first professorship in forensic psychiatry was established at the University of Kuopio (since then renamed as the University of Eastern Finland), for which post the Medical Director of Niuvanniemi, Dr. Panu Hakola, was appointed at invitation.

Today Niuvanniemi is the oldest psychiatric institution in Finland and largest forensic facility of the Nordic countries. Its over 130 years of history are beautifully reflected in the hospital buildings, protected by the Finnish Heritage Agency, whose original appearance has been successfully preserved during renovations while observing the needs of ever-evolving psychiatric treatment.

Further reading:

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

Vuorio K. Niuva. Niuvanniemen sairaala 1885-1952. Niuvanniemen sairaala 2010.

Vuorio K. Niuva. Niuvanniemen sairaala 1953-2010. Niuvanniemen sairaala 2011.