During these 48 hours of immersion, we will have come across dozens of faces. Captured hundreds of expressions. Smiles. Tears. absences. Dumb pains. Happy screams. Of despair. Hopes.
Above all, do not hastily interpret. Judge. Or be frightened for not being able to decipher. To simply observe, to collect a few testimonies from people living with mental disorders, and above all to listen to all these professionals, doctors, caregivers, psychologists… who accompany these very vulnerable patients on a daily basis and often suffer from the same stigmatization as them.
These patients, these professionals, are found within the confines of the hospital but also outside the walls. The number of psychiatric beds has indeed continued to decrease: 1,549 beds in 1961, 413 in 2012, 280 today, 255 in the near future.
At the Sainte-Marie hospital center (CHSM) in Nice, the leading player in mental health in the Alpes-Maritimes department, as in all psychiatric establishments in France, the process is inexorable.
Even if some oppose that we will not be able to go any further, nothing seems to be able to interrupt the deinstitutionalization movement advocated by the WorldHealth Organization (WHO) since the beginning of the 1970s and supported by the arrival early neuroleptics.
It is no longer a question of keeping the patient away from other citizens, of assisting him, he must first of all be treated and brought back to his social community.
This is how outside the walls of the hospital, we began to organize ourselves by developing a range of outpatient services: day hospitals, CMP (medico-psychological centers)…
A daily challenge
Photo Nice-Matin.
There are thus found, in the city, patients who are no longer in the acute phase of their disease, but who remain for the most part very fragile.
Because, if there is one thing that we can retain from this time (too short) spent alongside these women, these men, young or old, suffering from psychic disorders, it is the difficulty of a life to bear this burden.
Living with a psychiatric illness is a daily ordeal: dark thoughts, bizarre ideas, relationship difficulties, isolation…
These people are a danger. For themselves above all. The very high suicide rate in this population testifies to this: in 47 to 80% of cases of suicide and suicide attempts, there is a psychiatric history.
Dangerous also for others too sometimes. Various facts thus regularly revive the debates on the care of the mentally ill and safety.
Controversies that the professionals who, on a daily basis, accompany these complex patients regret. Because they harm all the actions that are carried out, often under difficult conditions, to improve their destiny. And help them get up when illness makes them stumble.
Critical Care at the Autism Clinic
To help us better understand the current issues around mental health, the largest psychiatric hospital in the Alpes-Maritimes department (two thirds of the Maralpine population depends on this structure) has agreed to open its doors to us. All its doors.
From those of the USIP (Intensive Psychiatric Care Unit) to those of the autism clinic, passing through more traditional closed services or even the only unit in the department dedicated to elderly patients with psychiatric disorders.
Because the disease does not decline with age. A lesson among many others provided by this report.
Photo Frantz Bouton.
“I made very harsh remarks before arriving here”
“It was December 7; I mightn’t take it anymore, I had to be locked up. I asked to be hospitalized. Otherwise, I would have taken action…”
Since then, T., 30, has been living in one of the closed wards at Sainte-Marie. We find him in the inner courtyard of the service. He wants to confide. he wants to tell us regarding his depression at the origin of his suicidal thoughts.
“I was working in Paris, in the 18th arrondissement. I was only working, I didn’t have enough personal life. So I broke down, and I returned to Nice and was followed in a medico-psychological center (CMP).” Without transition, T. returns to the present.
“I’m banned from the lawn [référence au grand parc à l’entrée du bâtiment où seuls les patients autorisés peuvent se promener, Ndlr]; it’s normal, I consumed cannabis inside the service.”
The exit is approaching for T. “I’m waiting for the second expertise… (silence). I made very harsh remarks before arriving here. I said that I was going to look for a Kalashnikov in the neighborhoods to put bullets in my head. …”
T. says he has decided to continue a CMP follow-up when he leaves the hospital. “I will continue my interviews, I am in a good vibe…”
If T. is in a hurry to leave the hospital, it is also because someone is waiting for him outside. A young girl hospitalized in the same department.
“I met her here and we got together, three days before she was due out. But she’s been waiting for me, and we’re Facetime calling each other every day.”
Photo Frantz Bouton.
“I can’t stand”
S. is sitting in a wheelchair. A few hours ago, the sexagenarian hospitalized in psychogeriatrics, was walking. There, she calls the caregivers and demands to be carried.
“I don’t walk, I can’t stand.” And indeed, if the team tries to put her on her feet, she threatens to fall. S. does not suffer from any motor deficit.
“Last night, she even refused to go to bed”, comments Dr. Belmas-Brunet. S. has been hospitalized for several weeks in her department.
After 3 or 4 rounds of ECT (electroconvulsive therapy, better known as electroconvulsive therapy), she is “resuscitated” – “what is happening to me?”she asks.
Unfortunately, the benefits of electroshock on his psychic disorders are temporary. In general psychiatry, the carers, fewer in number and also less seasoned in caring for older people than in this unit, were exhausted, forced to carry her to clean her.
“I understand them…”says S. “I made the decision to hospitalize her here for a while, so that the team can also breathe, but also because she feels better there. Here, we do nursing…”
Attention that does not erase the pangs of the sexagenarian, but reduces the intensity.
Photo C. D..
“Before, my TS were mostly calls for help…”
“I accept photos because I have no family…” The words clap sadly. É., 56, suffers from very severe depression. And it was a final suicide attempt on February 8 that led to this hospitalization.
“I made a big mistake, and I blame myself; I made this TS (suicide attempt, Editor’s note) in my daughter; it was she who found me lifeless.”
Death, she came very close to it this time. “I just remember taking an awful lot of medication.” His goal then was really “to end it”.
“Before, my TS was mostly calls for help; I took medication to feel better. There, it was more serious, I only cried, I didn’t wash myself anymore…”
When asked regarding the origin of his troubles, É. evokes a very old suffering that she associates with a difficult childhood. “I had problems”.
Ces “worry”, She will summarize them for us in these few words: “an alcoholic mother, an abusive father, intrafamilial sexual assaults”.
E. affirms: “Today, I feel better; I have an appointment with the doctor to organize my discharge.” She has already planned the sequel, far from Nice.
She hopes to reconnect with the profession she practiced with the elderly. “I love taking care of people, and more than anything I love the contact with older people.”
If she does not fear hospitalization – É. has already made several stays at Sainte Marie, the first of which more than 25 years ago, following the birth of her first child – she wants to believe that it will be the last.
Photo C. D..
“Hospitalization is the way to put me out of danger”
At 26, C. has already been hospitalized several times. And in various places: “Brussels, Paris, Nice, Cannes…”he enumerates in a weary tone.
The young man with the deep gaze will never mention the name of his disease during our exchanges. He’s talking regarding “disorders diagnosed 5 or 6 years ago”of his terrible anxiety attacks, aggravated by the consumption of toxic substances.
“I have addiction problems, but until now I did not understand the process that pushes me to consume; I was passive, I become more active.”
Hospitalization, the young man does not fear it, on the contrary, it is he who claims it when he feels slipping. “I know this is the way to get myself out of harm’s way…”
Meaningful words. Careful words, careful to describe reality well. “I started studying at the Faculty of Letters before interrupting them because of my illness; my passion is writing. Once stabilized, I will redouble my efforts to finalize a project around that…”he smiles before entrusting: “I would have liked to be a screenwriter. but I’m not difficult… As long as I can write…”
Since leaving the hospital, C. has been going to CMP Bellagio three times a week; vital to calm his anxieties which he modestly tries to hide behind a sad smile.
