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37 actions to ensure that mental disorders are less stigmatized and better cared for. Agnès Buzyn presents her Mental Health and Psychiatry roadmap. Detailed Review
The context is marked by significant inequalities in the offer of care and professionals present in the territories, by a social gradient in the prevalence of disorders and by heterogeneous responses implemented by the territories.
The recommended plan emphasizes: the situation of the people suffering from mental disorders in France is worrying. The demand for care is constantly increasing, particularly for anode-depressive disorders, psycho-traumatisms, behavioral disorders and addictions. prevention and early interventions are inadequate and diagnoses too late. Course breaks are too numerous and lead to deterioration of care and life trajectories. In addition, the stigma attached to mental disorders is still too pronounced. Special attention should be given to the most vulnerable populations.
37 measures divided into three major areas of intervention to bring a positive vision of mental health, an essential determinant of health, and to promote a psychiatry that is not or more the poor relation of medicine.
Mental well-being, suffering, psychic disorders, suicide …
![buzyn tweet psy "title =" buzyn tweet psy "clbad =" photo-left-sb "width = "502" height = "393" /> This is about the mental well-being of young people in order to preserve their mental health and increase their chances of recovery in the event of a disorder, with disorders usually occurring between the ages of 15 and 20 years. the "Ecout'Emoi" experiment will make it possible to send young people between the ages of 11 and 25 to psychologists' consultations supported by health insurance, after an badessment by the general practitioners, an experiment to be carried out in three regions: Ile-de-France, Grand Est and Pays-de-la-Loire. At the same time, an overall plan against suicidal risk will be deployed throughout the territory, under the guidance of Regional Health Agencies. </p>
<p> The development of psychosocial skills (management of emotions, stress, conflicts …) will be encouraged from an early age, in connection with national education and students (in a broad sense) will be trained in mental health first aid, <q> mental health first aid </q> a proven Australian model. This training will aim to identify the psychic disorders or precursors of crisis to intervene early, on the model of <q> gestures that save </q>. </p>
<p> Initiatives of prevention of suffering at work will be initiated, in particular for health and medico-social professionals (but also throughout the course of health students). An observatory of the quality of life at work will be set up Lastly awareness-raising actions or training of doctors, the media, users of mental health services and the general population will help to destigmatize these diseases and the people affected. 19659015] One of the first ways to promote mental health and prevention is to raise awareness and inform the general public about mental well-being </p>
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Mental health and psychiatric disorders: key figures
- Psychiatry represents in France: 2 , 4 million people cared for in health facilities in 2015, 569 authorized health facilities in psychiatry, 20.5 million outpatient acts in 2015.
- According to WHO, 1 in 4 Europeans is affected by psychic disorders during his life
- In France, it is estimated that 15% of 10-20 year-olds (1.5 million) need follow-up or care.
- 7.5% of French aged 15 at 85 years have suffered from depression during the last 12 months
- 8948 deaths by suicide were recorded in 2015 in Metropolitan France (25 per day against 9 for road accidents). There are 200,000 emergency room visits for suicide attempts per year
- Mental disorders (psychiatric illnesses or psychotropic drugs) represent the first item of expenditure of the general health insurance scheme, ie 19.3 billion.
- People with severe and persistent mental disorders usually suffer from great isolation, loss of ability to undertake, to live in independent housing, to hold a job and to perform the acts of life. daily and often a break in family and social ties.
- 30% of people who live on the streets or are in great precariousness suffer from mental disorders.
Care pathways, accessible, quality offer
The mental health journey needs to be better structured to help identify disorders and access mental health care as soon as possible. To this end, the roadmap specifies the conditions for the implementation of Territorial Mental Health Projects (MTPs), which should allow all the stakeholders concerned (psychiatric sectors, primary care teams, territorial health professional communities, platforms support services, general practitioners and specialists, medical and social services and institutions, local authorities, etc.) to come together in territorial networks of partnerships, to structure a local health and social services offer, ensuring continuity of monitoring throughout
Because the excess mortality of people with severe mental disorders worsens continuously, while the life expectancy of the general population increases, there is need to encourage people living with disorders psychic to have a doctor. In the same way, actions of therapeutic education (ETP), aimed at promoting a better lifestyle and the detection of chronic diseases should be initiated. In the same vein, home-based intervention is an integral part of the organization of outpatient care within the scope of the sector psychiatry mission (future update of the CMP specifications). The recommended measures will therefore aim to keep the person in his ordinary living environment and thus facilitate his social and professional integration. The use of telemedicine will also be encouraged for vulnerable populations and in underdeveloped areas.
Several measures are also planned to revitalize psychiatry: opening a mental health internship during the 2nd cycle of medical studies and during the 3rd cycle of studies in general medicine, increase in the number of trained professionals (in particular PU-PH and heads of clinics in child psychiatry), better complementarity of the interventions of nurse, psychomotor, and speech therapist, development of research in psychiatry , training of advanced practice nurses in the field of mental health and psychiatry for an exercise, both in institutional and ESMS, and in the liberal field
Implementation of the action plan to reduce the use of care without consent and in particular the reduction of the use of isolation and restraint measures in institutions.
Social life and citizenship
The road map states: people with intellectual disabilities must be able to live in the middle of all, access and participate in the same activities as all, be and remain useful to others, with respect and the richness of their difference
. The question of employment is very important here, as we know that the unemployment rate of people with disabilities is much higher (21%) than that of the population as a whole (9.2%) and that they, the psychic handicapped are the most affected. It will therefore be necessary to deploy supported employment schemes throughout the territories must make it possible to obtain and keep a paid job in the labor market.
housing is equally important for the person with a psychic disability. In fact, the access and maintenance of persons in independent or badisted housing is another essential condition of their autonomy
. For this purpose they will benefit, besides the extension of the device a home first
access to the inclusive housing provided in the draft law Elan. Finally, stronger support will be provided to peer-support groups). Indeed, the recovery and involvement of people with severe and persistent mental disorders in the development and monitoring of their project life and health care are at the heart of psychiatry and mental health. Peer support is one of the recognized factors in recovery, and Mutual Aid Groups (GEMs) are one of the best known examples of peer support.
Agnès Buzyn will meet once a year under her Presidency, the CSSMP, whose 29 members representing various sensitivities and legitimacies, will be called upon to follow the measures taken.
Bernadette FABREGAS Editor-in-chief Nurses.com [email protected] @FabregasBern
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