Dhe young psychiatrists rose up, in The world of April 17, against the report of the High Council of the family, childhood and age, which reports the increase in the prescriptions of psychotropic drugs in children and adolescents.
They see in this report a “disparagement [de la psychiatrie] which goes through regular attacks on its therapeutic practices”. Confusing the interest of treatments with the risk of over-prescription, they omit the part of the report which says that “the means dedicated to first-line care, and the deployment of psychotherapeutic, educational and social devices do not seem to have increased in the same proportions”.
Lack of means
Young psychiatrists too, we wonder what our colleagues are referring to when they talk about a discipline in ” booming “made of“major advances”. In our practice, we have not witnessed major scientific advances in the last twenty years in treatments, or in the understanding ” biological “ psychiatric illnesses.
Our observation is that of a stricken psychiatry: “bed managers” to compensate for the closure of 60% of beds since the 1980s (the primary objective of care now being to “get the patient out”), lack of training, dilapidated premises, lack of human and financial resources, management’s obligation to provide “pragmatic” care, inflation of administrative tasks to make account of “activity”, loss of sense of the profession leading to massive departures and unfilled vacancies, etc.
In Europe, France has long been in the forefront of the prescription of psychotropic drugs. Very often, “sedative” treatment or physical restraint are inevitably prescribed due to the delay in access to care, the lack of downstream beds, staff or time to develop the relationship with the patient. Indeed, treatments sometimes have the role of “doing something” for the patient, in the face of a feeling of failure, of being deprived of the rest of the tools necessary for treatment.
Our colleagues ” do not want “ abandon the field of psychotherapies, claiming an integrative approach, provided that these psychotherapies are “scientifically assessed”. They neglect the growing biases of “evidence-based medicine” (EBM, acronym for “evidence-based medicine”): pressure and inflation on publication, primacy of the hypothetico-deductive method and of supposedly objective judgment criteria, fraudulent practices, predatory reviews, etc.
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