European Psychiatry - Volume 33 - March 2016

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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.
EV778
Can physician incentives improve
continuity of care for patients
receiving depression treatment in the
primary care setting?
P. Joseph ∗, A. Kazanjian
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.
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 ∗, E. Marini , X. Antoniou , G. Nikolaidis
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, оccupational 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.
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.