Question 16541 — health

Summary

Ms. Alix Fruchon draws the attention of the Minister of Health, Families, Autonomy and People with Disabilities to the worsening of territorial inequalities in terms of mental health in rural areas and in particular in the department of Indre. While the territorial mental health project (PTSM) is supposed to structure a response adapted to the needs of the population, the findings drawn up locally reveal a particularly alarming situation: persistent shortage of psychiatrists, excessive delays in accessing care, insufficiently organized supply and lack of coordination between stakeholders. This situation finds a concrete illustration within the Châteauroux-Le Blanc hospital center, which is struggling to recruit mental health professionals. The establishment currently has only six psychiatrists and one child psychiatrist, including retirement is announced in the short term, further aggravating the fragility of healthcare provision in the region. This critical staff deficit, estimated at at least seventeen missing practitioners, has already led to decisions with serious consequences: closure of hospital beds from 2025, transformation of a pavilion into a day hospital in the summer of 2025. These choices, suffered more than decided, reflect a worrying decline in supply mental health hospital in an already highly desertified territory. In rural areas, these developments have particularly serious consequences: increased distance from healthcare structures, saturation of remaining systems, renunciation of healthcare and worsening of pathologies. In this context, the management of crisis situations appears largely deficient, with late, fragmented or non-existent responses, leaving patients and their families without a suitable solution. Even more worrying, it is now local professionals and in particular self-employed nurses who find themselves on the front line to intervene alone in patients' homes, including in acute crisis situations. In the absence of sufficient support mechanisms, clear protocols and effective coordination with services specialized and security forces, these professionals are exposed to increasing risks. Such a situation illustrates a progressive disengagement of the State in rural areas, which results in a concrete deterioration of access to care and a transfer of responsibility to local actors. It poses risks not only to the safety of health professionals, but also to social cohesion and public safety in these territories. This is why she asks how the Government justifies the closure of beds and the transformation of hospital units in territories already in a shortage situation; what exceptional and specific means it intends to mobilize to respond to the critical lack of mental health practitioners, particularly in the department of Indre; what urgent measures will be implemented to guarantee the safety of liberal nurses faced with crisis situations at home and within what precise timeframes these commitments will be translated into concrete improvements for the inhabitants of these territories. Finally, she would like to know if the Government intends to recognize the specificity of rural areas in its mental health policies and put in place a differentiated strategy, meeting the challenges, in order to to no longer leave these populations permanently on the margins of access to care.

Machine translation from French. The official text remains authoritative.

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