Syndrome de la porte tournante en psychiatrie en 2006

Abstract: The recent evolution of the public health system has led to a drastic decrease in the capacity of public psychiatric hospitals to receive patients. As patients can benefit from new drugs with better efficacy and higher safety, it has become possible for those who once were banished from the general population because of their symptoms, to live and to be accepted again in the city. But at the same time, the stress of social rehabilitation, precariousness of shelter and drug abuse behaviour contribute to constant relapses. Remission periods become shorter. Consequently the psychiatrists attend to a new phenomenon: A great number of patients are hospitalised for short periods, and return back to the hospital a few days after their exit. This phenomenon is called the revolving door syndrome. Our intervention aims to describe it and all its components and to estimate its reality in 2006. This paper is the result of a team work and the same crue as been working ten years ago on this subject, concerning the same topics. Inpatients with mental disease have specific and complex needs concerning their health but also concerning their material conditions for survival. The paradox is that solutions do exist and follow up is systematically proposed. However hospitalization seems to be the only solution that some patients can accept. Thus, the main question seems to be relative to the methods of follow-up. The patients do not always find the social and occupational support that the hospital provides. [Copyright &y& Elsevier]