The European Association of Epilepsy Centers Filadelfia, Danish Epilepsy Center, Dianalund, Denmark H. Hjalgrim ⁎, A. Nederland, C. Madsen, S. Birk, S.R. Madsen, K. Olofsson, C.E. Brandt, S. Beniczky, J.B. Rasmussen, L. Boserup, L.S. Lyngsø, L.L. Vilhelmsen, E. Sand, G. Kjær, K.P. Nielsen, J.T. Olsen, R.S. Møller, J.O.S. Jeppesen 1. Historical background In a time when people with epilepsy are still subjected to stigmatiza- tion and discrimination because of ignorance, misconceptions, and neg- ative attitudes surrounding the disease and still face serious difficulties in, for example, education, employment, marriage, and reproduction, looking back, it is evident that it was with great foresight and under- standing that Dr. Adolph Sell, a country doctor, founded “The Asylum for Epileptics in Tersløse” on February 7th, 1897. He, as a Christian, was inspired by visits to several European epilepsy centers, a.o. the Colony of Mercy in Scotland and Bethel in Germany, and was determined to create a Danish equivalent for people with epilepsy. It was to be “a home away from home”, with living, schooling, and working facilities for the patients/residents. Quickly, the offer was expanded to include admission of patients with psychiatric and nervous diseases. At first, education of staff was undertaken in Germany, but to ensure a well-motivated staff working in the spirit of Christian compassion, the vocational training of deacons was established at the Asylum. The name was quickly changed to ‘The Philadelphia Colony’— “Kolonien Filadelfia” (love of one's brethren) and, in 2007, again changed — this time to “Filadelfia”, signifying the beginning of a new era with more interaction with the surrounding world. In the beginning, the parish Tersløse was very small, but with time, the biggest village, Dianalund, grew because of “Kolonien Filadelfia”. At first, the staff had to live within the boundaries of the Kolonien, but with changing possibilities for laborers, it became eco- nomically possible for them to live outside the Kolonien Filadelfia, and they mainly took up residence in Dianalund. Today, Dianalund is a small town with approximately 4000 residents in the Western part of the island of Zealand, approximately 80 km from Denmark's capital Copenhagen. In the late 1960s, a gradual change was seen in the care for people with epilepsy, more emphasis being put on hospital care rather than institutionalization. With the introduction of social health reforms in the 1980s, the Epilepsy Center was given a unique opportunity to become an independent unit, as the care of people with epilepsy, unlike other areas, was not to be transferred to the counties. Since 1980, the majority of the health system in Denmark has been the responsibility of the regional counties encompassing public health and social services; in 2007, “Strukturreformen” changed the organiza- tion in Denmark: the number of municipalities was reduced from 275 to 98, and the country was divided into 5 regions with shared responsi- bility for a.o. the Health System. Filadelfia is a unique nonprofit private organization with specialized hospital and social services and as such mentioned in The Danish Law of Health. Filadelfia no longer provides for patients with primary psychiatric diagnoses. Preparations for this transition to our present position as an Epilepsy Center began in the early 1980s. The ownership of the psychi- atric hospital was transferred to the local county of Western Zealand, a relocation of the Epilepsy Hospital's wards was completed, the neuro- physiological department was modernized, and major staff changes took place. Officially, the Epilepsy Hospital was recognized in 1988 as Denmark's Epilepsy Center (National Center for Comprehensive Epilepsy Care & Research) with the opening of our 5-day unit (this has since closed). 2. Population served The population of Denmark, as of January 1st, 2016, is approximately 5.7 million. In Denmark, only physicians can refer patients to a hospital. Referrals to the Epilepsy Center come from all over the country, from the hospi- tals in the five regions, from Greenland and the Faroe Islands, and from general practitioners and consultants in neurology or pediatrics. Since 1993, legislation has ensured that any citizen with epilepsy has the right to be evaluated at our specialized Epilepsy Center on referral by their general practitioners. Since October 1st, 2016, all patients referred to a hospital have been entitled to either a diagnosis or an assessment plan within the first 30 days of the written referral date. Planning of specialized hospital services sets the framework for the specialized treatment at hospitals. The Danish Health Authorities define and determine which public hospitals (and a small number of private hospitals) should fulfill the special complex services. Services are divided into two groups, one of which is further subdivided into two. The basic group represents less than 10% of the patient cohort; the specialized group is divided into regional and highly specialized levels. In the pediatric department, almost all of the patients fall into the group of highly specialized patients; in the adult department, 75% are at the regional level, and 15% are highly specialized. Specialized groups are composed of patients (adults and children) with drug-resistant epilepsy and children with early onset epilepsy (epileptic encephalopathies). Typically, specialists in the regional neurological or pediatric wards have already seen the patients and are referring them either for a second opinion or continued care. The most common reasons for referral are medication, problems with subclassification, and doubts about the authenticity of the seizure disorder. A substantial number of patients are referred because of Epilepsy & Behavior xxx (2017) xxx–xxx YEBEH-05417; No of Pages 5 http://dx.doi.org/10.1016/j.yebeh.2017.07.020 1525-5050/© 2017 Elsevier Inc. All rights reserved. Contents lists available at ScienceDirect Epilepsy & Behavior journal homepage: www.elsevier.com/locate/yebeh Please cite this article as: Hjalgrim H, et al, Filadelfia, Danish Epilepsy Center, Dianalund, Denmark, Epilepsy Behav (2017), http://dx.doi.org/ 10.1016/j.yebeh.2017.07.020