[Outpatient mental health consultations: reducing delays, optimising organisation]. / Optimiser l'organisation des consultations ambulatoires en santé mentale.

The Hauts-de-France psychiatry unit has oriented its organisation to facilitate access to care. While the aim is to improve the time taken for patients to be seen, it corresponds to a need on the part of users that has been growing over the years. The key is an early clinical assessment of care situations, followed by an appropriate response for the patient in terms of referral and follow-up. Improving access to care is therefore directly linked to human resources and the resulting organisation. Medical on-call duty, nursing and psychological duty and the importance of the secretariat are all tools that need to be optimised.

[Towards ending compulsory community treatment in recovery approaches]. / Vers une disparition du programme de soins dans le parcours de rétablissement.

Psychiatric compulsory community treatment programmes are widely and heterogeneously used measures of coercion. The recovery oriented mental health service 59G21 used them to minimize violating the rights of persons under compulsory care. Based on a clinical situation of failing this objective, we discuss their place in the health system and the reasons why we chose to move towards a "zero recourse" objective.

[Towards a partnership-based care approach to adolescence]. / Pour une logique de soins partenariale à l'adolescence.

The transition from child psychiatry to adult psychiatry is difficult. The need to reinforce this 'bridge' between the services is clear. A system focused on the assessment and orientation of adolescents, set up a year ago by Lille-Métropole public mental health service, aims to favour collaboration on a local level between the different players from the social, medical and educational sector working with young people aged between 12 and 21 in order to facilitate this transition.

['Zero isolation', a care practice oriented towards recovery]. / "Zéro isolement", une pratique de soins orientée vers le rétablissement.

Some institutions do not have an isolation room. Agitation is managed otherwise, with the idea that restraint or isolation can only be a terrible experience. The care pathway is therefore designed to favour autonomy and to limit restrictions of freedom. In this context, professionals are in constant contact with the user. Example of a unit which advocates this concept of rehabilitation.

Mortality of people suffering from mental illness: a study of a cohort of patients hospitalised in psychiatry in the north of France.

BACKGROUND: The mortality of people suffering from psychiatric illnesses is far higher than that of the general population, all categories of diagnosis combined; mortality statistics can be used as an index of quality of care. The aim of this study was to assess the all-cause mortality in psychiatric patients covering all diagnostic groups. METHODS: The living or deceased status of 4,417 patients of majority age hospitalised in a public mental health establishment between 2004 and 2007 were requested from French National Institute for Statistics and Economic Studies on 1st January 2011. The cause of death of those people who had died was obtained from French National Institute for Health and Medical Research and comparative standardized mortality ratios (SMR) were established from the population in a region of northern France of the same age in 2006. RESULTS: The study population was made up of 54% men and 46% women, median age 41 and 45 years old, respectively. Four hundred and seventy-three people died during the period studied. The SMR were 421 for men (95% CI 378-470) and 330 for women (95% CI 281-388). The highest SMRs were found in patients aged 35-54, with a 20-time higher mortality risk than the general population of the same age. CONCLUSION: Our study confirms the considerably higher mortality in psychiatric patients than in general population, particularly in mean age and mostly due to an unnatural cause.