Déploiement d’équipes mobiles à Saint-Étienne

Abstract

In June 2017, the psychiatric catchment area (sector) of the city of Saint-Étienne (Loire, France) closed a full-time hospitalization unit to create a community treatment outreach team. This reorganization, which appeared necessary to both healthcare teams and direction teams of the hospital, was stirred by overwhelming presence of psychiatric users in the emergency department and difficulty in providing adequate care to the population of the catchment area. The complex situation of the city of Saint-Étienne thus proved to be an opportunity for change. The project was build according to concepts of recovery. The chosen models were assertive community treatment, intensive home monitoring, transitional case management (transition from hospital to home) and crisis intervention at home. The first observations highlighted some difficulties related to the hospitalization unit shutting, in particular because both health care providers’ staff and users relied on long-term hospitalization for rehabilitation. Many encouraging points were underlined, however. Indeed, this reorganization enabled new life project in the community for numerous patients, managing crisis without systematic requirement of hospitalization, as well as support and remobilization of the family. The first returns are both positive and promising. Thanks to a rich training program, constant exchanges with family and user associations, other unit in the sector and teams with similar experiences, the Saint-Étienne mobile psychiatry team is continuing to evolve and improve in supporting users and their families.