Profiles

 Jessica Storbjörk

Jessica Storbjörk

Docent

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Arbetar vid Institutionen för folkhälsovetenskap
Telefon 08-16 14 68
E-post jessica.storbjork@su.se
Besöksadress Sveavägen 160, Sveaplan
Rum 333
Postadress Institutionen för folkhälsovetenskap 106 91 Stockholm

Om mig

Jessica Storbjörk är docent i sociologi, universitetslektor på Institutionen för folkhälsovetenskap och föreståndare för Centrum för socialvetenskaplig alkohol- och drogforskning (SoRAD). Hon forskar om alkohol och andra droger med särskilt fokus på missbruks- och beroendevården och behandlingssystem i Sverige och internationellt. 

Storbjörk har under senare år studerat medborgares rättigheter och skyldigheter inom välfärdsområdet, politiken kring och organisatoriska förändringar i det svenska behandlingssystemet, internationella jämförelser av behandlingssystem, samt om och hur brukare ges inflytande över sin egen vård. Hennes huvudfokus ligger nu på missbruks- och beroendevårdens organisering och styrning och hur dessa faktorer inverkar på den dagliga praktiken i socialtjänstens, sjukvårdens och andra privata eller idéella aktörers verksamheter. Arbetet sker inom ramen för ett forskningsprojekt om vilka fördelar, spänningar och motsägelsefulla incitament som följer av New Public Management och andra organisatoriska tendenser och styrsystem, t.ex. offentlig upphandling av vård.

Hennes tidigare forskning utgick mer tydligt från brukares upplevelser i studier av hur personer med alkohol- eller drogproblem kommer till vårdsystemet, social kontroll, tvångsvård, hemlöshet, social marginalisering/exklusion, substansrelaterad dödlighet, vårdutfall, samt skäl till att minska ett problematiskt bruk.

Bland expertuppdrag kan nämnas att Storbjörk ingår i Statens institutionsstyrelses (SiS) och tidskriften Nordic Studies on Alcohol and Drugs (NAD) vetenskapliga råd, agerar som assisterande redaktör för Journal of Studies on Alcohol and Drugs (JSAD) och har deltagit i arbetsgrupper om missbruk och spel på Socialstyrelsen. Hon startade upp det nationella forskarnätverket Sonad (Socialvetenskapligt nätverk inom alkohol- och drogforskning) 2004 och var dess koordinator 2010-2017 och återigen från 2019. Hon har gästforskat vid olika forskningscenter i Australien, Finland och USA.

Undervisning

Jessica Storbjörk deltar i skapandet av nya kurser och kandidat- och masterprogram vid Insitutionen för folkhälsovetenskap. Hon undervisar för närvarande på en kurs om beroendeframkallande substanser och beteeden på grundnivå och på fyra kurser på avancerad nivå om välfärdsstat/-politik och kvalitativ metod.

Hon har tidigare undervisat på grund- avancerad och forskarnivå på samhällsvetenskapliga kurser om alkohol och andra droger, kvalitativ och kvantitativ forskningsmetod samt genus på olika institutioner vid Stockholms universitet, samt på Uppsala universitet, Karolinska institutet och via Nordiska nämnden för alkohol- och drogforskning (NAD).

Forskning

Pågående forskningsprojekt

Fördelar, spänningar och motsägelsefulla incitament i välfärdssystemet: New Public Management i svensk missbruks- och beroendevård (2015-2017, Riksbankens Jubileumsfond). Projektledare.

Alcohol and other drug treatment funding, purchasing and workforce: empirical analyses to inform policy (2017-2019, NHMRC Australia, PI Ritter). Associate investigator.

Tidigare forskningsprojekt

Nätverk: Socialvetenskapligt nätverk inom alkohol- och drogforskning, Sonad (2004-pågående, Forte). Projektledare 2010-2017.

Individens ställning i missbruks- och beroendevården – en studie av brukarinflytande i praktiken (2013-2017, Forte). Projektledare.

En reformerad missbruks- och beroendevård? Aktörer, argument och makt (2012-2013, lektorstjänst). Projektledare.

Rättigheter och skyldigheter i välfärdsstaten enligt politiker, professionella grupper och socialt inkluderade och exkluderade medborgare (2010-2011, Forte). Projektledare.

Jämställda problem i ett jämställt vårdsystem? Likheter och skillnader mellan kvinnor och män i behandling: konsumtion, problem och vårderfarenheter (2009-2010, delstudie i forskningsprogrammet Kvinnor, hälsa och rusmedel, projektledare Törrönen, Forte). Projektledare.

Hur, när och för vem används tvångsvård? (2008, Statens institutionsstyrelse (SiS), projektledare Palm). Forskare.

Hur går det för alkohol- och droganvändare efter behandling? Utfall i relation till påtryckningar att söka vård och behandlingssystemets decentraliseringsgrad (2008, Systembolagets råd för alkoholforskning (SRA), projektledare Stenius). Forskare.

En komparativ studie av behandlingssystem, behandlingsinsatser och långtidsförlopp bland missbrukare i Stockholms län och norra Kalifornien (2007-2009, FAS/Forte, Socialförvaltningen Stockholms stad, Länsstyrelsen i Stockholms län och SRA, projektledare Stenius). Forskare.

Utvärdering av Vårdkedjeprojektet (2005-2007, SiS, projektledare Stenius). Forskningsassistent.

Convictus Bryggan City: Gästerna, deras nätverk, problem, behov och resurser (2005, Mobilisering mot narkotika (MOB), projektledare Room). Studiekoordinator & doktorand.

Risk Opiate Addicts Study (ROSE-EU), Management of high risk opiate addicts in Europe (2002-2004, EUs 5e ramverk, multi-cite study, PI Krausz, projektledare i Sverige Romelsjö). Forskningsassistent & doktorand.

TREAT-2000, Treatment Systems Research on European Addiction Treatment (2000-2003, EUs 4e ramverk, multi-cite study, PI Gastpar, projektledare i Sverige Room). Biträdande studiekoordinator & doktorand.

Kvinnor och män i svensk missbruksbehandling (2000-2004, Socialdepartementet, projektledare Room). Biträdande studiekoordinator & doktorand.

Publikationer

I urval från Stockholms universitets publikationsdatabas
  • 2019. Kerstin Stenius, Jessica Storbjörk. Nordic Studies on Alcohol and Drugs, 1-26

    Aim: In increasingly market-oriented welfare regimes, public procurement is one of the most important instruments of influencing who produces which services. This article analyses recent procurement regulations in four Nordic countries from the point of view of addiction treatment. The implementation of public procurement in this field can be viewed as a domain struggle between the market logic and the welfare logic. By comparing the revision of the regulations after the 2014 EU directives in Denmark, Finland, Norway, and Sweden, we identify factors affecting the protection of a welfare logic in procurement. We discuss the possible effects of different procurement regulations for population welfare and health. Data and theoretical perspective: The study is based on the recently revised procurement laws in the four countries, and adherent guidelines. The analysis is inspired by institutional logics, looking at patterns of practices, interests, actors, and procurement as rules for practices. Results: Procurement regulations are today markedly different in the four countries. The protection of welfare and public health aspects in procurement – strongest in Norway – is not solely dependent on party political support. Existing service providers and established steering practices play a crucial role.  Conclusion: In a situation where market steering has become an established practice and private providers are strongly present, it can be difficult to introduce strong requirements for protection of welfare and population health in procurement of social services.

  • 2018. Jessica Storbjörk, Kerstin Stenius. Social Policy & Administration

    Given its traditions of universal welfarism and social democracy, Sweden had already scored unexpectedly high on New Public Management by the 1980s. Health and welfare services remain primarily tax‐funded, but the production of care is increasingly transferred to a competitive quasi-market. To what extent can this development be understood in terms of right‐wing governments, and to what extent in terms of other, socioeconomic and pragmatic factors? We examined this question through official statistics on providers of institutional addiction care since 1976, and through the total expenditure and purchases by local‐level municipal social services of interventions for substance users in Sweden in 1999, 2004, 2009, and 2014. We have analyzed the distribution across publicand private providers within the addiction treatment system, and whether national developments and local differences across the 290 municipalities—which bear the major treatment responsibility—can be understood in terms of local‐level political majority, population size, and local wealth. The share of purchased services has remained stable, but the treatment system shows increasing financial turnover and an increasing share of for‐profit providers among producers of purchased care, especially in outpatient treatment. While venture capital enterprises emerged as a new actor, non‐governmental organizations lost out in importance. Bourgeois government correlated with larger shares of purchasing and purchases from for‐profit providers. However, purchasing on a market dominated by for‐profit providers has also become the “newnormal”, regardless of ideology, and recent years have shown a reversed effect of left‐wing municipalities purchasing more services than right‐wing governments. Pragmatic reasons also influence local‐level purchasing.

  • 2019. Jessica Storbjörk, Kerstin Stenius. Journal of Studies on Alcohol and Drugs (s18), 31-39

    Objective: Researchers generally assume that addiction treatment systems can be viewed as entities and planned with the citizens’ best interests in mind. We argue that another steering principle, the market logic, has permeated many Western World treatment systems but is neglected in research. We demonstrate how it may affect system-level planning, service provision, and the service users.

    Method: Wedraw on an ongoing Swedish study, with some Nordic references, using several data sources: (1) public statistics on treatment expenditures and purchases; (2) interviews with service users (n = 36) and their service providers (n = 23) on different market features; (3) an observation of a large public procurement process concluding framework agreements based on competitive tendering; (4) interviews with officials involved with steering of the system and procurement (n = 16); (5) a workshop on procurement in the Nordic countries (n = 11 participants); and (6)77 interviews with professionals, managers, and elected representatives.

    Results: We outline seven propositions that call for further research attention: public procurement, as regulated in the European Union, is not suitable for addiction treatment; marketization challenges democracy, equity, needs assessment, and treatment planning; marketization causes new accountability problems and idle monitoring; marketization causes fragmentation and obstructs coordination and continuity of care; marketization causes unification of services and favors big bureaucratically sophisticated providers; treatment professionals’ values are downplayed when a mistrust-based market logic replaces a trust- and needs-based logic; and marketization marginalizes treatment professionals and service users by limiting discretion.

    Conclusions: Findings point toward the importance of acknowledging and mitigating market principles in treatment systems to safeguard needs assessments and planning that serve the interests of the service users and the public. (J. Stud. Alcohol Drugs, Supplement 18, 31–39, 2019)

  • 2019. Jessica Storbjörk, Erik Antonsson, Kerstin Stenius.

    Summary: Welfare systems in Sweden and internationally have gone through major changes regarding modes of operation and means of government in New Public Management (NPM) reforms, which have sought to balance autonomy and control. There is a lively debate about NPM, but research is scarce. NPM indicates improved performances but also unintended consequences and inconsistencies concerning ideas, demands on the services and performance incentives – such as tensions between medical and social professional autonomy and knowledge on the one hand and administrative control, auditing and a growing bureaucracy (e.g., procurement, inspections, documentation) on the other. The research project used addiction treatment with different organisations and professions as a case for studying the impact of NPM on the daily work in regional health care and municipal social services organisations.

    We charted the broad steering and organisation of addiction treatment. We analysed the extent to which tendencies of NPM have conveyed advantages or created conflicting logics by comparing addiction treatment in three regions and six municipalities with varying degrees of NPM. The study used official statistics, documents, interviews and a web survey. A total of 85 interviews were made with 93 individual state, regional and local policy-makers and officials (including the previously unstudied procurers) and public and private care providers (managers and treatment professionals) in 2017–2018. The interviews formed the basis for a web survey among professionals in Sweden in 2019. Purchasing addiction services was further examined by observing a large procurement process, by organising a workshop with Nordic procurement experts, and by interviewing civil servants in Finland, Denmark and Norway.

    The study shows how addiction treatment is governed and organised, highlighting developments over time with special emphasis on various NPM features. The interviews addressed advantages and tensions in the daily work and if and how professionals seek to adapt to new, perhaps inconsistent, demands. The web survey allows for comparisons across organisations and professional groups. This technical report presents the background and aims of the study and describes in detail the Swedish study setting, and the study design, methods and data sources used.

    Open access: https://su.figshare.com/articles/The_Swedish_Addiction_Treatment_System_Government_Steering_and_Organisation_Technical_Report/9906542

  • 2018. Jessica Storbjörk. Drug and Alcohol Review

    Treatment providers demonstrate a quite strong support for a disease model of addiction, particularly so in the United States. However, conceptions vary and the problems may be perceived as primarily a disease, moral or social problems, or a combination of these (Barnett et al. in press). This commentary discusses the ongoing and dynamic process of defining addiction problems and notes that non-medical perspectives often appear in the shadow of and tend to oppose the disease model that stands quite inviolable – i.e., like the One Ring to rule them all by citing The Lord of the Rings. Recent changes in the Swedish Addiction treatment system, well known for its social perspective on the nature and handling of addiction problems, are highlighted to demonstrate that the world may be changing, or not. It is argued that there cannot be just one model. 

  • 2018. Jessica Storbjörk, Eva Samuelsson. Socialtjänstmarknaden, 85-115

    Kapitlet behandlar brukarinflytande inom missbruks- och beroendevården och diskuterar den potentiella konflikten mellan denna företeelse och New Public Management (NPM). Kapitlet diskuterar hur företeelser som ofta förknippas med NPM (t.ex. upphandling och ramavtal, valfrihet, prestationsbaserade ersättningssystem) inverkar på handlingsutrymme och vårdbeslut utifrån personalens och brukarnas utsagor, liksom hur klienter och patienter ser på sina möjlighetertill inflytande i en NPM-inspirerad vård.

  • 2017. Jessica Storbjörk, Joshua B. B. Garfield, Andrew Larner. Substance Use & Misuse 52 (4), 439-450

    Background: Clinical studies of alcohol and drug treatment outcomes frequently apply participant eligibility criteria (EC), which may exclude real-world treatment seekers, impairing the representativeness of studied samples. Some research exists on the impact of EC on alcohol treatment seekers. Little is known about drug treatment and country differences. Objectives: We tested and compared the degree to which commonly used EC exclude real-world treatment seekers with problem alcohol and drug use in Sweden and Australia, and compared the impact of EC on outcomes. Methods: Two large naturalistic and comparative service user samples were used. Respondents were recruited in Stockholm County (n = 1,865; data collection 2000–2002), and Victoria and Western Australia (n = 796; in 2012–2013). Follow-up interviews were conducted after 1 year. Cross-tabulations, Chi-square (χ2) tests and logistic regressions were used. Results: Percentages of the samples excluded by individual EC ranged from 5% (lack of education/literacy) to 70% (social instability) among Swedish alcohol cases and from 2% (low alcohol problem severity) to 69% (psychiatric medication) among Australian counterparts; and from 2% (age 60+ years) to 82% (social instability) among Swedish drug cases and from 1% (age 60+ years) to 67% (psychiatric medication) among Australian counterparts. Country differences and differences across substances appeared independent of country effect. Co-morbid psychiatric medication, noncompliance, poly drug use, and low education EC caused positive 1-year outcome bias; whereas female sex and old age introduced negative outcome bias. Conclusions/Importance: Commonly used EC exclude large proportions of treatment seekers. This may impair generalizability of clinical research, and the effects of many EC differ by country and drug type.

  • 2016. Harald Klingemann, Storbjörk Jessica. The SAGE Handbook of Drug & Alcohol Studies, 260-286

    Following some introductory notes on addiction treatment management as a specific case of societies’ response to deviant behaviours and social problems, an overview of the theoretical classifications and dimensions of addiction treatment systems is presented. The anti-thesis to these ideal-type system concepts is represented by the market New Public Management model oriented towards outcomes, regardless of the nature and organizational features of addiction interventions. As complementary to these general theoretical orientations, this serves as a review of specific issues concerning ‘a combined and integrated approach versus a specialized and segregated approach’, ‘the quest for the best treatment modalities’, ‘empirical and ethical aspects of coercion in treatment’ and ‘the relevance of user needs and orientation’. The empirical part begins by highlighting the ‘expert survey‘, ‘case study‘ and dynamic diffusion‘  approaches as treatment mapping strategies and informs on some key results, e.g. from the WHO Atlas –SU survey and the International Studies in the Development of Alcohol and Drug Treatment Systems. Results from an expert survey from fourteen countries conducted in 2014 illustrate the role of general political changes, efforts to control treatment systems, integration dynamics, the treatment gap and changing outcome criteria with concrete current examples. The conclusions point to the relative importance of professional addiction interventions drawing upon self-change research and the role of alternative lay help and outline factors in impeding system changes.

Visa alla publikationer av Jessica Storbjörk vid Stockholms universitet

Senast uppdaterad: 8 januari 2020

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