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“Psychiatric epidemiology studies the frequency of mental disorders and their risk factors. As a psychiatrist and epidemiologist I have compared the frequency of mental health disorders in diverse populations in urban and rural areas as well as in the homeless. I have conducted research for the European Union by comparing the mental health of adults and children across member states. I was head of the epidemiological and biostatistics department at EHESP (the French school of public health) where I promoted mental health teaching including work on environmental risks known as psycho-social risks. Indeed we are training hospital executives who have to deal with these risks by managing medical doctors and nurses as well as other professions. I was also trying to destigmatise their perception of mental health patients. This was so have a better understanding of how psychiatric patients can recover and live a relatively normal life, at least for a period of time, and can be integrated into society taking into account their difficulties.

Epidemiology can and should support policy making for the prevention and organisation of health care systems. I have studied how many people suffer from anxiety and depressive disorders do not need to be hospitalised are treated. Most of the time they turn to general practitioners who may prescribe psychotropic drugs that may not be necessary. How can we improve the care of these patients? One solution could be better training for general practitioner in psychiatry. Another solution could be to reimburse psychotherapy sessions provided by psychologists that are currently entirely paid out-of-pocket. These psychologists should be trained to focus on brief therapies and problem-solving approaches for patients who require this type of care. Indeed, talking to someone for a limited number of ten sessions or less can be life-changing. It is also important to improve cooperation between general practitioners and psychiatrists by having them consult on cases. This would be a great help for practitioners who are isolated and have to deal with severe cases. Last but not least, we must find ways to avoid or shorten hospitalisation for the most severe patients.”

Viviane Kovess
Psychiatrist, Researcher EHESP, Paris Descartes University Paris Cité

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