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Tijdschrift voor Psychiatrie 55 (2013) 6, 427 - 438

Review article

Consensus regarding the definition of persons with severe mental illness and the number of such persons in the Netherlands

PH. Delespaul, Consensusgroep EPA

background Insurance companies and mental health service planners need to have information about the prevalence of severe mental illness (smi) and about the numbers of persons affected. They require these data in order to be able to develop, implement and evaluate innovative mental health care for such patients. This information lets them draw up their budgets and define their priorities.
aim To reach a consensus regarding the number of patients with smi in the Netherlands.
method A consensus was reached regarding the definition of smi, and the prevalence of smi was determined on the basis of epidemiological literature and policy papers relating to mental health care in the Netherlands. When figures from the literature were inaccurate or unavailable, estimates were checked by a group of experts.
results The definition of smi was adjusted and amended in relation to psychiatric comorbidity. An analysis of the care-loads of all the mental health care providers yielded an estimate of 160,000 smi patients aged 18-65, including those receiving addiction care and forensic care (1.6% of the adult population). When children and adolescents (< 18 years) and the elderly (> 65 years) were included, the total number of patients came to 216,000 (1.3%). The prevalence among the population was estimated to be 281,000 (1.7%).
conclusion The Consensus group is of the opinion that the consensus document estimates of the number of smi patients in the Netherlands are as accurate as they can possibly be. Of course, the document contains assumptions and extrapolations which will require further research. The figures will be confirmed or adjusted in the future as soon as new evidence becomes available.

keywords availability of care, epidemiology, serious mental illness (SMI)