Tribune. The dramatic consequences of the health crisis on the mental health of the French will have escaped no one. Almost half of 20-24 year olds suffer from anxiety disorders, depressive disorders have doubled since September 2020 and the consumption of psychotropic drugs is exploding. Uncertainties, economic precariousness, bereavement, social isolation are all fertile grounds for increasing mental suffering.
Faced with this major public health issue, which risks being long-term, the offer of psychiatric care is devastated. Indeed, despite the importance of the resources devoted each year by Medicare to psychiatry (23.2 billion euros, far ahead of cardiovascular diseases or cancer), access to care remains very low and the half of people suffering from psychiatric disorders do not receive any care.
In the absence of in-depth reflection on the subject and in the absence of a certain form of radicalism in the decisions taken, the situation of deep crisis in which psychiatry finds itself risks becoming bogged down, to the detriment of both patients and patients. health professionals, currently suffocated by a growing demand that they cannot meet.
Collaborative care
Today, psychiatry, too often isolated from the rest of the healthcare system, is overwhelmed. In many countries, a so-called “graduated” approach has made it possible to greatly increase access to care and to ensure much earlier identification. This approach involves investing massively in the first line and in particular in general medicine where more than 60% of the first consultations for mental disorders take place.
It is urgent to give general practitioners the means to properly take charge of the most frequent disorders such as depression and anxiety disorders, which affect nearly 20% of the population each year. To achieve this shift, they must be allowed to have nurses at their side who help them on a daily basis in their care of people with mental illness. This organization, called collaborative care, has proven itself in many countries.
“The reimbursement of city psychologists, which has just been announced for children in the context of the health crisis, must also extend to psychologists specializing in adults”
General practitioners, supported in their practice by these nurses, must also be able to prescribe psychotherapies to their patients when necessary. However, today, psychologists are not recognized as health professionals and their care is not reimbursed, unlike what is done in most neighboring countries. An experiment carried out by the Health Insurance in four departments for three years has shown the interest of such a device, the generalization of which would cost, according to the Court of Auditors, 85 million euros per year: a sum to be compared suffering caused by non-support, overcrowding of specialized services and 23.2 billion euros invested each year in psychiatry. The reimbursement of city psychologists, which has just been announced for children in the context of the health crisis, must also extend to psychologists specializing in adults.
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