Question 16202 — health establishments

Summary

Mr. Bérenger Cernon draws the attention of the Minister of Health, Families, Autonomy and People with Disabilities to the consequences of the new regulatory framework applicable to medical-psycho-pedagogical centers (CMPP) and the instruction addressed to regional health agencies (ARS) on May 13, 2026. CMPPs have constituted for several decades an essential link in the mental health system for children and adolescents. In By 2024, they were monitoring more than 141,000 children and adolescents, or nearly a third of young people treated in outpatient child psychiatry. Their specificity is based on an unconditional, free and local welcome, as well as on multidisciplinary care involving in particular child psychiatrists, educational psychologists, psychologists, speech therapists, psychomotor therapists, specialized educators and specialized educators and social service assistants. However, several professionals in the sector are concerned about the consequences of the new decree reforming the CMPP intervention framework. Presented as a modernization of the existing regulatory framework, this text seems to lead to a profound redefinition of the missions and vocation of these establishments. It would tend to prioritize the CMPPs in courses dedicated to neurodevelopmental disorders and in functions of identification, diagnosis and coordination, even though these structures historically welcome children presenting a wide variety of psychological, relational, academic or social difficulties requiring multidisciplinary therapeutic approaches adapted to each situation. This development raises serious concerns among professionals concerned. By favoring coordination missions that are increasingly standardized and removed from psychological care in its relational dimension, it could profoundly modify the meaning of the work carried out within CMPPs. Many caregivers fear being progressively dispossessed of their clinical expertise, their ability to appreciate individual situations and to their professional autonomy for the benefit of standardized protocols and managerial logic. This transformation could also have significant consequences in terms of psychosocial risks. The loss of autonomy, the degradation of the meaning of work and the calling into question of multidisciplinary teamwork are in fact recognized factors of professional disengagement and suffering at work. Furthermore, then that the external evaluations carried out in accordance with the standards of the High Authority for Health show that the CMPPs offer, in the vast majority, responses adapted to the needs of the children and families supported, the ARS instruction of May 13, 2026 seems to allow a reorientation of these establishments towards diagnostic and coordination functions, to the detriment of their primary mission of care. Many actors of the sector fear that this development will further weaken access to local psychological care in a context already marked by the saturation of child psychiatry and the lengthening of treatment times. Consequently, he asks whether the Government considers that this new regulatory framework fully preserves the historic vocation of the CMPPs. He also wants to know why he intends to direct prioritize these establishments towards missions of identification, diagnosis and coordination around neurodevelopmental disorders and what guarantees it intends to provide in order to preserve their mission of care, the clinical autonomy of multidisciplinary teams, the working conditions of professionals as well as access for all children to therapeutic support adapted to their needs.

Machine translation from French. The official text remains authoritative.

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