ABSTRACTS - World Psychiatric Association

PO3.133.
PATTERNS OF CARE IN PATIENTS DISCHARGED
FROM ACUTE PSYCHIATRIC INPATIENT FACILITIES:
A NATIONAL SURVEY IN ITALY
A. Preti, P. Rucci, A. Gigantesco, G. Santone, A. Picardi,
R. Miglio, G. de Girolamo, for the PROGRES-Acute group
Department of Psychology, University of Cagliari, Italy;
Department of Psychiatry, School of Medicine, University
of Pittsburgh, PA, USA; Mental Health Unit, Center
of Epidemiology, Health Surveillance and Promotion, Italian
National Institute of Health, Rome, Italy; Psychiatric Clinic,
United Hospitals of Ancona and Polytechnic University
of Marche, Ancona, Italy; Faculty of Statistics, University
of Bologna, Italy; Health Care Research Agency, Emilia-Romagna
Region, Bologna, Italy
The present study focuses on the characteristics of patients scheduled
for discharge enrolled in the framework of a nationwide survey of
acute psychiatric inpatient facilities in Italy, and their pattern of care,
i.e., two topics that have rarely received comprehensive attention.
Socio-demographic and clinical characteristics, and pattern of care of
1,330 patients discharged from public (n=130) and private (n=36)
inpatient facilities in Italy were assessed during an index period in the
year 2004. The most common diagnoses were schizophrenia and
bipolar disorder. Polypharmacy (prescription of two or more drugs of
different classes) was the sample’s most frequent form of treatment,
involving more than 90% of patients; approximately 25% of these
patients received more than one antipsychotic drug. Treatment with a
combination of different antidepressants was less frequent (ranging
from 6% to 15%, according to the facility type). Patients of male gender,
single, and unemployed were more likely to be discharged to
community residential facilities or to other inpatient facilities than to
their homes. Families were significantly involved in decisions about
patients’ discharge and this emphasizes their role for patients’ support
after the hospital stay, as well as the burden of informal care of
severe psychiatric patients. This study provides important information
for improving the care of patients admitted to public and private
inpatient facilities in a country that has closed down all its mental
hospitals, providing all psychiatric care by a network of communitybased
mental health services.
PO3.134.
TRIAGE: A NEW MODEL FOR ACUTE INPATIENT
PSYCHIATRY
M. Lanzaro
Department of Psychiatry, Camden and Islington Foundation
NHS Trust, London, UK
The aim of this paper is to describe a new model of psychiatric care
which has been used for 18 months across an adult psychiatric service
in North London. The Grove Centre opened in August 2005 and
is a purpose-built inpatient unit. We have 44 inpatient beds on three
wards: Fleet, Solent and Isis. Isis is a 12 assessment unit and the local
consultants provide input to assist with initial triage/assessment (up
to 21 days). Fleet and Solent are intermediate (second triage step)
wards and both have 16 beds, with one whole-time equivalent consultant
and two trainees. The introduction of the new model has
apparently resulted in a more efficient use of beds, with encouraging
preliminary results in terms of bed occupancy and other performance
indicators, with good feedback from patients and staff. The model
supports the evolving relationship between inpatient and community
services through a whole system approach, and aims to better meet
patient needs and minimise the length of stay by providing meaningful
integrated therapeutic interventions. An audit has been planned to
determine whether benefits persist or disadvantages emerge. The role
of the dedicated consultant(s) is discussed, in the light of the changing
roles for mental health staff auspicated by the principles of “new
ways of working” in the UK.
PO3.135.
FIRST RESULTS ON THE MENTAL
HEALTH OF THE POPULATION LIVING
IN THE EPIDEMIOLOGIC CATCHMENT
AREA IN MONTREAL, CANADA
J. Caron, D. Pedersen, M. Perreault, M-J. Fleury, A. Crocker,
A. Brunet, J. Tremblay, S. Beaulieu, G. Turecky, V. Nair,
M. Daniel, M. Cargo, Y. Kestin , M. Tousignant
Douglas Mental Health University Institute, McGill University,
Montreal, Quebec, Canada; School of Health Sciences, University
of South Australia, Adelaide, Australia; University of Montréal,
Quebec, Canada
We received a grant from the Canadian Institute of Health Research to
develop the first Epidemiological Catchment Area Study in Canada.
Five neighbourhoods in the south-west of Montreal regrouping
258,000 persons will be studied. The objectives of that research program
are: a) to examine the links and interactions between individual
determinants, neighbourhoods’ ecology (physical and socioeconomic
environment) and mental health in each areas of the predetermined
region; b) to identify the conditions facilitating the integration of individuals
with mental health problems in each community and the obstacles
to that integration, such as social stigma and antisocial behaviour;
c) to understand the impact that social, economical and physical
aspects of neighbourhoods’ ecological context have on mental health
using a geographic information system; d) to verify the adequacy of
mental health services in relation with the needs of the population. The
methods include a longitudinal epidemiological study under the form
of a community survey, followed by qualitative studies of particular
issues (i.e., services organization, social stigma and social support
actualization). The longitudinal study, using standardized instruments,
includes a randomly selected sample of 2,400 individuals aged from 15
to 65 years, who will be interviewed at a two-year interval. We present
the results of the first wave of the research program, including the incidence
and prevalence of psychological distress, mental disorders, substance
abuse, parasuicide and risky behaviour; quality of life; risk and
protective factors in mental health and the effects of poverty.
PO3.136.
GENERAL PRACTICE AND MENTAL HEALTH CARE:
DETERMINANTS OF OUTPATIENT SERVICE USE
H.-M. Vasiliadis, R. Tempier, A. Lesage, N. Kates
Department of Community Health Sciences, University
of Sherbrooke, Quebec; Department of Psychiatry, University
of Saskatchewan, Saskatchewan; Department of Psychiatry,
University of Montréal, Quebec; Department of Psychiatry
and Behavioural Neurosciences, McMaster University,
Ontario, Canada
This study aimed to examine the determinants that lead Canadian
adults to consult family physicians (FPs), psychiatrists, psychologists,
psychotherapists and other health professionals for mental health reasons
and compare the determinants of service use across provider
types. Data from the CCHS1.2 was used for persons aged 18 years and
older (n=35,236). A multivariate logistic regression was used to model
284 World Psychiatry 8:S1 - February 2009