Introducing community mental health services. The effects on a suburban patient population

By means of a computerised psychiatric case register, the effects on a defined population with 71,371 inhabitants were studied when the mainly hospital-based psychiatric services in the area were changed to community mental health units with substantial outpatient resources. Diagnostic, social and demographic variables and care utilisation rates were compared. A 29% increase in patients under the new system was observed. Most of the newcomers had acute crisis reactions, were younger, on average, than previous patients and registered alcohol abuse and somatic diseases. Outpatient utilisation increased (170%) and hospital admissions decreased (22%). Compulsory admissions increased (43%), as did sick-leave registrations (21%). These trends are discussed in light of the new organization.