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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805

S597

addictions within a multidisciplinary team. The striking point of

this model is the intense support made towards the community

(general practionners, somatic and psychiatric cares) in order to

maintain and develop addiction cares in the general health system.

The case management model, still rare in France, is being imple-

mented in the center resources management. Detailed descriptions

are proposed.

Lack of psychiatrists in the French speaking Canton of Vaud makes

it very attractive for European specialists. Work and academic facil-

ities, including psychotherapy training are accessible to foreign

psychiatrists.

Conclusions

Work migration is a unique way to experience dif-

ferent practices in psychiatry within Europe. Living and working

conditions in Switzerland make it a country particularly attractive.

Disclosure of interest

The author has not supplied his/her decla-

ration of competing interest.

Reference

[1] Pinto da Costa M. EFPT International Brain Drain Study. IJCNMH

2015;2(Suppl. 1):L9.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1756

EV772

Outcomes for assertive outreach

service users when the specialist team

has closed – findings from a series of

‘dismantling’ studies

M. Firn

, M. Alonso-Vicente

South West London & St George’s Mental Health NHS Trust,

Springfield Consultancy, London, United Kingdom

Corresponding author.

Introduction

Specialist assertive outreach (AO) teams, for hard to

engage patients with psychosis, are closing due to financial imper-

atives and a disappointing evidence base.

Objectives

Compare patient outcomes, experience and service

use before and for up to 4 years after closure of 3 specialised

assertive outreach (AO) teams in London, UK.

Aims

Flexible assertive community treatment (FACT) was

adopted as the service model for the standard care community

mental health team replacing AO care. We aimed to demonstrate

non-inferiority in clinical effectiveness and thereby show cost effi-

ciencies.

Method

Observational mirror-image studies of the closure of

3 teams with service utilisation data, cost-consequence analy-

sis and service user experience interviews both before and after

team closure using satisfaction with services and team attachment

instruments.

Results

The FACT 1 study, with 112 patients, was published in

2013 and surprisingly showed a significant reduction in bed use

following AO closure, with no significant change in the use of cri-

sis services as an alternative to admission. A new 4 year pre-post

analysis (in press) shows lower use of beds and crisis services is

maintained despite fewer contacts and higher caseloads. We will

report on the FACT2 replication study from a separate locality with

the additional patient experience findings.

Conclusions

AO patients are remarkably resilient to significant

reductions in the intensity of care and this holds for up to 4 years.

Enhancing multi-disciplinary CMHTs with FACT appears to pro-

vide a clinically effective and integrated alternative to orthodox

AO teams. FACT offers a cost-effective model compared to AO.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1757

EV773

The development of a novel,

automated smartphone application

for treating depression

C. Giosan

, V. Muresan , O. Cobeanu , A. Szentagotai , C. Mogoase

Babe-Bolyai University, Cluj-Napoca, Romania

Corresponding author.

In the recent years, automated CBT (interventions delivered on

the computer, or online, which use no or minimal therapist sup-

port) has emerged as a solution that can, on some dimensions, be

as effective as the classical CBT. However, the existing comput-

erized interventions for depression also come with less desirable

outcomes, such as high dropout rates (50–60%), limited endurance

of long-term benefits, or limited improvement in functioning. We

believe that these limitations characterizing the existing comput-

erized solutions are caused by:

– reduced or non-existent personalization of the intervention (e.g.,

same standard intervention delivered to various people, making

some unable to identify with the treatment);

– reduced immersion (and attractiveness) of the treatment expe-

rience (e.g., compared to other online activities, some intervention

platforms may be perceived as uninteresting or repetitive);

– lack of a customized, personalized manner of providing feedback

(most solutions present total scores for quizzes and scales).

Recognizing these shortcomings, we plan to use insights from

graphic design (e.g., user interfaces), gamification theories (e.g.,

“serious games”) and artificial intelligence to develop an auto-

mated application aimed at both prevention and intervention for

depression, which will substantially increase the quality of the user

experience, thus leading to better outcomes (e.g., reduced attrition

rates, more stable improvements, increased functioning).

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1758

EV774

Review of outcome domains in

European Mental Healthcare

I. Großimlinghaus

LVR-Institute for Mental Healthcare Research, Department of

Psychiatry and Psychotherapy, Düsseldorf, Germany

Introduction

Quality in mental healthcare is a complex, multi-

faceted construct. It can be categorized into structures, processes

and outcomes. In the past decade, there have been many initiatives

on the assurance and improvement of process quality through the

development, evaluation and implementation of process indicators

for several important process domains including, for example, con-

tinuity and coordination of care. Moreover, outcomemeasurement,

focusing on the extend to which intended outcomes of mental

health service provision are achieved, is receiving growing interest

and should be pursued through a systematic approach.

Objectives

Systematic compilation of outcome domains in men-

tal healthcare.

Aims

Identification of the full range of outcome domains in men-

tal healthcare.

Methods

Systematic literature review on outcome domains in

mental healthcare.

Results

A whole range of outcome domains can be identified and

categorized onto a continuum ranging from ‘traditional’, objective

outcome domains, such as mortality and symptomatology, to more

subjective outcome domains, such as quality of life and well-being.

Moreover, outcome measures in different outcome domains can

be assessed taking different perspectives into account, including

either the provider or the patient.

Conclusions

In order to develop and implement systematic out-

come measurement in mental healthcare, a first step is the