Psychiatric patients: mistreatment in emergency rooms

The investigation begins at the Le Mans hospital center. We are entering an area where dozens of patients suffering from severe mental disorders live day and night. Some have been there for nine days, due to lack of space in a psychiatric hospital, others have spent up to three weeks in the emergency room, mixed with other patients in the greatest promiscuity. Patients who are often agitated, sometimes dangerous for themselves or for caregivers and who must be restrained. In one of the rooms, a patient we meet has just been released from her restraint.

“My legs were tied and I got a bedsore last night.”

an anonymous patient

At “The Eye of the 8 p.m.”

Still in the emergency room, several caregivers tie up a man experiencing delirious and violent seizures. At least five nurses and caregivers are around him to secure his arms, legs and pelvis, using restraints attached to the bed. In this hospital, there are up to five restraints per day. Sometimes, some patients remain attached for several days.

“Institutional mistreatment”

The caregivers we met recognize that restraint is sometimes maintained unjustifiably. They resort to it, they say, due to a lack of suitable premises and trained staff.

“Sometimes, patients defecate on them, it’s undignified, whereas if they were in a psychiatric ward, they would not be attached. That’s what’s difficult and it’s no longer exceptional, it’s becoming our daily life.”

An anonymous caregiver

At “The Eye of the 8 p.m.”

In 2022, in France, among the 76,000 people hospitalized without consent, 37% were placed in solitary confinement and more than 11% were restrained. The country is in the upper range of countries that use these coercive methods the most.

Risks for patients

For more than a month, staff at Le Mans hospital, on strike, have demonstrated every week to denounce this situation. By the emergency chief’s own admission, tying up a patient is not without consequences.

“There are risks of bedsores, pulmonary embolism, phlebitis and we find ourselves giving them medication to prevent complications linked to these treatments which we should not maintain for so long. becomes delusional.”

Dr Lionel Imsaad, head of the emergency department at Le Mans Hospital Center (Sarthe)

At “The Eye of the 8 p.m.”

The management of Le Mans hospital promises alert systems for the safety of caregivers, training on the management of mental illness as well as security of the premises. Measures to deal with the crisis, while waiting for places to open in the only psychiatric hospital in Sarthe. L’Allonnes public mental health establishment has lost 180 beds in eight years and is struggling to recruit. Twenty-nine psychiatrist positions are still vacant.

As a result, due to lack of space, patients who are dangerous to themselves or to others are left without a solution. One mother we met says she lives in fear. Her violent son has no psychiatric follow-up.

“Each time, the hospital lets him out. However, when he is in crisis, he attacks us. Punches, threats with a knife, attempted strangulation… Who says that one day he won’t succeed, with this gesture?”

An anonymous mother

At “The Eye of the 8 p.m.”

In Toulouse, due to lack of appropriate care, the Purpan hospital was unable to prevent the suicide of a 48-year-old patient a few weeks ago. Admitted to the emergency room for mental disorders, the man had spent ten days in a consultation office which is not supposed to accommodate a patient.

“For ten days, he was in a consultation box on a stretcher, without sanitary facilities. He couldn’t stand it. This is someone who could have been helped. This suicide was preventable.”

Julien Terrié, CGT secretary of the Toulouse University Hospital

At “The Eye of the 8 p.m.”

The hospital management now assures that these boxes will no longer accommodate psychiatric patients. When he came to Toulouse, the Minister of Health, Frédéric Valletoux, announced 15 additional psychiatric beds and the use of the private sector to relieve emergency room congestion.

At the national level, more than 3 billion euros for mental health have been released to meet the growing needs of patients.

AMONG OUR SOURCES

https://www.cglpl.fr/wp-content/uploads/2016/05/Rapport-isolation-et-contention_Dossier-de-presse.pdf

https://ansm.sante.fr/uploads/2020/12/30/20201110-rapport-contention.pdf