The politics of numbers has entered psychiatry. Faced with these new constraints, caregivers are trying to adapt their clinics but are in spite of themselves setting up a series of boundaries separating them from patients. In the past, they had to free up patients; now they have to free up beds. This paradigm shift inevitably has repercussions on the experience that patients have in public hospital psychiatry. They must be autonomous, time their requests, demonstrate adaptation to the tense context of care units, and accept incomplete care.
Today, nearly one in five people are affected by mental disorders during their lifetime. The tensions on the provision of psychiatric care illustrate the need to strengthen the Psychiatric sector and Child and Juvenile Psychiatry. Therefore, we, the New Popular Front, are keen to respond to the psychiatric precariousness in Saône-et-Loire, which is observed by the growing difficulties encountered by the Public Mental Health Establishment (EPSM) of Sevrey.
Despite the goodwill of caregivers, the government policy aimed at reducing hospitalizations for cost reasons has led in a few years to the elimination of 30 adult beds. In Sevrey, 10,000 patients are monitored, and of these 10,000 patients, there are now 250 beds left. Thus, only 2.5% of the total population monitored can access a bed. Indeed, the ARS (Regional Health Agency) with a view to budgetary restrictions now favors home hospitalization, managed by mobile teams such as Vigilan’s. However, Vigilan’s is only present in the Chalon-sur-Saône urban area, leaving other localities in the department without access to these resources.
Home care is even more significant and harmful regarding child psychiatry. In fact, the Sevrey psychiatric establishment only has 10 beds; 10 child psychiatric hospitalization beds for the entire Saône-et-Loire department! 10 beds for a population under 18 years of age which is more than 110,000 people in our department. However, in France, between 2016 and 2021, the number of visits to emergency rooms for mental disorders among those under 18, including suicide attempts, increased by 65%. Having your son or daughter in a psychiatric hospital is difficult, but seeing your child destroy himself daily at home, having to manage his treatment, sometimes facing violence, is unbearable suffering made unfortunately possible by the cost-cutting policies of our public services undertaken by the government and supported by the votes of elected representatives of the National Rally.
Finally, the shortage of psychiatrists and paramedical professionals leads to major difficulties in welcoming patients. There is currently a 30% shortage of psychiatrists in public mental health institutions nationwide. Also, 25% of institutions say they are having great difficulty in meeting the needs of the population. This situation is explained by the observation we have just made, namely, the difficulty of the conditions of care for caregivers, subject to the stress of numbers, and sometimes also to violence from patients.
Thus, in the same way as for the Montceau-les-Mines hospital, it is appropriate to build a real project in favor of our healthcare establishments to deal with the deterioration in patient care over several years. This will require a strengthened budget which will make it possible to invest massively in our public services in order to guarantee access, safety and continuity of care throughout the territory. In addition, caregivers are there to care. However, the situation in psychiatric establishments is such that they are subject to regular violence from patients, they are forced to move quickly to manage the flow, thus degrading the dignity of their function which is dear to them. It will therefore be necessary to change the status of professionals for better recognition, strengthen the training of professionals and obviously restore meaning to work in psychiatric establishments.
Fatima KOURICHE, New Popular Front candidate, 5th constituency of Saône-et-Loire
Damien SALEY, alternate candidate
