title: The new asylums in the community: severely ill psychiatric patients living in psychiatric supported housing facilities. A Danish register-based study of prognostic factors, use of psychiatric services, and mortality.
abstract: BACKGROUND
  Reorganization of psychiatric treatment in Denmark involved a declining number of psychiatric long-stay beds and an increasing number of psychiatric supported housing facilities in the community. Very few studies have focused on the population in such facilities.
  
  
  METHODS
  Information was generated combining addresses of supported psychiatric housing facilities with information from the Danish Civil Registration System to create a case register of persons living in supported psychiatric housing facilities. Through linkage with the Danish Psychiatric Central Register, we examined predictors of becoming a resident in a psychiatric housing facility, use of psychiatric services around the time of entrance to a supported psychiatric housing facility, and mortality rates for residents in a psychiatric housing facility compared to non-residents and to persons in the general population who never experienced a psychiatric admission.
  
  
  RESULTS
  We identified schizophrenia as the strongest diagnostic predictor of becoming a resident in a supported psychiatric housing facility, followed by organic mental disorders, substance abuse, and affective disorder. In addition, the higher the number of psychiatric bed days, the higher the risk. Compared to the years before the first entrance to a supported psychiatric housing facility, the number of bed days in the year following the first entrance dropped more among residents than among comparable psychiatric patients. Mortality rates were slightly higher among residents in a supported psychiatric housing facility than among comparable psychiatric patients, but more than tenfold higher when compared to the general population of Danes.
  
  
  CONCLUSIONS
  The vast majority of persons who became residents in supported psychiatric housing facilities had previously been diagnosed with schizophrenia, schizophrenia-like disorders, and organic mental disorders, and a large proportion had substance abuse and a high use of bed days. Moving into such a facility reduced the number of bed days.
authors.affiliation: Psychiatric Centre Copenhagen, Copenhagen University, Faculty of Health Sciences, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark. mn@dadlnet.dk
authors.forename: Merete
authors.initials: M
authors.lastname: Nordentoft
authors.forename: Marianne G
authors.initials: MG
authors.lastname: Pedersen
authors.forename: Carsten B
authors.initials: CB
authors.lastname: Pedersen
authors.forename: Søren
authors.initials: S
authors.lastname: Blinkenberg
authors.forename: Preben B
authors.initials: PB
authors.lastname: Mortensen
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D040561:Assisted Living Facilities / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006798:Housing; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D028642:Persons with Psychiatric Disorders / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012720:Severity of Illness Index; D017678:Sex Distribution; D055815:Young Adult