Le repas thérapeutique en hôpital de jour de pédopsychiatrie à l’épreuve des contraintes sanitaires : thérapie institutionnelle et Covid-19

Abstract

In the context of the COVID-19 pandemic, the Pordegui children's hospital – a day psychiatric centre at Montauban hospital – first closed its doors in March 2019, like many ambulatory care facilities. As a result, the first confinement had a strong impact on the accessibility to care for particularly vulnerable patients. While the lockdown has been eased after a few weeks, the respect of hygiene rules and barrier gestures still impacts the therapeutic framework of the institution. This article aims to document reflections on the effects that the current arrangements, inherent to the pandemic health situation, seem to produce over the organization of care in psychiatric children's hospitals, using the example of therapeutic meals. The latter should not be taken for granted, even though the minimal conditions for this caring time have been reinstated. Such conditions include a repetitive, structuring and reassuring framework with schedules, collective arrangements characterized by the regular presence pattern of the caregivers and their availability, as well as feedback sessions in the form of institutional meetings. After the reopening of the center, specific phenomena that were not so identifiable during the other care times were noticed during the meals of individual and group of patients. A situational analysis was led, based on observations, experience with patients and cross-examination (institutional psychotherapy and phenomenology) in order to understand these movements and highlight what seems to be irreducible for a meal to be therapeutic.