long-awaited Assizes for a discipline in crisis

Presented by the Ministry of Health as a “Historic moment of the national debate”, the Assises of mental health and psychiatry Will they lead to concrete responses to the psychological ailments of the French and to the distress of those who treat them? Announced by Emmanuel Macron on January 14, 2021, first scheduled for July, they will finally be held on September 27 and 28 and will be closed by the President of the Republic, a confirmation for some of the attention paid to the subject by the Elysee Palace .

The context is all the more perilous as the pandemic, with its deleterious effects on the mental health of the population, has worsened an already critical situation.

While mental disorders (depression, schizophrenia, anxiety disorders, addictions, etc.) concern millions of French people, and represent the first item of expenditure for the general health insurance scheme by pathology, reports and forums have been accumulating for many years. years to denounce an untenable situation, against a background of strong disparities in the territory. “The working conditions and therefore the conditions of care have continued to deteriorate, causing suffering for the patients, their relatives and the medical teams”, already indicated to the World Pierre-Michel Llorca, head of department at Clermont-Ferrand CHU in September 2018.

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“We are not going into the wall, we are already in”, now summarizes the psychiatrist Antoine Pelissolo in a text co-written with the deputy Boris Vallaud (PS), published in The world September 6. “As there were very useful presidential plans for cancer or Alzheimer’s disease, it is therefore urgent today to make mental health and psychiatry a great cause for the next five years”, they call out.

Child psychiatry, particularly affected

The capacity for psychiatry in public hospitals fell by 13% between 2013 and 2019, to the benefit of the private sector. The times for a first appointment in medico-psychological centers, the first link in the public sector, can exceed one year, especially in child psychiatry, which is particularly affected. In recent months, some young people cannot find a bed when they arrive urgently for anxiety disorders and a high risk of suicide, while these situations have increased with the pandemic.

“We always focus on the issue of emergencies and the shortage of beds due to critical situations, and it’s dramatic, but psychiatry should be there to prevent hospitalization, prevent suicide attempts in children, c is a discipline of prevention, underlines Professor Olivier Bonnot, head of the child psychiatry department at Nantes University Hospital. For that, it is necessary to reinforce the attractiveness, to reorganize the care with ambition, and to distribute the means. “

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