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

S599

case-management approach in terms of the BPRS and the mea-

sures of life satisfaction and recovery-promoting relationships.

ACT, however, may have some advantages over a standard-case

management approach.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1762

EV778

Can physician incentives improve

continuity of care for patients

receiving depression treatment in the

primary care setting?

P. Joseph

1 ,

, A. Kazanjian

2

1

School of Population & Public Health, Vancouver, Canada

2

School of Population & Public Health, Faculty of Medicine,

Vancouver, Canada

Corresponding author.

Introduction

In 2008, the province of British Columbia, Canada

introduced financial incentives to encourage general practition-

ers (GPs) to assume the role of major source of care for patients

seeking mental health treatment in primary care. If successful, this

intervention could strengthen GP–patient attachment and conse-

quently improve continuity of care. The impact of this intervention,

however, has never been investigated.

Aim

To estimate the population level impact of physician incen-

tives on continuity of care (COC).

Method

This retrospective study examined linked health admin-

istrative data from physician claims, hospital separations, vital

statistics, and insurance plan registries. Monthly cohorts of indi-

viduals with depression were identified and their GP visits tracked

for 12 months, following receipt of initial diagnosis. COC indices

were created, one for any visits (AV) and another for mental health

visits (MHV) only. COC (range: 0–100) was calculated using pub-

lished formula that accounts for the number of visits and number

of GPs visited. Interrupted time series analysis was used to esti-

mate the changes in COC before (01/2005–12/2007) and after

(01/2008–12/2012) the introduction of physician incentives.

Results

The monthly number of people diagnosed with depres-

sion ranged from 7497 to 10,575; yearly rates remained stable

throughout the study period. At the start of the study period, mean

COC for AV and MHV were 75.6 and 82.2 respectively, with slopes

of –0.11 and –0.06. Post-intervention, the downward trend was

disrupted but did not reverse.

Conclusions

Physician incentives failed to enhance COC. How-

ever, results suggest that COC could have been worse without the

incentives.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1763

EV779

An innovative day centre in Athens

with expertise in children neglect and

abuse. A unique therapeutic

intervention through the fog of

economic crisis

A. Kanellopoulos

1 ,

, E. Marini

2

, X. Antoniou

2

, G. Nikolaidis

2

1

National Kapodistrian University of Athens, Evgenidion

Therpaeftirion, Mental Health Care Unit, Athens, Greece

2

Smile of the Child- Athens, Day Care Centre- The House of the Child,

Athens, Greece

Corresponding author.

The Day Centre “THE HOUSE OF THE CHILD” is a unique in Greece

community unit providing customized clinical mental health

services for therapeutic treatment and psychosocial rehabilitation

of children and adolescents victims of abuse, neglect or domestic

violence, as well as children or adolescents involved in cases of

bullying. The Day Centre was founded by the non-profit voluntary

organisation “THE SMILE OF THE CHILD”. The Day Centre’s services

are addressed to children and adolescents up to age of 18 who live

either in residential care or in the community having a documented

history of exposure to violence of any kind. Services are free of

charge and are expanded to the following areas:

– early intervention-evaluation-counselling;

– diagnosis and treatment of the full range of child psychiatry dis-

orders and issues of clinical attention;

– diagnosis and treatment of specific learning deficits and provi-

sion of speech therapy,

о

ccupational therapy and special education

support when needed;

– counselling for parents and carers of victimized children and

adolescents;

– registering and statistical analysis of psychosocial rehabilitation

needs arising from the child abuse incidents.

More general activities for raising awareness and sensitivization of

the wider community in order to prevent all forms of child abuse

and victimization.

The Day Centre’s personnel

comprises from a

psychiatrist–scientific coordinator, three child psychiatrists,

three clinical psychologists, a special educator, a speech therapist,

a social worker, an occupational therapist and two administrators.

This interdisciplinary therapeutic team undertakes a comprehen-

sive diagnostic evaluation and therapeutic intervention scheme to

address the complex disorders and wider psychosocial needs of

children – victims.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1764

EV780

Doing more than ACT: The Dutch FACT

model, flexible assertive community

treatment

R. Keet

GGZ, Noord-Holland -Noord, Community Mental Health Service,

Heiloo, Netherlands

Background/objectives

Assertive community treatment (ACT) has

become the standard for integrated care for people with severe

mental illnesses. Limitations of ACT are the lack of flexibility, the

limited feasibility in rural areas, the limited population and the

time-unlimited nature. These limitations can be overcome by flex-

ible assertive community treatment (Flexible ACT), developed in

the Netherlands and introduced in several European countries.

Methods

Three studies were done between 2006 and 2015 on the

results of the introduction of Flexible ACT, two in The Netherlands

and one in the UK.

Results

The outcomes in the Netherlands data show the effec-

tiveness of Flexible ACT. Remission of schizophrenia increased form

19% to 31%. Bed use was reduced and quality of life increased. Effec-

tiveness of FACT was also shown in the UK, where total patient

time in hospital declined by half, even though the average time

service providers spent with patients also declined. Collected data

of the digitalized boards show that the board is used in accordance

with the FACT model. Transition rate to primary care is 5–10% per

year.

Discussion/conclusion

The introduction of Flexible ACT has been

shown to benefit patients with severe mental illness and indicate

the ability of to allocate human resources in mental health care

more efficiently. Introduction to other countries will be accompa-

nied by research on the effectiveness and feasibility within other

cultures.