The aims of the study were to investigate how the characteristics of the psychiatric services, the environmental factors and the patient characteristics are related to contact rates and use of psychiatric services.

The study included all new patients contacting the psychiatric services during one year in 7 Nordic catchment areas. For each patient a 1-year follow-up of service use in terms of inpatient care, day care and outpatient care was performed. An one-day point prevalence study was performed in 5 of the catchment areas.

Multifold differences existed between the services in treated prevalence, contact rates and patterns of care. The accessibility of the services and the amount and allocation of resources were of minor importance in determining the contact rate and use of services. Rates of outpatient staff was the only service characteristic associated with the contact rates.

The use of services was very skewed, e.g. 10% of the patients accounted for 90% of all inpatient days. High consumption of services was related to older age, living alone, being unemployed, female gender, a diagnosis of psychosis and a history of psychiatric service use. Use of inpatient services was correlated to supply of beds. Highly staffed community services did not reduce the use of inpatient services. An availability of day care services was related to less use of inpatient services for psychosis patients.