Seven patients admitted, ten discharged, two waiting for a hospital bed near their home… During a break in her office, on July 30, shortly after 10 a.m., and after the meeting with the on-call team, psychiatrist Nadia Cheffi keeps the accounts. A daily arithmetic that, she explains, is a reflection of the “virtuous turnover” established within the Reinforced Center for Psychiatric Emergencies (CRUP). This new unit, which the young doctor has been responsible for for ten months, is backed by the emergency department of the Delafontaine hospital in Saint-Denis, even if it falls under the public health establishment of Ville-Evrard, the psychiatric hospital of the sector, in Neuilly-sur-Marne (Seine-Saint-Denis).
“Our goal is to get out of the emergency room as quickly as possible the “psychiatric patients” who arrive there in acute crisis and who risk sinking, to make room for them in one of our fifteen beds, she explains, assess them and begin to treat them quickly, before reintegrating them into a care pathway, in the community or in a hospital environment, relevant to their sector. All this within a maximum period of seventy-two hours. Sometimes less: the average length of care for the 1,500 patients who have passed through the CRUP since it opened in September 2023 is thirty-six hours. Another encouraging result: a return home has been organized for a quarter of these patients, with outpatient follow-up.
Symbols of the hospital crisis, exacerbated during the summer period, the “stretcher patients” who clog up emergency services are also the consequence of tensions on the provision of psychiatric care. With people suffering from mental disorders who often constitute a great difficulty for emergency services, which are ill-equipped to take care of them. The suicide of a patient in the psychiatric emergency department of Purpan Hospital (Toulouse University Hospital), on February 14, after ten days on a stretcher, had caused shock among caregivers.
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“Strike fast, strike hard, so as not to let the crisis worsen” : this is somewhat the philosophy of Fayçal Mouaffak, head of the Ville-Evrard psychiatry unit, who defended the CRUP project for ten years before it was inaugurated. His guiding principle: welcoming patients in “decent conditions”and allow his team (three doctors, sixteen nurses, five nursing assistants) to do “with dignity” his work, he insists, by limiting coercive measures and extracting itself from the “temporal nature of emergencies”.
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