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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S303–S364


to date, including evolving local and national policies that have

been developed to allow medical assistance in dying in certain cir-

cumstances. We will also review work of the Canadian psychiatric

association task force on medical assistance in dying (presented by

the Task Force Chair), with a focus on challenges and issues relevant

to mental health and mental illness.

Disclosure of interest

The author has not supplied his declaration

of competing interest.


Beyond the crisis: Ongoing psychiatric

treatment and service utilization after

initial symptom stabilization

following first-episode psychosis for


R. Gearing

, 1

, K. Brewer


, I. Mian


, K. Moore


, P. Fisher



J. Hamilton


, J. Mandiberg



University of Houston, GCSW, Houston, USA


University of New Hampshire, college of health and human services,

Durham, USA


The hospital for sick children, department of psychiatry, Toronto,



Columbia university, CSSW, New York, USA


New York state psychiatric institute/Columbia college of physicians

& surgeons, division of child and adolescent psychiatry, New York,



UT health McGovern medical school, department of psychiatry and

behavioral sciences, Houston, USA


Hunter university, CUNY, New York, USA

Corresponding author.


The importance of timely identification and treat-

ment of psychosis are increasingly the focus of early interventions,

with research targeting the initial high-risk period in the months

following first-episode hospitalization. However, ongoing psychia-

tric treatment and service utilization after the symptoms have been

stabilized over the initial years following first-episode has received

less research attention.


To model the variables predicting continued ser-

vice utilization with psychiatrists for adolescents following their

first-episode psychosis; examine associated temporal patterns in

continued psychiatric service utilization.


This study utilized a cohort design to assess adolescents

(age 14.4


2.5 years) discharged following their index hospitaliza-

tion for first-episode psychosis. Bivariate analyses were conducted

on predictor variables associated with psychiatric service utiliza-

tion. All significant predictor variables were included in a logistic

regression model.


Variables thatwere significantly associatedwith psychia-

tric service utilization included: diagnosis with a schizophrenia

spectrumdisorder rather thanmajor mood disorder with psychotic

features (OR = 24.0;


= 0.02), a first degree relative with depression

(OR = 0.12;


= 0.05), and months since last psychiatric inpatient

discharge (OR = 0.92;


= 0.02). Further examination of time since

last hospitalization found that all adolescents continued service

utilization up to 18 months post-discharge.


Key findings highlight the importance of early diag-

nosis, that a first degree relative with depression may negatively

influence the adolescent’s ongoing service utilization, and that 18

months post-discharge may a critical time to review current treat-

ment strategies and collaborate with youth and families to ensure

that services continue to meet their needs.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Opinions of professionals and family

members about the National mental

health law regulating involuntary

commitment of psychiatric patients:

An international comparative study in

10 countries

I. Georgieva

, 1

, C. Lauvrud


, R. Almvik


, R. Whittington



St. Olav’s university hospital, Forensic department, Trondheim,



St. Olav’s university hospital, Forensic department Brøset, centre for

research and education in forensic psychiatry, Trondheim, Norway

Corresponding author.


Previous research illustrated that the laws regula-

ting involuntary placement and treatment of persons with mental

health problems are very diverse across countries: procedures for

involuntary commitment and stakeholders involved in the initia-

tion and decision making vary across countries; most laws include

criteria of danger/risk, which take various forms in EU Member

States’ legal frameworks, while the need for treatment in the best

interests of the patient is sufficient to detain individuals in other

countries, etc.


This study will compare the opinions of professionals

and family members about the operation of the National mental

health law regulating forcibly admission and treatment of psy-

chiatric patients in ten countries: Ireland, Iceland, UK, Romania,

Slovenia, Denmark, Sweden, Germany, Norway and India.


To gain insights into stakeholders’ satisfaction with the

operation of their national legislation and to compare the effec-

tiveness and acceptability of different legislative processes across

countries. Such scientific findings are needed in order to improve

and harmonize legal practices, and to enhance fundamental rights

protection of persons with mental health problems, which even-

tually could result in a lower rate of compulsory admissions.


A short anonymous questionnaire consisting of 9 items

was developed, using the online software Survey Monkey. It was

distributed to representative samples via e-mail to psychiatrists,

general practitioners, acute and community mental health nurses,

tribunal members, guards and family members in each collabora-

ting country. The levels of agreement/disagreementweremeasured

on a Likert- scale.


The study’s results and conclusions will be

presented at the conference.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


PALOMA project – developing National

mental health policies for refugees

S. Jokela

, J. Mäki-Opas

National institute for health and welfare THL, department of welfare,

Helsinki, Finland

Corresponding author.


Earlier researches have established that migrants

with refugee background have increased risk for variety of men-

tal health problems due to often traumatic reasons for leaving

their home country, hazardous journey and post-migration adver-

sity. The challenge is that mental health work with refugees is not

systematically organized in Finland. PALOMA (developing National

mental health policies for refugees 2016-2018) project was laun-

ched to answer these challenges. The project is carried out through

the combined effort of National institute for health and welfare,

The Finnish association for mental health, Helsinki and Kuopio uni-

versity hospitals, and the municipality of Hämeenlinna. PALOMA