Mental health is a major issue for France, where the State and health professionals seek to improve care and treatment for patients.
This article looks at the current challenges and the prospects for the evolution of mental health with a focus on France, in particular with regard to the financing and adoption of new technologies.
We will explore the five levels of evolution of mental health care, ranging from the isolated work of health professionals to the use of artificial intelligence (AI) to support patients.
In Level 1 mental health care, professionals such as psychiatrists work in isolation. They take notes on paper and help patients through speech (psychotherapy) and medication treatments.
In this context, health professionals, often self-employed, generally work independently.
A psychiatrist, for example, will prescribe medication and carry out his tasks without collaborating proactively with other health professionals or associations.
Thus, patients are left to themselves to form their healthcare team (psychologist, peer helper, association, etc.).
In addition, health professionals, despite being competent mental health generalists, may not have in-depth expertise in a specific pathology.
This may limit their ability to offer personalized care adapted to the needs of each patient, but their versatility remains an asset in treating various issues.
The second level introduces collaboration between health professionals.
Here psychiatrists, psychologists, peer helpers, nurses and secretaries work together to improve overall patient care.
This approach makes it possible to better meet the needs of the patient and to ensure more consistent follow-up.
In the Level 2 approach, health professionals tend to divide roles among themselves.
Generally, the psychiatrist takes care of the supervision and, in particular, the medication part. He usually works with a psychologist, who is in charge of psychotherapy and sets up the right mental guidelines to help his patient, for example with cognitive and behavioral therapy. (TCC)
Then, there are other jobs involved in this collaborative approach. One example is the role of the secretary, who is in charge of organizing information and defining schedules. The secretary plays an important role in coordinating and managing information, thus contributing to a more structured and effective follow-up of the patient.
In addition, it is important to mention the role of associations in the collaboration between health professionals and patients. These associations organize meetings between people concerned with the same pathology, in particular through discussion groups and exchanges.
This type of support, called peer support, allows patients to share experiences, learn from each other, and feel less alone in their situation.
These associations play a crucial role in collaboration, by facilitating communication between patients and health professionals, by contributing to the dissemination of information on various pathologies and by offering emotional support to those concerned.
They actively participate in the acceptance of pathology in order to improve the overall care of patients and reinforce the collaborative approach within level 2 of mental health care.
Level 3 mental health care is characterized by patients accessing online resources in addition to consultations with their health care team.
This approach allows patients to join online support communities, to follow Trainings, watch videos, listen to podcasts, and read articles.
This way, they can work on their mental health outside of consultations and benefit from wider support.
In this context, patients can work independently on various aspects of their mental health using online resources. For example, a patient suffering from depression can follow training courses to understand the mechanisms of depression and listen to podcasts to learn how to get out of it (nutrition, sport, etc.).
This approach reinforces learning and memory by actively involving the patient in the healing process.
In addition to online resources, Level 3 also encourages patients to be active after their consultations.
For example, they can summarize what they have learned during their appointments with health professionals and send this information in writing.
This approach reinforces learning and memory by actively involving the patient in the healing process.
At level 4 of mental health care, the use of data plays a central role in improving patient follow-up and treatment.
Data can be collected proactively or passively, including information about sleep, movement, mood, and medication, mood chart.
This data makes it possible to adjust treatments, to set up emergency units and to offer consultations more quickly if necessary.
Unlike other conditions, such as cancer, where tests such as blood tests and MRIs help determine the most appropriate treatment, psychiatry rarely has such information.
Psychiatrists often test a medication by shortening consultation times and then assess its effectiveness and possible side effects over time.
The objective of Level 4 is to provide healthcare professionals with much more reliable data so that they can make the right decisions.
Data collected by smartphones, whether Android or iOS, such as sleep time, travel, and social interactions, could allow healthcare professionals to understand whether a medication meets the patient's needs more reliably and quickly.
One could even imagine using this data before treatment to better identify the patient's needs and propose a more appropriate medication.
Finally, the fifth level involves the use of artificial intelligence (AI) to provide daily support to patients. AI, such as ChatGPT, can serve as an interactive diary, allowing patients to discuss their problems at any time.
Data collected by AI can also be transmitted to healthcare professionals to adapt treatments and better understand patients' needs.
This level of care represents a major evolution, as artificial intelligence offers 24-hour availability and a capacity to remember information greater than that of a human.
While this presents some risks, it can also be seen as an opportunity for patients to access more effective support.
Artificial intelligence could retrieve data from all conversations and, as it gets to know the patient, offer solutions to work more effectively.
Like a diary, patients could converse and explain how they are feeling, their challenges, and their successes, and AI would help them navigate life choices that benefit their mental health.
However, it is important to recognize the potential limitations of this approach.
Despite these challenges, artificial intelligence offers remarkable potential to improve mental health care. The data and information collected could be used by healthcare professionals to create a personalized care journey, in collaboration with AI, online resources, associations, and collected data.
This integrated approach could offer optimal mental health support to patients (especially in countries where access to health professionals is sometimes impossible).
The French State is currently seeking to develop mental health from level 1, where health professionals work in isolation, to level 2, with collaboration between professionals to improve productivity (nursing home...).
This development is a step in the right direction, but is it fast enough in the face of current challenges?
In France, the mental health sector is marked by unequal access to care and by a lack of funding.
Patients often have access only to psychiatrists reimbursed by Social Security, while self-employed psychologists are not covered.
In addition, businesses and laboratories invest little in mental health, due to the low financial impact and the lack of drug data.
Each year, the French state spends around 9.4 billion euros for bipolarity and 109 billion euros for mental health according to the High Authority for Health (HAS).
These costs are mainly related to hospitalizations, which could be avoided through better prevention.
However, patients often consider that health should be free and do not invest in prevention, which leads to high costs for the state and a significant human impact for patients.
Faced with these challenges, the French State has set up Level 2 Psychosocial Medical Centers (CMP) to offer mental health care.
However, these centers face problems of lack of doctors, resources and growing demand from patients. The central question is therefore how to finance mental health in advance to prevent rather than cure.
To solve these problems, it is essential to move to higher levels of mental health care, by integrating data and why not one day artificial intelligence.
However, legal and technical obstacles prevent the rapid adoption of these technologies.
Today, it is very complicated in France to use mental health level 5, i.e. artificial intelligence, due to legal restrictions concerning the collection and use of data that is still little known and presents significant risks.
For example, it is not possible to passively collect data on a person's mobile phone and transmit it to health professionals.
However, we chose to work with an application from the Ministry of Health called Mental garden, which allows patients to report health data, such as sleep time and mood.
This information, once shared with health professionals, makes it possible to optimize the time in consultation.
We also collaborate in team bringing together psychiatrists, psychologists, peer helpers who work together for the care of the patient, with well-defined roles. By specializing in specific pathologies, such as bipolarity, rather than remaining generalists.
The work done outside of online consultations, through exercises and training, is already ingrained in the way we work. Our support community includes more than 2,000 people, and we offer training to understand and overcome depression, for example.
Mental health care is evolving and diversifying, with five levels of care ranging from the isolated work of health professionals to the use of artificial intelligence.
These levels include collaboration between healthcare professionals, access to online resources, use of data, and the integration of artificial intelligence (AI) for daily support.
Although some advances, such as the use of AI, are still limited by legislation in France, initiatives such as the Jardin Mental app allow patients to share declarative data with their healthcare team.
Collaboration between professionals, access to online training and exercises, and the development of specific expertise for certain pathologies contribute to improving the quality of mental health care.
Chez HopeStage, we strive to adopt these innovative approaches to offer our patients a comprehensive care path adapted to their needs.
Active patient participation, collaboration between professionals, and the use of online technologies and resources are key elements for optimal mental health care.
