Communitybased approaches bring the best results

A civilized country must support its old and its crazy. "The old adage made sense after the recent statements by Nicolas Sarkozy. Beginning of December, the President of the Republic announced the establishment of a plan for securing psychiatric hospitals"that made a lot of ink. Some 30 million euros will be devoted to the control Geolocation. In addition, an envelope of EUR 40 million will be dedicated to the creation of four units reserved for dangerous patients.

The support of the mentally ill is a source of permanent mark in all developed countries. In France, a new State of affairs is being finalized. The report asked Edouard Couty, Advisor master to the Court of Auditors and Chairman of the commission on the Organization of the supported in psychiatry and mental health, will be ready in the coming weeks. Neither doctor or psychiatrist, this expert is a diagnostic mixed on the current situation. "The number of psychiatrists to population is satisfactory in France, but clearly lacking in public structures." "It cannot be a health policy without an important component dedicated to mental health." A few figures summarize the magnitude of the problem and the price for the community. According to the World Health Organization psychiatric disorders affect nearly 20 of the world's population and one person in three is likely to meet with them during his life. After seventy years, nearly one in two uses psychotropic drugs to relieve his anxiety and his insomnia. These disorders that comprise a large family of diseases are the leading cause of disability and the second for work stoppages.

Received ideas

At Lille, Jean-Luc Roelandt leads the WHO collaborating centre the research and training in mental health. It has since long a fight against the stigma and ideas. "In France, there is only 265 criminal irresponsible, who went from prison to the hospital and only 12 of hopitalisations under stress." According to this expert, the France is not underequipped. "We have 22 psychiatrists per 100,000 inhabitants, against Italy 9 and 12 to the United Kingdom." The hexagon is also 100 beds per 100,000 inhabitants, compared with 20 in the United Kingdom and Italy 10. "The United Kingdom spends 14 of its health budget, which is equivalent to the mental health and the France 11.5."

But with budgets of the same order of magnitude, the strategies differ completely from both sides of the channel. "Since seven years, England has invested massively in teams that keep people at home, even if three times a day." Mobile crisis teams have been implemented throughout the country. "According to him, the best solution is no doubt: should treat people in their homes as long as possible. "Community-based approaches bring the best results. This is true in the world. When it closes beds, need massive resources on mobile teams available 24 hours a day. This is what should have been done in France for thirty years.

In awaiting a hypothetical redeployment "Anglo-Saxon", which would encounter in France huge resistance from the hospital world, scientific and health issues remain huge. This is the case of schizophrenia. The hexagon has about 600,000 people and these personality disorders can affect everyone. The list of victims into account in its ranks the poet Antonin Arthaud, the second son of Albert Einstein, producer Phil Spector and even a Nobel Prize, the mathematician John Forbes Nash, who has struggled all his life against the hallucinations ().

Stigmatization of the sick

Several parameters of "genetic vulnerability" have been identified and psychosocial risk factors have been discovered. So that a majority of scientists now believe (or better) that it is a combination of genetics and environment conducive to the birth of the disease. It is also the case for epilepsy, and autistic syndromes (see sidebar). Bipolar disorders are another scourge, sixth cause of disability in the world, including the diagnosis is very difficult. Eight patients in ten are not correctly diagnosed, and some doctors consider that more than 30 of the depressions are in fact hidden bipolar disorders.

This disease, Annie Labbé, President of the association of sick Argos, for years fighting the stigma of mental illness. "We are 1.5 million people in France." From the time a diagnosis is made, we are able to be full citizens. Do not treat disease and delinquency. "Facing these emergencies, psychoanalysts and neurologists compete continuously since Freud will make peace Not sure. According to the psychoanalyst Elisabeth Roudinesco: "After the fanaticism of the"all-psychic"and"all-social", we are in a period of belief in"all chemical","all-organic"and the"all-genetics", which may lead to an increase in pathologies."