This is an unprecedented speech. “I have never seen an initiative of this type”, confirms an experienced psychiatrist about a letter written by 18 patients from the unit for difficult patients in Cadillac (Gironde). In this letter, addressed in particular to the Ministry of Health, these patients claim that the lack of nursing staff affects the quality of their care and their individual freedoms.
Cet ” call for help “ draws attention because it was launched on the initiative of a rather special patient: Romain Dupuy, author in 2004 of a double murder which had marked public opinion, that of the two caregivers of the psychiatric hospital of Pau . Declared criminally irresponsible by the courts, he has been hospitalized for almost 18 years in this secure unit.
Patients with diverse profiles
Today there are 10 UMDs in France intended to accommodate patients who cannot be cared for in a conventional psychiatric hospital. These are first of all patients, like Romain Dupuy, whose justice considered that they were not in a condition to be judged. There are also people, sentenced or awaiting trial, whose state of health no longer allowed them to be kept in prison. “But we find in UMD many patients who are not under the control of justice but whose care turns out to be too complicated in traditional psychiatry”, indicates Doctor Laurent Layet, psychiatrist who has long been head of the UMD center in Montfavet, in the Vaucluse.
In this letter, revealed by The Parisianthe 18 Cadillac patients emphasize that, in a structure of “deprivation of freedom like the UMD where the stays are a minimum of one year”, the relationship between staff and patients “must imperatively be harmonious”. However, this is no longer the case in view of the rest of the missive. Patients denounce the multiplication of work stoppages or the departure of caregivers for lack of recognition. “In the application of medicinal and therapeutic care, we, the patients, have a crucial need to keep a stable care team, who knows us, for quality care”, write the patients claiming to see “scroll” caregivers on CDD (fixed-term contracts), interim or who have come to reinforce other units.
“An essential bond of socialization”
“Our psychological stability is essential in our care, in order to be able to reintegrate into society one day. All these various issues undermine individual freedoms, cloistering us in confinement and with minimal therapeutic care,” says the letter, specifying that this lack of caregivers deprives patients of therapeutic outings. “These are outings for a few hours where the patient is accompanied by a nurse and a driver. This allows him to run errands, go to the movies or just have a coffee. It is an essential link for socialization with the outside world. However, since April, Romain Dupuy has not had a single outing, ” underlines his lawyer, Me Hélène Lecat.
This letter has received the support of Printemps de la psychiatrie, a body which brings together patients, families and professionals. “Everything in this letter is absolutely correct. For years, the caregivers of this UMD have been in a state of very large exhaustion ” says Jocelyne Gout, secretary general of the CGT at the Cadillac hospital. “It is important to listen to these patients, who have been there for a long time. What makes their opinion relevant”, she adds. “Because of these very long stays, it is essential to forge lasting therapeutic links with the healthcare teams to obtain stabilization of the patient’s condition”, adds Doctor Layet.
Beyond this letter, Romain Dupuy continues to fight to get out of this UMD and join a classic psychiatric service. Since January 2018, a favorable opinion on this transfer has been issued by the medical follow-up commission, the body responsible for ruling on his state of health. “All the experts recognize that he is psychiatrically stabilized. But the Gironde prefecture continues to oppose any transfer to a conventional hospital. However, keeping him at Cadillac is validating a therapeutic confinement for life, ” deplores Me Lecat.