Experience from the first ACT programme in Denmark. II. Severe mental illness. A register diagnosis.

Community psychiatry in Denmark has been criticized because of drop-outs of the patients with severe mental illness. In order to deal with these problems, the first Assertive Community Treatment (ACT) project in Denmark was started in the Tønder region on 1 May 2001. Before starting the clinical study, an epidemiological analysis of severe mental illness was performed. Severe mental illness was defined from register data on the basis of psychosis and high use of psychiatric services. Data concerning drop-out (inactive during a period), death and address were obtained. The point prevalence rate of severe mental illness on 31 December 2000 in Sønderjylland (SJ) county was 1.31/1000. The rate of inactive patients was 0.28/1000. The rates were distributed inhomogeneously between regions. In a 4-year cohort, half of the patients were inactive at least once. The Tønder and Aabenraa regions had homogeneous patterns. In conclusion, the register diagnosis is a target group for ACT. The register diagnosis and the status active/inactive may be used as an unbiased effect parameter.