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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.785

Symposium: psychosocial rehabilitation and

mental health

CS05

Evidence-based psychosocial

measures in rehabilitation

T. Becker

1 ,

, U . G

uehne

2 , S. R

iedel-Heller

3

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.786

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.787