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The SOS of psychiatrists launched to the Prime Minister

2022-05-30T14:01:42.104Z


EXCLUSIVE. 75 caregivers appeal to Élisabeth Borne, the new Prime Minister, entitled "Let's create jobs to avoid shipwreck


They are psychiatrists, interns, psychologists, nurses… And all of them are crying out to the new Prime Minister, Élisabeth Borne, in a tribune “Let's create jobs to avoid sinking!

".

The equation no longer works.

On the one hand, the Covid-19 pandemic is creating an unprecedented influx of patients to psychiatric emergencies: suicidal crises, delirious outbursts, depression.

“Especially among young people, without landmarks, anxious about the future.

When you lose hope, it takes a long time to find it, ”warns Antoine Pelissolo, psychiatrist at Henri-Mondor hospital, in Créteil (Val-de-Marne).

On the other, "15% of beds are closed in AP-HP hospitals, for lack of nurses", continues this head of department.

Admittedly, these difficulties are not new, but they are getting worse, the consequences are “dramatic”.

Height of this tension, one Sunday in April, in a hospital in the Paris region, 18 patients, all in very serious condition, found themselves waiting, when they had to be hospitalized, urgently.

To "welcome them, reassure them, monitor them", that day, only a psychiatrist and a nurse were there.

The signatories of the platform warn: "This overflow of reception capacities translates into hours and days of waiting on a stretcher or a chair in a corridor, running away, agitation, even fights, and inevitably overwhelmed and exhausted professionals, wishing only one thing: to change jobs, hospitals, or even professions.

Such a waste.

".

Another consequence, according to Antoine Pelissolo: “The use of isolation and restraint is on the rise because caregivers can sometimes be overwhelmed by the situation, which should not happen”.

And faced with the influx of requests, the patients, once hospitalized, according to the psychiatrist, come out more quickly, “result, they relapse”.

The text of the forum: "Let's create positions to avoid sinking!"

"One Sunday in April in the emergency room of a large hospital in the Paris region, 18 patients are waiting for psychiatric care, all in serious situations requiring immediate hospitalization: suicidal crisis, delirious puffs with agitation, extreme depressive states, etc. .

To welcome, assess, reassure, monitor, treat, contact families and hospitals for these 18 patients: a psychiatrist and a nurse, and insufficient premises.

This overflow of reception capacities translates into hours and days of waiting on a stretcher or a chair in a corridor, running away, agitation, even fights, and necessarily overwhelmed and exhausted professionals, only wishing one thing: changing jobs, hospitals, or even professions.

Such a waste !

The situation of overcrowding in psychiatric emergencies is not new, it is getting worse from year to year, in adult psychiatry as well as in child psychiatry.

But, since the pandemic, we are experiencing a dramatic acceleration of this gear.

Two main reasons: the very sharp increase in the need for psychiatric care on the one hand, and the closure of a large number of beds in specialized services due to a shortage of nursing staff on the other.

Read also“The fear is that there will be a tragedy this summer”: France faces a worrying shortage of caregivers in hospitals

For many acute psychiatric states, and all the more so in degraded social contexts, recourse to hospitalization is unavoidable.

It is certainly necessary to intervene upstream of crises and

on an outpatient basis

, and this is being done better and better.

But there will always be situations imposing a time of hospitalization.

However, working in psychiatric care units, especially the most intensive ones, is particularly trying and stressful.

This is teamwork which can be exciting but which requires spending a long time with patients and supporting them in their suffering.

Fortunately, many caregivers have this vocation and this skill, and thanks to them very good therapeutic results can be obtained.

But alas, everything is done today to dissuade them from investing in it and finding meaning in it: they are asked to do it ever faster, with fewer staff and fewer means, and weigh on them more and more administrative charges.

The numbers are calculated as accurately as possible, often without taking into account the specificities of psychiatric care and the vagaries of absences and difficult situations (peak numbers of patients, various crises, etc.).

This loss of meaning and this pressure of time and savings to achieve generate a

vicious circle of shortage

.

Not enough at the base (even when all positions are occupied), caregivers leave our hospitals or are absent for health reasons, which further reduces the available workforce.

Staff are then asked to replace each other from one service to another, to work overtime, and to change their schedules constantly.

This encourages them to jump ship even more, with a domino effect on all psychiatric and emergency services where the workload increases.

The main reason for staff discouragement is not the amount of remuneration but working conditions, stress, the feeling of exhaustion and insecurity, and the gap between professional aspirations and the reality of imposed work.

Read alsoBlack thoughts, depression, anorexia … diving into the hospitals where teenagers are repaired

While we are short of candidates, it might seem illusory to set upward personnel targets.

But not displaying such normal ambitions only feeds the shortage: the positions are not attractive when the candidates find that, in any case, there will be insufficient numbers of them to treat properly.

The definition of minimum ratios of caregivers per service is a vital necessity, demanded by all those who are worried about the future of our hospitals (Senate report in 2022, general controller of places of deprivation of liberty, etc.).

The authorities refuse to do so, fearing that they will not have the means to finance such measures, but this abstention risks costing our society much more very quickly.

The closure of services, even hospitals, can only lead to human tragedies through the absence of care, with obvious economic consequences: unemployment, work stoppages, social complications, etc.

We must continue to develop ambulatory care, crisis prevention and recovery-oriented practices but, as long as they are necessary, maintain hospitalization teams in sufficient numbers to avoid any mistreatment.

The solution therefore exists.

Who will finally be able to take this courageous decision to loosen the shackles that constantly constrain hospital staff and lead us to shipwreck?

Hospital management must balance their budgets and respect employment ceilings, and the ARS cannot grant budgets that they do not have.

The Minister of Health does not seem to have this power, the commitment must come from

above

.

Be that as it may, and

whatever the cost

, if nothing is done in this direction, a very bleak future awaits us.

»

The petitioners

1. AKOUAKOU Laura, specialist educator, Cergy

2. BARRETEAU Sylvie, child psychiatrist, Asnières-sur-Seine

3. BENYAMINA Amine, professor of psychiatry, Paris-Saclay University

4. BIZARD Sarah, hospital psychiatrist, Argenteuil

5. BONHOURE Adriana, specialist assistance, Villejuif

6. BONNOT Olivier, professor of child and adolescent psychiatry, Nantes

7. BORWELL Baptiste, hospital psychiatrist, Marseille

8. BOUAZIZ Noomane, hospital psychiatrist, Neuilly-sur-Marne

9. BOUCHER Morgane, hospital psychiatrist, Créteil

10. Mathilde BRAGEOT, hospital practitioner, addiction psychiatrist, Paris XXth

11. CANCEIL Olivier, hospital psychiatrist, Saint-Maurice Hospitals

12. CANTERO Alain, psychiatrist, head of department, Saint-Maurice Hospitals

13. CARRET Vincent, psychiatrist, Marseilles

14. CHENE Margaux, intern in psychiatry, Paris

15. CLAVEL Estelle, hospital psychiatrist, Villejuif

16. CLÉMENT Judith, peer health mediator, Paris

17. COHEN David, professor of child and adolescent psychiatry, Paris

18. CONDEMINE Marie, psychologist, Paris

19. CONSOLI Angèle, professor of child and adolescent psychiatry, Paris

20. CORTÈS Marie-José, President of the Union of Hospital Psychiatrists, Mantes-la-Jolie

21. CRAVERO Cora, child psychiatrist, hospital practitioner, Paris

22. DEMERY Malika, psychiatrist, Briançon

23. DUBERTRET Caroline, professor of psychiatry, head of the AP-HP department, Colombes

24. DURANTÉ Étienne, intern in psychiatry, Villejuif

25. DZIERZYNSKI Nathalie, Medical Head of Psychiatry Unit, Tenon Hospital, Paris

26. FOGLIA Noémie, specialist educator, Argenteuil

27. FOLIGNÉ Marine, psychiatrist, hospital practitioner, Paris

28. Guillaume BACKGROUND, hospital psychiatrist, Marseille

29. GORIOT Élisabeth, former senior health manager, La Ville-du-Bois

30. GOUSSET Robin, hospital practitioner psychiatrist, Clamart

31. GRANGER Bernard, Professor of Psychiatry, Cochin Hospital, Paris

32. GRAU Léa, psychiatrist, Argenteuil

33. Laurence GUEZ, psychiatry attaché, Tenon hospital, Paris

34. HIRSCH Raphaëlle, hospital psychiatrist, Marseille

35. HUMBAIRE Camille, Hospital psychiatrist, Villejuif

36. HUPPERT Thomas, child psychiatrist, Argenteuil

37. IAMANDI Alexandra, hospital psychiatrist, Villejuif

38. JANUEL Dominique, professor of psychiatry, EPS Ville Evrard, Neuilly-sur-Marne

39. JEAN-FRANÇOIS Paul, hospital psychiatrist, Villejuif

40. KORCHIA Theo, head of clinic, Marseille

41. LAIDI Charles, hospital psychiatrist, Créteil

42. LAMISSE Christophe, head of psychiatry and mental health, Argenteuil

43. LANÇON Christophe, Professor of Psychiatry, Marseille University Hospital, Marseille

44. LE BLANC Eve, hospital psychiatrist, head of department, Paris

45. LE GUEN Emmanuel, hospital psychiatrist, Paris

46. ​​LECONTE Dominique, family peer support worker, Garches

47. LEGUAY Denis, psychiatrist, president of Mental Health France, Angers

48. LIEVRE Bertrand, hospital psychiatrist, Joinville-le-Pont

49. LLORCA Pierre-Michel, Head of Department, CHU Clermont-Ferrand

50. LOPEZ Ofelia, psychologist, Saint-Maurice

51. LORIC Marie, psychiatrist, Créteil

52. MAKSOUDIAN Azad, hospital psychiatrist, Paris

53. Éric MALBOS, hospital psychiatrist, Marseille

54. MALLET Luc, professor of psychiatry, CHU Henri-Mondor, Créteil

55. MARULAZ Laurent, hospital psychiatrist, Villejuif

56. MIFORT Béatrice, Psyado liaison nurse, Argenteuil

57. MONSONEGO Hélène, head of department, Clamart

58. MONTAGNIER Delphine, hospital psychiatrist, Paris

59. MOREAU Elsa, psychologist, Paris

60. NKAM Irène, hospital psychiatrist, Créteil

61. NUEVO Julia, psychologist, Vanves

62. OTMANI Ouardia, hospital psychiatrist, department head, Paul-Guiraud hospital, Clamart

63. PAQUIS Jean, hospital psychiatrist, Saint-Claude

64. PELISSOLO Antoine, professor of psychiatry, CHU Henri-Mondor, Créteil

65. PERISSE Didier, child psychiatrist, Paris

66. PIGNON Baptiste, hospital psychiatrist, Créteil

67. RAFFIN Marie, hospital psychiatrist, Paris

68. RICHIERI Raphaëlle, professor of psychiatry, Marseilles

69. SAYOUS Romain, hospital psychiatrist, Créteil

70. SPINU Ramona, hospital practitioner, Argenteuil

71. TASTEVIN Maud, head of clinic, Marseille

72. TEPES SIMWAMI RODICA, hospital practitioner, Argenteuil

73. VALENTIN Marie, psychiatrist, Argenteuil

74. VIDAL Camille, hospital practitioner 94G17 Paul-Guiraud hospital group, Thiais

75. ZHENG Monique, hospital practitioner, Clamart

Source: leparis

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