European Psychiatry - Volume 41 - April 2017

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S618 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S583–S644
e-Poster viewing: Mental health policies
EV0658
Task-shifting in mental health
services: Extent, impact and
challenges in Ghana
V. Agyapong
University of Alberta, Department of Psychiatry, Edmonton, Canada
Aim To examine the role and scope of practice of community
mental health workers (CMHWs) as well as the impact and chal-
lenges associated with of work of CMHWs within Ghana’s mental
health delivery system.
Methods A cross sectional survey of 11 psychiatrists, 29 health
policy directors and 164 CMHWs as well as key informant inter-
views with 3 CMHWs, 5 psychiatrists and 2 health policy directors
and three focus group discussionswith 21 CMHWs. Results of quan-
titative data were analysed with SPSS version 20 whilst the results
from qualitative data were analysed manually through thematic
analysis.
Results In addition to duties prescribed in their job descriptions,
all the CMHWs identified several jobs that they routinely perform
including jobs reserved for higher level cadres such as medication
prescribing for which most of the CMHWs have no training. Some
CMHWs reported they had considered leaving the mental health
profession because of the stigma, risk, lack of opportunities for con-
tinuing professional development and career progression as well as
poor remuneration. Almost all the stakeholders believed CMHWs
in Ghana receive adequate training for the role they are expected
to play although many identify some gaps in the training of these
mental health workers for the expanded roles they actually play.
All the stakeholders expressed concerns about the quality of the
care provided by CMHWs.
Conclusion The study highlights several important issues, which
facilitate or hinder effective task-shifting arrangements from psy-
chiatrists to CMHWs and impact on the quality of care provided by
the latter.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV0659
Could promoting happiness mental
health policy prevention against
suicide?
A. Chaouqi ∗, Y. Alaoui Mamouni , Z. Hammani , M. Yassari
1 Hôpital militaire Mohamed V, psychiatry, Rabat, Morocco
2 Hôpital militaire My Ismail, psychiatry, Meknes, Morocco
∗ Corresponding author.
What do we know about happiness? What is the essence of hap-
piness? What are the causes of happiness? Is there a difference
between individual happiness and collective happiness? Can we
measure happiness? Let us see if there is a correlation between
suicide and happiness?
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0660
Fit note use in UK clinical practice
2010–2016: A systematic review of
quantitative research
S. Dorrington ∗, E. Roberts , S. Hatch , I. Madan , M. Hotopf
1 King’s College London, Department of Psychological Medicine,
London, United Kingdom
2 King’s College London, Occupational Health, London, United
Kingdom
∗ Corresponding author.
Background The fit note, introduced in England, Wales and
Scotland in 2010, was designed to radically change the sickness cer-
tification process from advising on individuals’ inability to work to
what they could do if adjustments weremade available. Our review
aimed to evaluate: (1) the percentage of fit notes utilizing the new
“may be fit for work” option or advising on work adjustments, (2)
the impact of the fit note on sickness absence and return to work,
(3) demographic variation in fit note use.
Methods We systematically searched in Embase, Cochrane CEN-
TRAL, Pub Med, Worldcat, Ovid and PsychInfo from 1 Jan 2010–30
Nov 2016 for studies on working aged adults which included
the search terms “fit note” or “fitnote”. Relevant abstracts were
extracted and we assessed the quality of the papers and assessed
bias using the modified Newcastle Ottawa Scale.
Results Nine papersmet the inclusion criteria, four of whichwere
based on the same cohort. Maybe fit notes made up just 6.6% of
all fit notes. Work adjustments were most often recommended for
patients who were less deprived, female and patients with phys-
ical health problems. Fit note advice for patients with physical
health problems increased over time, but the opposite was seen
for patients with mental health problems.
Conclusions Further research needed to evaluate the use, impact
and potential of the fit note, especially for patients with mental
illness.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0661
The impact of change in the 2007
English law on mental health act
detentions
J. Beezhold , G. Mosa , A. Pandey , S. Pandey , M. Dyer ,
C. Kitromilidou ∗
1 Norfolk and Suffolk NHS Foundation Trust, Department of
Psychiatry, Norwich, United Kingdom
2 University of East Anglia, Norwich Medical School, Norwich, United
Kingdom
∗ Corresponding author.
Background The Mental Health Act (MHA) 2007 made some sig-
nificant changes from the Mental Health Act 1983, including the
fact that detention is now only allowed if an appropriate medical
treatment is available to the patient at the time here was con-
siderable concern at the time that the 2007 Act would lead to an
increase in detentions.
Objective The primary objective is to assess how the change in
the English law with the MHA 2007 has affected the number of
detentions under the MHA.
Methods A retrospective, observational and noninterventional
study used anonymised and routinely collected data regarding
11,509 peoplewhowere formally assessedunder theMental Health
Act during the period of 2001–2011 in the county of Norfolk. This
included 7885 assessments before the 2007 MHA and 3620 done
after implementation.
Results The proportion of people detained following assessment
decreased from 53.2% before the 2007 MHA to 42.9% after imple-