The health crisis and its corollaries – confinements, curfews, reduction in social interactions, etc. – raise concerns about mental health, and in particular that of children and young people. In its recent report, the National Assembly’s commission of inquiry into the effects of the covid-19 crisis on children and youth was also concerned about the possible consequences of this extraordinary event (see our article in January 14, 2021). And the suicides or attempted suicides of students, but also of young people under 16, confirm the concerns in this area. To the point of provoking the intervention of the Head of State.
Towards general coverage of psychologist consultations
During a videoconference organized on January 14 with child psychiatrists, Emmanuel Macron indeed announced the holding, before the summer, of Assises of psychiatry and mental health. These will have a general scope, but will include a section dedicated to children and young people. Even if it is difficult to have precise figures on the matter, the President’s interlocutors insisted on the continuous increase in the number of children suffering from disorders in recent years. According to them, this trend was indeed already at work before the pandemic, but has accelerated sharply with the health crisis. They mention in particular massive increases in hospitalizations for mood disorders, eating disorders or anxious behavior, with increases ranging from 50% to more than 100% compared to 2019.
In addition to holding the Psychiatry and Mental Health Assizes, Emmanuel Macron also announced other measures. According to the report of the Élysée, he “approved the reimbursement of the care of psychologists in liberal, in particular for the children, in order to make them accessible to the greatest number”. In practice, the experimentation with reimbursement of consultations with psychologists by health insurance, which has been tested for more than two years in four departments (Bouches-du-Rhône, Haute-Garonne, Landes, Morbihan) could quickly be generalized. The Head of State also approved the launch, in the spring, of a national survey by Public Health France on the mental health of young people and children. Finally, he hoped that the issue of pricing and that of strengthening school medicine would be raised during these meetings. The latter could, moreover, be transferred to the departments, which already manage the PMI, within the framework of the 4D bill.
A recovery initiated in 2018
The public authorities were already aware of this situation of tension on psychiatry. On November 18, 2020, Olivier Véran thus assured that the government wanted “at all costs to avoid a third wave, that of mental health”. As an extension of this statement, the Minister of Health announced on January 7 several measures as part of the third circular relating to the 2020 pricing and budget campaign for health establishments.
The main one is the creation of an additional envelope of 50 million euros dedicated to psychiatry. This concerns the implementation of the “Mental health and psychiatry” roadmap and its translation into the “My health 2022” plan, announced in September 2018 by Emmanuel Macron. A budget of 20 million euros will finance 48 projects targeting child and adolescent psychiatry (as part of a second call for projects after that of 2019). Another envelope of 30 million euros will finance two important projects. On the one hand, the contribution of 20 million euros (i.e. a doubling of its 2020 endowment) from the organizational innovation fund in psychiatry, which will finance nearly 80 projects. On the other hand, the creation of 160 psychologist positions within the CMP (medico-psychological centers), provided for in the framework of the Ségur de la santé.
For the record, it will be recalled that Agnès Buzyn, then Minister of Solidarity and Health, had already allocated to psychiatry, in the last days of December 2018, an additional perennial envelope of 50 million euros to psychiatry, with for objective of “responding to the difficulties of the sector and initiating the necessary transformations, in line with the legitimate expectations of patients and families”.
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