Reorganizations are underway in psychiatric departments in Val-de-Marne.
Should we be alarmed at this when the health crisis has serious psychological consequences?
The head of the psychiatry department at the GHU Henri-Mondor (AP-HP), Prof. Antoine Pelissolo, who alerted the Ministry of Health in 2019 with a letter co-signed by more than 100 professionals on the insufficient care of psychiatric patients , returns to this context.
Should we be concerned about the reorganizations underway in several establishments?
PR.
ANTOINE PELISSOLO.
Almost everywhere, tensions exist, in Val-de-Marne, as in the rest of France.
We know that the means available have been insufficient for a long time.
And if the Val-de-Marne concentrates a lot of structures, they are not all dedicated to Val-de-Marne.
It is increasingly difficult to find psychiatrists, especially in cities far from Paris.
Each year, less than a hundred psychiatrists are trained and finish their internship in Ile-de-France.
But it must be seen that these movements are not necessarily implemented to restrict resources but to adapt as best as possible to the crisis, since the means will not increase.
Better coordination of structures can be a strength and not a handicap, with the objective of offering a better course of care for the patient.
However, the health crisis raises fears of an increase in requests for care, right?
Yes, especially among young people, there is an inflation of demands, with a whole panel of troubles.
In some patients, these disorders even worsened, as we were less available because of the confinement.
But there are also all those who are not followed.
There is also an increase in suicide attempts.
This has repercussions in emergencies or in town doctors.
Except that the system is saturated.
It's a time bomb.
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How to remedy this lack of resources?
Beyond hospital beds, we especially lack living spaces to support patients who are not independent.
Some live on the streets, others remain hospitalized for lack of places in homes, specialized reception centers and unfortunately, they continue to be sent to Belgium.
Outpatient projects are also a solution for offloading hospitals upstream and downstream, such as the mobile teams that we launched two years ago.
But above all, to the future service of access to care of the Samu, it would be necessary to add a service of regulation of the calls to the emergencies, under psychiatry.
This would make it possible to provide a faster response to all those who, not knowing where to go when they need a psychiatrist, go to the emergency room, when it is not a suitable place.
It would save everyone's time and avoid critical situations.