Repenser les partenariats entre écoles primaires et secteurs de psychiatrie infanto-juvénile en temps de COVID-19.

INTRODUCTION: On a global scale, bringing together schools and public child psychiatry services is favored to promote the development of early interventions that could improve health trajectories, from prevention to treatment, for children exposed to psychological and psychiatric difficulties. In a public health perspective, contextualizing these practices is essential in order to ensure their sustainability and efficiency. This article sheds light on the stakes of these partnerships and their advantages in responding to the health, social, and economic mark that has been left behind by the crisis accompanying the brutal onset of the Covid-19 epidemic. AIMS: Improving the health care management for children with mental health problems or problems of a psychological nature implies taking into account their environment beyond the therapeutic framework. Interventional research, currently underway, is taking place in several sites in France: primary schools, Medical-psychological centers (CMP), and Local Committees on Mental Health (CLSM). The goal is to provide an inventory and an analysis of the partnership and interventional structures that are most efficient, based on the needs and available resources at each site. This research envisages a diversification and a contextualization of the offer of care, with great concern for equity and therapeutic efficacy, starting from school. RESULTS: More than simple results, our aim is to make suggestions as to how to better accompany the end of confinement and the months to come. The development of partnerships in regions that are strongly marked by social and economic inequalities is a priority in terms of public health and the direction of local policies. These partnerships would contribute to a global strategy of evaluating the needs and the personalized accompaniment of children. Formalizing the intervention with the interface being the school sector will support the school staff in overcoming the health crisis that is affecting their institution. The steady rise of CLSMs will enhance local coordination and collaboration to help the most psychologically vulnerable children and aid their parents, given their situation, to support the development of their children. CONCLUSION: Restoring human and material resources to existing structures, notably in the sector of child psychiatry so that it can accomplish its public service mission seems to be a priority today. Establishing school-CMP-CLSM partnerships can contribute to providing local policy direction in the interest of elaborating individual and collective strategies that can ensure needs-adapted care that is accessible to as many children as possible.

Results of a Qualitative Study Aimed at Building a Programme to Reduce Cardiovascular Risk in People with Severe Mental Illness.

People with severe mental illness (PSMI) have a shorter life expectancy and are more likely to have cardiovascular disease than the general population. Patients, carers, psychiatric professionals and primary care providers can all play a role in increasing PSMI physical health. The present qualitative exploratory study aimed to explore the views of these four populations as part of the multi-phase COPsyCAT project, whose objective is to build and test a cardiovascular risk prevention programme for PSMI. Overall, 107 people participated in the study's 16 focus groups, which were transcribed and analysed in a thematic analysis. With a view to building the health promotion programme, major themes identified in the corpus were translated into a list of needs as follows: communication, information, training and support. Results show that it is essential to improve communication between all the different stakeholders in mental health. The greatest challenge facing this programme will be to adapt it to the needs and expectations of PSMI while facilitating work between the various mental health stakeholders. Simple and inexpensive actions could be taken to improve the cardiovascular health of PSMI and will be experimented with during the programme's feasibility study which will start in September 2022.

Social Representations of e-Mental Health Among the Actors of the Health Care System: Free-Association Study.

BACKGROUND: Electronic mental (e-mental) health offers an opportunity to overcome many challenges such as cost, accessibility, and the stigma associated with mental health, and most people with lived experiences of mental problems are in favor of using applications and websites to manage their mental health problems. However, the use of these new technologies remains weak in the area of mental health and psychiatry. OBJECTIVE: This study aimed to characterize the social representations associated with e-mental health by all actors to implement new technologies in the best possible way in the health system. METHODS: A free-association task method was used. The data were subjected to a lexicometric analysis to qualify and quantify words by analyzing their statistical distribution, using the ALCESTE method with the IRaMuTeQ software. RESULTS: In order of frequency, the terms most frequently used to describe e-mental health in the whole corpus are: "care" (n=21), "internet" (n=21), "computing" (n=15), "health" (n=14), "information" (n=13), "patient" (n=12), and "tool" (n=12). The corpus of text is divided into 2 themes, with technological and computing terms on one side and medical and public health terms on the other. The largest family is focused on "care," "advances," "research," "life," "quality," and "well-being," which was significantly associated with users. The nursing group used very medical terms such as "treatment," "diagnosis," "psychiatry"," and "patient" to define e-mental health. CONCLUSIONS: This study shows that there is a gap between the representations of users on e-mental health as a tool for improving their quality of life and those of health professionals (except nurses) that are more focused on the technological potential of these digital care tools. Developers, designers, clinicians, and users must be aware of the social representation of e-mental health conditions uses and intention of use. This understanding of everyone's stakes will make it possible to redirect the development of tools to adapt them as much as possible to the needs and expectations of the actors of the mental health system.