Connect with us


Murder of a nurse at the Reims University Hospital: a new illustration of the crisis in psychiatry in France



the essential
The man who killed a nurse and injured a medical secretary in Reims suffered from psychiatric disorders. The 59-year-old had been violent in the past. A drama that revives the debate on the crisis of psychiatry in France.

Could the death of a nurse in Reims, killed in hospital by a patient suffering from psychiatric disorders, have been avoided by better care? Impossible to say, but the drama brings to light the long-standing collapse of this sector. The murder “immediately raises the question of the catastrophic situation of the care of the mentally ill in our psychiatric establishments”, reacted Tuesday Force Ouvrière Santé, after the announcement of the death of a 37-year-old nurse, stabbed Monday at the CHU of Reims.

According to the first elements of the investigation, the attacker, a 59-year-old man under curatorship, suffered from severe psychiatric disorders and had already been violent on several occasions. Even if it is not possible at this stage to determine what precise role played his pathology – the nature of which is also unknown – questions are already being asked about the psychiatric follow-up to which he was subject.

“The patient had not been taking his treatment for more than a year,” said a local union source, who requested anonymity. Several actors in the hospital world therefore see in this drama a new illustration of the difficulties of French psychiatry, a sector plunged into a deep crisis for several decades.

Read also :
Murder at the Reims University Hospital: “gentle”, “appreciated by all”, “always smiling”… who was Carène Mezino, the stabbed nurse?

Tense times in terms of psychiatry

“We are going to experience tense moments in terms of psychiatry” in the coming years, admitted Tuesday on RTL Arnaud Robinet, president of the French Hospital Federation (FHF). He used a term ubiquitous among observers of the sector: psychiatry is the “poor relation” of the French health system. The observation is the same on the ground, in terms often more virulent than those of Arnaud Robinet, also mayor of Reims and member of the presidential majority (Horizons). And it’s not from this week. In recent months, the main organizations of psychiatrists at the hospital have repeatedly denounced the “advanced dilapidation” of the sector and the “great contempt of the government”.

A lack of psychiatrists

Psychiatry experiences problems common to the entire hospital, but amplified by the specificities of mental disorders: these often require long-term follow-up and drug treatments must generally be accompanied by psychotherapy, which requires long consultations. To respond to this, the means of the public hospital appear inadequate, which results for many patients, in particular children and adolescents, in the impossibility of finding an appointment for many months and then of benefiting from sufficiently regular follow-up.

A figure shows that this trend goes back a long way: between 1997 and 2021, the number of inpatient psychiatric beds fell by around a fifth, from almost 100,000 to just over 80,000. This drop is not obvious to absorb because it reflects a lack of carers – psychiatrists and specialized nurses – due to a lack of income and satisfactory working conditions in hospitals.

Excessive use of confinement, according to psychiatrists

These conditions can have disastrous consequences for hospitalized patients. In 2021, several dozen psychiatrists denounced, in the newspaper The Parisianan excessive use of confinement, seeing it as the “shame” of their discipline because of excessive pressure on caregivers.

Known for a long time, the crisis of psychiatry therefore returned to the political field on Tuesday: the leader of the Republicans, Eric Ciotti, thus called for a “big psychiatry plan”, a concern hitherto rarely expressed on the right. But “it is not by snapping our fingers that we will have more doctors tomorrow, we will have to wait 10 years”, warned the Minister of Health, François Braun, at the National Assembly, also defending the “sharing of skills with specialist nurses. As he recalled, the government has taken several measures since the start of Emmanuel Macron’s presidency.

But, among the actors of psychiatry, they are still considered to be very insufficient. The most emblematic consists in proposing the reimbursement of several consultations with a psychologist for “mild to moderate” disorders. But the amounts reimbursed are considered too low by psychologists, the number of consultations often insufficient for effective therapy. In addition, many patients are left out, their disorders being considered too serious for such a course but not serious enough for hospitalization.

Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *