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

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.

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.

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.

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.