Inside a French emergency psychiatric unit: Social stigma, an absence of beds and drug shortages

[ad_1] No less than one in 5 individuals in France undergo from a psychological well being situation. The difficulty has been named a precedence for the federal government in 2025, which hopes to deal with a variety of situations, from delicate signs to extreme and persistent diseases. Every single day, psychiatric emergency departments in hospitals deal with sufferers in misery, whereas working in more and more troublesome situations. To seek out out extra, we hung out with the Ville-Evrard psychiatric unit of the Delafontaine Hospital in Saint-Denis, north of Paris.

Fayçal Mouaffak is a psychiatrist who heads up the Emergency Psychiatric Providers unit of Ville-Evrard in Seine-Saint-Denis. When he arrives at work, 4 sufferers are already ready for him on stretchers within the emergency room corridors. All of them have spent the evening there and one 18-year-old woman has already been there for 3 days. The hustle and bustle and noise of the ward usually aggravates their signs. The writer of "Diary of a Psychiatrist on the Frontline in Seine-Saint-Denis" begins his working day at breakneck velocity, looking for beds for them as shortly as potential whereas additionally offering the mandatory medical care.

A scarcity of house and workers shortages Discovering beds for sufferers is a day by day battle for the psychiatrists. They spend a superb a part of their day making cellphone calls to get sufferers transferred. In 2023, there have been 566,000 visits to emergency rooms for psychiatric causes, a rise of 21 % in comparison with 2019. On the similar time, 8,800 beds have been minimize in public hospital psychiatric wards over the previous 15 years.

These shortages are partly as a result of an absence of workers. Psychiatry is without doubt one of the least common specialties amongst medical college students.

The CRUP, an answer to overwhelmed emergency rooms Stereotypes go some approach to explaining this lack of curiosity. There are lots of assumptions in regards to the sufferers. "Folks assume psychiatry is a violent sector, however that is as a result of they do not know any higher. There is no such thing as a extra violence than anyplace else," says Nadia Cheffi, psychiatrist and head of the safe psychiatric emergency unit (referred to as CRUP in French) at Ville-Evrard. Psychiatry was her first alternative for specialisation in medical faculty and he or she "has no regrets". Misconceptions additionally exist amongst healthcare professionals. "In discussions with our colleagues (...) we regularly see the previous stereotypes come up: that psychiatry is not actually medication," laments Dr. Mouaffak. Nonetheless, he insists, "there are efficient therapies, medical protocols (...) analysis is advancing quickly (...) and there are additionally physiological elements concerned in these diseases."

Dr Mouaffak was one of many initiators of this safe psychiatric facility (CRUP), a response to seeing sufferers ready far too lengthy within the emergency rooms of hospitals with out specialised care. The CRUP opened two years in the past throughout the Delafontaine Hospital. Sufferers have their very own rooms, obtain therapy in a a lot calmer ambiance, and might keep for as much as 72 hours. This offers medical doctors the time to stabilise their situation earlier than they return house. Alternatively, they are often transferred to different wards for longer stays in hospital. Each the sufferers and their caregivers say it’s an actual reduction: "It makes what I do significant once more," says Hakima, an emergency room nurse.

Dr Mouaffak hopes to see this mannequin adopted extra extensively. The Emergency Psychiatric Providers unit of Ville-Evrard is ready to open one other CRUP throughout the Avicenne Hospital in Bobigny – additionally situated within the larger Paris area – within the close to future.