European Psychiatry - Volume 33 - March 2016

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S6 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S5–S7
CS04
Prioritization in medicine – a special
role for mental healthcare?
T. Meyer
Hannover Medical School, Institute for epidemiology – social
medicine and health system research, Hannover, Germany
The international debate on priority setting in health care has been
around for more than 30 years now, Denmark, Norway, the US
state of Oregon, Sweden, UK and the Netherlands being among
their vanguards. From the beginning, the debate has been related
to – or was even seen as identical to – the discourse on rationing
in health care. Based on these international debates, the presen-
tation will introduce different understandings and characteristics
of the priority-setting concept in health care and will argue for
a clear distinction between priority setting and rationing. Dif-
ferent ways of implementing priority setting, i.e., by means of
guidelines or ethical frameworks, will be introduced to set the
frame for the current choosing-wisely initiative. It will be argued
that priority setting is important for the organisation of mental
health care, as it is for health and social care of different chronic
disorders.
Disclosure of interest The author has not supplied his declaration
of competing interest.
Symposium: psychosocial rehabilitation and
mental health
CS05
Evidence-based psychosocial
measures in rehabilitation
T. Becker ∗ uehne iedel-Heller
1 Günzburg, Germany
2 Universität Leipzig, Selbständige Abteilung für Sozialmedizin,
Leipzig, Germany
3 Universität Leipzig-Medizinische Fakultät, Institut für
Sozialmedizin- Arbeitsmedizin und Public Health, Institut für
Sozialmedizin- Arbeitsmedizin und Public Health, Germany
∗ Corresponding author.
Background Psychosocial interventions are essential tools in
mental health care and rehabilitation. A range of interventions rel-
evant to rehabilitation that are covered in a German DGPPN S3
guideline on psychosocial interventions are discussed.
Methods Literature search and (mostly) systematic reviews were
performed for a range of psychosocial interventions.
Findings Milieu therapy (MT) includes measures that impinge
on therapeutic milieu/atmosphere in joint professional/user
groups in the course of treatment. MT provides a context in
which psychosocial interventions can be implemented. There
is evidence of its effectiveness in improving mental health out-
comes. Peer involvement (PI) and peer support are supported by
promising evidence as innovative interventions in mental health
care. Findings on case management (CM) are inconsistent. There
are difficulties in defining CM. CM strengths include treatment
satisfaction and continuity of care. With respect to integration
in the labour market for people with severe mental illness sup-
ported employment (SE) has been shown to be more effective
in achieving job placement. A proportion of SE users fail to find
jobs on the general labour market. Other types of work rehabili-
tation are required, and there is room for pre-vocational training
interventions.
Discussion Psychosocial interventions are strong interventions.
The strength of the evidence is varied. The use of psychosocial
interventions rests on experience, evidence and ethics.
Conclusions Psychosocial interventions are indispensable in
building mental health care systems. Vocational interventions and
residential services are mandatory. Peer involvement could help in
moving mental health services forward.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
CS06
Quality assessment of mental health
rehabilitation services
H. Killaspy
University College London, London, United Kingdom
Objectives Providing good quality mental health care is vital to
achieve better outcomes but service quality is a complex, multidi-
mensional construct that extends beyond the delivery of specific
evidence based treatments and interventions. This makes it diffi-
cult to operationalize andmeasure, particularly at the international
level where different socioeconomic and political contexts impact.
Mental health rehabilitation services focus on people with severe
and complex psychosis. This group are one of the most socially
excluded in society and are vulnerable to exploitation and abuse.
They are also, be definition, difficult to treat and, historically, have
often been institutionalised in hospital or community facilities.
Aims This presentation will report on the development and
application of an internationally validated quality assessment tool
for longer term mental health care facilities, the Quality Indicator
for Rehabilitative Care (QuIRC).
Methods The content of the QuIRC was derived from a system-
atic literature review, international Delphi exercise and review of
care standards in ten European countries. Its psychometric proper-
ties were assessed in over 200 longer-term mental health facilities
across Europe involving validation with over 1750 service users. It
has subsequently been used in a national programme of research
into inpatient mental health rehabilitation services in England
which will also be briefly described.
Results The QuIRC has excellent inter-rater reliability and valid-
ity. Specific aspects of care assessed by the QuIRC have been found
to be associated with successful community discharge from inpa-
tient mental health rehabilitation services.
Conclusions The QuIRC is a free to use, standardised and vali-
dated on-line international quality assessment benchmarking and
research tool, available in ten European languages.
Disclosure of interest The author has not supplied his declaration
of competing interest.