European Psychiatry - Volume 33 - March 2016

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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.
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.
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.
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