Mental health: what Agnès Buzyn proposes in her “Mental health and psychiatry” roadmap

Six months after presenting 12 measures to revalue psychiatry, “the poor relation of medicine” whose funding model she wished to “change”, the Minister of Solidarity and Health continues her work for better care of the Mental Health.

Thursday June 28, Agnès Buzyn presented its “Mental health and psychiatry” roadmap. Focused on good practices and prevention, it aims to diagnose patients with mental disorders earlier and improve their care. With a thinly veiled objective: to reduce the economic and health impact of mental health problems.

The burden of mental health

Because there is an emergency. According to the new annual report of the Health Insurance, health expenditure covering mental and psychiatric disorders amounted to 23 billion euros in 2016, and thus come in 2e position behind occasional hospitalization, ahead of cancer and cardiovascular disease. In the space of 5 years, these expenses show an increase of 1.7 billion euros. At issue: the aging of the population, but also a more efficient diagnostic system, which has boosted health insurance spending related to mental health.

Representing 14% of total health insurance expenditure in France, psychiatric care currently concerns 7 million French people: 2.1 million suffer from psychiatric problems, while 7 million receive chronic psychotropic treatment.

Prevent and promote mental well-being

Better prevent the onset of psychiatric disorders by promoting mental well-being: this is the first axis of the roadmap presented by Agnès Buzyn, who wishes to “identify suffering and psychological disorders at an early stage and prevent suicide”. Among the measures mentioned, that concerning young people, particularly vulnerable, since 80% of disorders are declared between 15 and 20 years. The Ministry of Solidarity and Health plans to launch in three regions Ecout’Emoi, an experiment which will make it possible to refer young people from 11 to 25 years old towards consultations of psychologists supported by the health insurance, after an evaluation by general practitioners.

At the same time, a comprehensive plan against the risk of suicide will be rolled out throughout the country, under the guidance of Regional Health Agencies, in particular the VigilanS system for the systematic recontact of people who have attempted suicide. Actions to prevent suffering at work will be put in place, in particular for health and medico-social professionals. Finally, awareness-raising or training actions for doctors, the media, users of mental health services and the general population will help to de-stigmatize these diseases and the people affected.

Coordinated care pathways

Another axis affirmed by the roadmap: “Guaranteeing coordinated care courses supported by an accessible, diversified and quality psychiatry offer”. Among the measures envisaged, that of opening a mental health internship during medical studies and of training more professionals in order to “promote the identification of disorders and access to mental health care as early as possible”. Other avenues mentioned: the development of outpatient care in order to offer patients continuity of follow-up throughout the course and telemedicine for fragile populations and dense areas.

Promote autonomy

Thirdly, Agnès Buzyn wishes to “improve the living conditions and social inclusion and citizenship of people with mental disabilities”. For this, the roadmap proposes to allow them to benefit from the supported employment system which provides for medico-social support and support for professional integration. Access and maintenance of people in independent or supported housing is also at the heart of this third axis. Also, the roadmap provides for the extension of the “Home First” system. “Experienced for people on the street with serious and persistent mental disorders”, the latter must go from 4 sites currently to 16 others by 2021, says the press release from the Ministry of Solidarity and Health.