« Inhumane and degrading treatment, mental health patients who had been unjustifiably tied up or left waiting in the general emergency department for several days and had not been able to wash, change, or have access to their mobile phones ». Adeline Hazan, Controller-General of the CGLPL, the independent public authority in charge of ensuring respect for the fundamental rights of persons deprived of their freedom.
The increasing use of restraint to manage patients is the most indicative sign, but beyond that, all the warning lights are red. This is the conclusion drawn by psychiatrists Marion Leboyer and Pierre-Michel Llorca in their book Psychiatrie, l’état d’urgence (Psychiatry, a State of Emergency), published in September 2018. In it, they denounce “a deafening silence that is ongoing and speaks volumes about the perception of psychiatry in [the] country, which lies at the junction between ignorance, misconception, prejudice, denial and shame”.
To protest against the loss of meaning in their work, mental health professionals have been protesting for several years…
Part of the problem also lies in the shortage of practitioners in public hospitals. “In my department alone, two young doctors have just left the hospital to go private,” sighs the nurse. According to hospital psychiatrists’ union SPH, 2,525 mental health care jobs are either vacant or occupied by non-permanent staff.
While staffing levels are falling, patient numbers are constantly on the rise : between 1991 and 2003, they increased by 62 per cent for general psychiatry, with an annual increase of three to five per cent. It can take patients years to get an appointment. These same delays would be inconceivable and unacceptable in an oncology department
To understand the current overcrowding in France’s psychiatric hospitals, we have to look back to the 1960s and the birth of modern French psychiatry. The new system emerged out of a tragedy : during the Second World War, between 1940 and 1945, 45,000 patients died of hunger, forgotten in the overpopulated French asylums under the Vichy regime.
Opposed to the ‘confinement of lunatics’, the post-war healthcare system opted to ‘deinstitutionalise’ mental health care and to treat patients outside the hospital environment. “The duty of psychiatrists is to go to the people,” explained Dr Lucien Bonafé in 1975. Various structures were then set up : day care centres, part-time care centres, spas, therapeutic apartments, etc. The aim was to reduce the need for full hospitalisation, which was costly and stigmatised the patient. The number of beds was reduced over the years, from 120,000 to 55,000 between 1990 and 2011. But the problem has not been solved.
Marion Leboyer and Pierre-Michel Llorca also advocate fighting against stigmatisation. For mental health professionals, the lack of resources reflects a long-standing indifference on the part of the public authorities to the suffering of the patients, and the staff. Psychiatry is indeed the “poor relative” of the health care system.
https://www.equaltimes.org/france-s-mental-health?lang=fr#.Y3IPVyXfslQ
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Le journal du peintre 2 