Schizophrenia is one of the most severe mental illnesses. This makes it an important test of how well countries support those with the most complex needs.

Schizophrenia can involve hearing voices, delusions and difficulties with thinking, motivation and everyday activities. It does not mean having a split personality and improvement is possible.

But recovery is about more than just having fewer symptoms. It means a life of value: healthy relationships, a home, good physical health and something meaningful to do, which is often work or study.

Yet, research shows that in both Denmark and the UK, two countries with publicly funded healthcare systems, just under half of those with schizophrenia are in work, education or training early in their illness. But as life with schizophrenia progresses, that number drops to around one in ten.

Health Gap / Sundhedskløften is a collaborative series from The Conversation UK and Denmark’s Videnskab.dk exploring what the two countries can learn from each other when it comes to health and wellbeing.

From cycling and alcohol to inequality, healthcare and everyday habits, the series looks beyond hospitals and medical treatment to explore how culture, politics and society shape the way people live – and how healthy they are.

So what can both countries learn from each other when it comes to better care? What helps someone build a life after diagnosis – and how does that differ between Denmark and the UK?

From diagnosis to treatment

In both countries, people with a first episode of schizophrenia are usually referred to a specialist team. In England (where most of our UK examples come from), early intervention in psychosis teams serve people between 14 and 65, and support can be offered for up to three years.

Denmark’s equivalent, Opus, is mainly for 18- to 35-year-olds and support normally lasts for two years.

Both teams combine medication with talking therapy, involvement of family and help with study or work. With Opus, a named contact coordinates this care and links with the local council. Research has found that this approach reduces symptoms more than standard care.

The care someone with schizophrenia receives in the UK is much more of a postcode lottery compared with Denmark. England’s 2023-24 national audit of early intervention teams found that 93% of teams in the east of England met the “performing well” standard, compared with just 21% in the south west.

Research shows that the end of that specialist care is a fragile moment in both countries. Interviews with people coming to the end of their care with early intervention teams in England found that people valued the care they had received, but some felt abandoned when it ended. Interviews with people in Denmark with long-term mental illness described how hard it was to find their way through services.

In and out of hospital

When someone needs a hospital bed, the two countries struggle in different ways. In England, a shortage of beds means some people are sent far from home, sometimes hundreds of miles away. At the end of July 2026, there were 285 “inappropriate” out-of-area placements. This meant that a national goal to end the use of these out-of-area psychiatric placements by 2021 was missed.

In Denmark, the pressure shows mainly as crowded wards. In the Central Denmark Region, only one psychiatric department briefly dropped below its 90% occupancy target during 2024.

Leaving hospital also shows where services are well connected and where they are not. Similar to the UK, psychiatric hospitals in Denmark are run by one government department, while local councils run housing support, social care and job centres.

Denmark’s 2025 psychiatry plan found that patients who could not leave hospital without council support waited on average for 43 days in psychiatry, compared with just four days in physical healthcare.

England has the same split between NHS hospitals and councils – that are responsible for social care and housing – this presents similar problems. Indeed, people stuck on mental health wards waiting for supported housing cost the NHS in England £102 million between 2024 and 2025.

Work rarely offered

Both countries have employment specialists within mental health teams to help people find a job. In a Danish trial of 720 people, this kind of support was found to lead to more time in work or education than the usual job services.

Neither country offers this service consistently everywhere, although Denmark aims for every psychiatric service to work this way by 2028.

In our Danish study, we followed more than 65,000 people with schizophrenia for up to ten years after diagnosis and in terms of employment status, we found that work, training or education accounted for 48% of the weeks we recorded.

While an audit in England and Wales found that in community psychosis care only 2% of people looking for a job had been offered work. Treatment and support alone cannot remove that barrier.

Health checks and follow-up

Antipsychotic medicines can also have side-effects. These can include increases in weight and blood sugar levels. And poor physical health in schizophrenia is often overlooked.

In both countries, it’s mainly GPs who must spot and treat the diabetes and heart disease that can follow. In Denmark, research has found that people with schizophrenia and diabetes are often tested as much as others. But in England,fewer than three in five people living with severe mental illness had a full physical health check in the last year.

So while it’s clear that both countries already monitor the quality of care, the task in both places is to use that evidence to make support dependable.

This is important because success should be judged by whether people can build lives they value. Ideally, a diagnosis should be the start of a plan for living, not the end of one.

This series was commissioned as part of a partnership between Videnskab.dk and The Conversation, where articles are published in English and Danish.