Seven patients admitted, ten discharged, two waiting for a hospital bed near their home… Time for a break in her office, on July 30, shortly after ten in the morning, and after the meeting with the custody team, psychiatrist Nadia Cheffi keeps track of the accounts. A daily arithmetic that, she explains, is a reflection of “virtuous rotation” established within the Reinforced Psychiatric Emergency Centre (CRUP). This new unit, of which the young doctor has been in charge for ten months, is attached to the emergency room of the Delafontaine hospital in Saint-Denis. although it is dependent on the Ville-Evrard public health establishment, the sector’s psychiatric hospital, in Neuilly-sur-Marne (Seine-Saint-Denis).
“Our goal is to get the “psychological patients” who arrive there in acute crisis and who are at risk of collapsing out of the emergency room as quickly as possible, in order to make room for them in one of our fifteen beds. She explains, assess them and begin treating them quickly, before reintegrating them into a care pathway, in the city or in a hospital environment, within their sector. » All this within a maximum period of seventy-two hours. Sometimes less: the average duration of treatment for the 1,500 patients who have been treated at CRUP since its opening in September 2023 is thirty-six hours. Another encouraging result: a quarter of these patients were able to return home, with outpatient follow-up.
Symbols of the hospital crisis, which has been exacerbated during the summer, the “stretcher patients” who are crowding emergency services are also a consequence of the tensions in the provision of psychiatric care. People suffering from mental disorders often constitute a major challenge for emergency services, which are unable to care for them. The suicide of a patient in the psychiatric emergency room of the Purpan Hospital (University Hospital of Toulouse) on 14 February, after ten days on a stretcher, caused shock among caregivers.
“Strike fast, strike hard to prevent the crisis from getting worse” : This is a bit like the philosophy of Fayçal Mouaffak, director of the Ville-Evrard psychiatric centre, who championed the CRUP project for ten years before its inauguration. Their common theme: welcoming patients in “decent conditions”and allow his team (three doctors, sixteen nurses, five nursing assistants) to do “worthily” his work, he insists, limiting coercive measures and moving away from the “temporality of emergencies”.
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