European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S583–S644 S619
mentation (P = .000). The total proportion of patients admitted
(whether informally or detained) also decreased from 63.3% before
the 2007 MHA to 52.8% thereafter (P = .000).
Conclusion These results show a significant decrease in the rate
of detentions under the MHA since the 2007 Act became law.
Keywords Assessment; Detention; England; Admission; Mental
Health Act
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Reference
[1] The National Archives. Mental Health Act 2007: explanatory
notes; 2007 [Available from:
, Online, acces-
sed 14th December 2016].
EV0662
Admission to in-patient psychiatric
care in the Veneto region (Italy),
specialisation vs. personal continuity
of care approach. Preliminary findings
from the COFI study-Italian sites
E. Miglietta ∗ , A. Lasalvia , P. Sara , G. Zanatta , S. Zoppei ,
G. Dimitri , C. Comacchio , D. Cristofalo , C. Bonetto ,
D. Giacco , S. Priebe , M. Ruggeri
1 University of Verona, Department of Neurosciences, Biomedicine
and Movement Sciences, Section of Psychiatry, Verona, Italy
2 Queen Mary University of London, Unit for Social and Community
Psychiatry, London, United Kingdom
∗ Corresponding author.
Introduction In Italy, considerable variations exist in the organi-
sation of out- and in-patient mental health care. One main issue is
whether to prioritise specialisation (distinct clinicians for inpatient
and outpatient care) or personal continuity of care (same primary
clinician for a given patient within the two settings).
Aims To study the use of psychiatric in-patient units in the
Veneto region (Italy) and to evaluate differences between personal
continuity of care and specialization systems.
Methods Study conducted in the context of the COFI, multisite
naturalistic EU-funded research aiming to compare the two care
approaches in 5 European countries. In Italy, baseline data collec-
tion was carried out in 14 in-patient units. Data on hospitalisation,
diagnosis, severity of the illness (Clinical Global Impression Scale-
CGI) and patients’ appraisal of inpatient care (Client Assessment of
Treatment Scale- CAT) were collected.
Results Overall, 1118 patients were assessed. Most frequent
diagnostic categories were mood (41.6%) and psychotic (38.3%)
disorders, while anxiety disorders were less represented (11.9%).
The majority of patients were at least at their second admission
(69.4%) and had been voluntary admitted (91.5%). Length of stay
and CGI scores were significantly higher for patients with mood
and psychotic disorders. No difference in CGI score between the
two systems was found. Patients in the continuity of care sys-
tems reported higher level of satisfactionwith initial treatment and
longer hospital stay (P < .001).
Conclusions These preliminary findings suggest higher service
satisfaction for personal continuity system, possibly reflecting a
more individualised and comprehensive focus on the patient’s
needs, rather than on symptoms reduction only.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0663
Symposium: Mental health law
differences and coercive measures
over four countries
E. Noorthoorn ∗, P. Lepping (Consultant Psychiatrist) ,
T. Steinert , E. Flammer , B. Massood , N. Mulder
1 GGnet, Research and training, Zutphen, The Netherlands
2 Bangor University and Mysore Medical College and Research
Institute, India
3 Betsi Cadwaladr University Health Board, Centre for Mental Health
and Society, Technology Park, Croesnewydd Road-Wrexham LL13
7TP-Wales, Division of Mental Health and Learning Disabilities,
Wrexham, Wales, United Kingdom
4 ZfP Weissenau, Regionale Geschäftsbereichsleitung, Klinik für
Psychiatrie und Psychotherapie Weissenau, Weissenau, Germany
5 Klinik für Psychiatrie und Psychotherapie Weissenau, Forschung,
Weissenau, Germany
6 Betsi Cadwaladr University Health Board, Division of Mental Health
and Learning Disabilities, Wrexham, Wales, United Kingdom
7 Erasmus Medisch Centrum, Psychiatrie, Rotterdam, The Netherlands
∗ Corresponding author.
In 2008, the UNHCR issued a convention on the rights of persons
with disability. Since then, many countries were visited by the
High Commissioner for Human Rights. In a number of countries,
for example Germany and the Netherlands, mental health legisla-
tion was considered unsatisfactory and either regional variations
in procedures or new legislation was drafted. In Germany, the final
decision after different admission procedures is always made by a
judge. In the Netherlands, detention on mental health ground with
involuntary admission is decided by a Governmental administrator
working for the local Major. In England and Wales, it is decided by
threemedical/psychiatric professionals. Currently, the Netherlands
is drafting a law following the main principles of the Anglo-Saxon
law. InGermany, all federal states are currently adopting theirmen-
tal health laws to fulfil requirements of the Constitutional Court,
which decided that coercive treatment is only admissible under
very strict conditions after a judge’s decision. Studies show the
Dutch legislation is associated with higher seclusion rates, in num-
bers, and duration. Moreover, recent German findings show in a
recent period when involuntary medication was not admissible,
inpatient violence and coercive measures increased significantly.
In this symposium, we discuss the several laws and regulations of
four countries (Wales, Ireland, Germany, Netherlands), now and in
the near future. Eachpresentation of a certain countries’ regulations
is followed by a description of standard figures of the country, first
by an expert in the respective country’s law, and consequently by
an expert in nationwide or regional figures.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0664
Stigma as an obstacle to paradigm
change in mental health care in
Lithuania
E. Sumskiene (Social Work)
Vilnius University, Vilnius, Lithuania
The paper is based on the data gathered during implementation of
the “Project paradigm change of mental health and Well-being in
Lithuania: towards empirically valid model”. This project is aimed
to contribute to the paradigmatic change by scientific research
and evaluation of efficacy of pharmaceutical and psychothera-
peutical treatment to psychological and social functioning and
to estimate economic burden of treatment and mental diseases.
Aim of the research is to analyse stigma as an obstacle for tran-
sition from biomedical to bio-psycho-social paradigm. Objectives