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SEXUAL HARASSMENT

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')
Gabriella
Ida
Ida
Juliana
Amanda

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

#metoobackstage 
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
 

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FOOD AND DRINK

OPINION: Are tips in Sweden becoming the norm?

Should you tip in Sweden? Habits are changing fast thanks to new technology and a hard-pressed restaurant trade, writes James Savage.

OPINION: Are tips in Sweden becoming the norm?

The Local’s guide to tipping in Sweden is clear: tip for good service if you want to, but don’t feel the pressure: where servers in the US, for instance, rely on tips to live, waiters in Sweden have collectively bargained salaries with long vacations and generous benefits. 

But there are signs that this is changing, and the change is being accelerated by card machines. Now, many machines offer three preset gratuity percentages, usually starting with five percent and going up to fifteen or twenty. Previously they just asked the customer to fill in the total amount they wanted to pay.

This subtle change to a user interface sends a not-so-subtle message to customers: that tipping is expected and that most people are probably doing it. The button for not tipping is either a large-lettered ‘No Tip’ or a more subtle ‘Fortsätt’ or ‘Continue’ (it turns out you can continue without selecting a tip amount, but it’s not immediately clear to the user). 

I’ll confess, when I was first presented with this I was mildly irked: I usually tip if I’ve had table service, but waiting staff are treated as professionals and paid properly, guaranteed by deals with unions; menu prices are correspondingly high. The tip was a genuine token of appreciation.

But when I tweeted something to this effect (a tweet that went strangely viral), the responses I got made me think. Many people pointed out that the restaurant trade in Sweden is under enormous pressure, with rising costs, the after-effects of Covid and difficulties recruiting. And as Sweden has become more cosmopolitain, adding ten percent to the bill comes naturally to many.

Boulebar, a restaurant and bar chain with branches around Sweden and Denmark, had a longstanding policy of not accepting tips at all, reasoning that they were outdated and put diners in an uncomfortable position. But in 2021 CEO Henrik Kruse decided to change tack:

“It was a purely financial decision. We were under pressure due to Covid, and we had to keep wages down, so bringing back tips was the solution,” he said, adding that he has a collective agreement and staff also get a union bargained salary, before tips.

Yet for Kruse the new machines, with their pre-set tipping percentages, take things too far:

“We don’t use it, because it makes it even clearer that you’re asking for money. The guest should feel free not to tip. It’s more important for us that the guest feels free to tell people they’re satisfied.”

But for those restaurants that have adopted the new interfaces, the effect has been dramatic. Card processing company Kassacentralen, which was one of the first to launch this feature in Sweden, told Svenska Dagbladet this week that the feature had led to tips for the average establishment doubling, with some places seeing them rise six-fold.

Even unions are relaxed about tipping these days, perhaps understanding that they’re a significant extra income for their members. Union representatives have often in the past spoken out against tipping, arguing that the practice is demeaning to staff and that tips were spread unevenly, with staff in cafés or fast food joints getting nothing at all. But when I called the Swedish Hotel and Restaurant Union (HRF), a spokesman said that the union had no view on the practice, and it was a matter for staff, business owners and customers to decide.

So is tipping now expected in Sweden? The old advice probably still stands; waiters are still not as reliant on tips as staff in many other countries, so a lavish tip is not necessary. But as Swedes start to tip more generously, you might stick out if you leave nothing at all.

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