3 questions to… Magali Coldefy and Coralie Gandré following the publication of the Atlas de la santé mentale en France (Atlas of Mental Health in France), May 2020, in the IRDES Books collection.
The care of people living with mental disorders is being questioned and is undergoing major changes in France and around the world. Even if the follow-up of people is still too often focused on care, it is oriented towards their recovery, as well as their social and professional inclusion. However, in France, the cooperation of the many actors involved - from civil society to the healthcare and social sectors - still confronts with compartmentalized functioning. The 2016 Law on the Modernization of the Health System called on these actors, together with users of mental health services, to build formal mental health networks, based on a territorial diagnosis shared by the various stakeholders. Many sources of information are available in France to contribute to this diagnosis, but they are scattered, sometimes unknown, and fields not covered by these sources may be overlooked. This is why we have designed this atlas, in collaboration with the Provence-Alpes-Côte d'Azur (PACA) Regional Health Agency (ARS) and the Directorate for Research, Studies, Assessment and Statistics (DREES, French Ministry of Health), in order to bring together existing data sources and to provide an inventory of the different methods of access and use of care and support, both at the national and territorial levels. The populations concerned by mental disorders are indeed very diversified, as well as the care practices; foregone care and inequalities in access to the various forms of care are also significant. It may be recalled that we are talking about more than 7 million people who have had care for a mental disorder or a psychotropic treatment (2017 data).
The atlas offers an unprecedented snapshot view of both care practices and supply in different territories based on existing information systems. The numerous commented maps offer a synthetic and explicit vision. The atlas presents specific situations, such as those of populations that are particularly vulnerable because of their age or living environment: children and adolescents, adults aged 18 to 64 years old treated for frequent mental disorders or severe and persistent mental disorders, the elderly and the prison population. In this sense, it is aimed at the actors concerned, including users of mental health services, as well as their families, health and social and medico-social sector professionals, national and local political decision-makers and researchers. A secondary objective is also pedagogical: to disseminate the existing data in France in the field of mental health and their gaps in certain areas, and to help the actors to get familiar with this information.
This atlas project is not new; it came out of the 2016 Law on the Modernization of the Health System and was intended as a tool for actors in the field to contribute to shared territorial diagnoses in mental health. The urgency was therefore to identify the relevant indicators, collect the necessary information, to define the indicators and make them available to the greatest number of people. The idea of an online atlas was thus favoured, in collaboration with the Atlasanté team. It allows everyone to zoom in on the territory that interests them, to compare themselves with their neighbours or similar territories, or at the national level. The online atlas allows to modify the scale of observation (municipality, “territoire de vie”, department, region). It also has the advantage to gather a very large number of indicators on different themes and allows data to be updated. The Atlas of Mental Health in France is more of a "text setting" that makes it possible to address issues not covered by the data. A descriptive analysis of the French situation is carried out on the basis of this information, but it is enriched with a scientific analysis of each theme, allowing the reader to better know and understand the current challenges of mental health policy in France.