“My psychological support” does not respond to a requirement for quality care, but to economic logic”

For several years, the public psychiatric service in France has been inexorably deteriorating: declining staff numbers, closures of facilities, reduction in the number of beds, even though all indicators point to a worrying development in the mental health of the French.

In this worrying context, Emmanuel Macron announced in 2021 the launch of the Mon soutien psy scheme , which promises easier access to psychological care, by virtue of the reimbursement of a limited number of sessions with approved psychologists, for people suffering from mild to moderate mental health disorders. The stated objective: to relieve congestion in medical-psychological centers (CMP), strengthen prevention, and avoid hospitalizations, while clarifying the role of psychologists within a more coordinated care pathway.

The original intention of this system was laudable, but the reality of its implementation is nevertheless considered disappointing, as the President himself acknowledged during his television interview devoted to the "challenges of France" on May 13. The first report evaluating the system , submitted to Parliament on March 27, raises many questions.

While the rate of use of the system clearly demonstrates a crying need for care (nearly 600,000 French people have already benefited from it), the low adherence and the abnormally high dropout rate raise fears of inadequate care. The fact that only a quarter of patients reach the eighth session out of the twelve planned cannot be considered a success – the average is 4.8 sessions per patient.

Should we really see this, as the Minister of Health, Yannick Neuder, recently suggested, as a sign of the effectiveness of the system, when the scientific literature shows that premature termination of psychotherapy is most often a marker of failure, and that a clinically significant improvement often requires several dozen sessions? And what is the value, compared to the approximately 50,000 patients who did not return to see their psychologist after an initial consultation, of the generally satisfied opinion collected by a survey by the BVA institute among... ten patients, using a methodology consisting of relaying the survey to patients who were members, but not those who left the system?

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