After submitting a report from experts commissioned on early intervention in psychiatry, Stéphanie Rist, Minister of Health, Families, Autonomy and Persons with Disabilities, announced initial commitments, and in particular, the implementation of three major stages: establishing “a map of resources” by territory, “clarify the roles of each structure” and reorganize “a coherent territorial network” based on needs.
Creation of a national resource center, territorial coverage, increased training of professionals… On February 12, the report commissioned by the ministry, devoted to the identification and early intervention in mental health among young people, was submitted to the Minister of Health, Stéphanie Rist. This report drawn up by Professor Rachel Bocher, Professor Marie-Odile Krebs and Madame Angèle Malâtre-Lansac, after hearing 100 people, proposed 10 emergency measures for identification and early intervention which should allow the ministry to “move from observation to action”. Among these measures (see box below), the rapporteurs recommended in particular “to establish a map on a territorial scale of the resources and partners involved in the identification and care of young people”of “rethink the connection between identification, orientation and care” or even “to network the territory with early intervention systems”, also emphasizing that “Early intervention in adolescent and young adult psychiatry does not currently constitute a structured area of health policy in France. It is based neither on a stabilized national definition, nor on an identified organizational framework, nor on management tools allowing a homogeneous reading of the offer and its results.
It is in continuation of this report that Stéphanie Rist spoke on the occasion of the 19th international day of emerging psychiatric pathologies of young adults and adolescents, on March 31, to share the actions taken by the government. In a video speech, she mentioned three recommendations from the report that the government wishes to implement.
Three emergency measures adopted
“Psychological disorders are the leading cause of illness and disability among 15-25 year olds, and without sufficient identification, weaknesses become severe and devastating pathologies”recalled Stéphanie Rist. The minister castigated current responses “still too fragmented, leaving the journey lost in ineffective systems for young people and their families”. Based on the report of the trio of experts, she called for“a profound transformation with more understandable pathways, reduced delays in accessing care and strengthened cooperation between all those involved in the field”. “For this, we are not starting from nothing”she assured, greeting “long-time work” of the Transition network (which brings together nearly seventy structures at the national level currently dedicated to early intervention) or the Dippe* experiment in Pays de la Loire.
Listing the investments made or in progress (the sustainability, since 2019, of “eighteen organizational innovation projects on identification and early care in psychiatry« (…) » or investment « of 25 million euros in the call for child and adolescent psychiatry projects »), the minister expressed her desire to “consolidate” this support and “go further faster stronger : “I would like to announce to you that three major steps will be implemented (…). We will establish a precise map of the resources present in each territory, the front-line actors, those of the second line, the entry points, the possible articulations« . The ministry then works « to clarify the offer, roles and missions of each structure”, to ensure that the system is more understandable for young people, their families and professionals. Finally, “we want to structure a coherent territorial network based on real needs with clear circuits and solid partnerships between institutions”, with a goal: “that no young person slips through the cracks and that no beginning disorder becomes a broken trajectory, due to lack of having been spotted” early. “We have the evidence, the actors, the momentum, we now have the responsibility to transform this progress into a sustainable reality everywhere in France”she concluded.
Le rapport remis à la ministre de la Santé, des Familles, de l’Autonomie et des Personnes handicapées propose 10 mesure urgentes pour l’intervention précoce en santé mentale chez les jeunes.- Établir une cartographie à l’échelle des territoires des ressources et partenaires impliqués dans le repérage et les soins pour les jeunes
- Repenser l’articulation entre repérage, orientation et soins
- Structurer un pilotage national du repérage et l’intervention précoce avec un centre ressource national
- Mailler le territoire avec des dispositifs d’intervention précoce
- Former l’ensemble des acteurs aux nouvelles pratiques de soins adaptées à l’intervention précoce
- Favoriser le changement de pratiques à l’échelle des territoires
- Développer les nouvelles technologies en santé au service du repérage et de l’intervention précoce
- Assurer un financement pérenne et pluriannuel
- Soutenir les programmes de recherche sur l’intervention précoce et la prévention en santé mentale des adolescents et jeunes adultes
- Renforcer la coconstruction avec les usagers et leurs proches.
*The DIPPE is an experimental project built in partnership with the Nantes University Hospital, the Angevin Mental Health Center (CESAME d’Angers) and the Public Mental Health Establishment of Sarthe (EPSM) in partnership with local medico-social actors, including L’Etape pour la Loire-Atlantique. Its objectives are to detect and/or limit the functional impact of psychotic disorders in young adults (15-30 years old) by offering intensive multi-disciplinary support over a period of three years.
