Mental health care in Paris.
OBJECTIVE
Characterised by its population density, cultural and ethnic diversity, familial fragmentation and high levels of HIV/AIDS, crime and homelessness, Paris poses specific problems with regard to mental healthcare.


METHODS
Epidemiological studies show high rates of generalised anxiety and drug and alcohol abuse and dependence, greater use of psychoactive medication and, at the same time, apprehension about looking after mentally ill family members at home.


RESULTS
Although the Greater Paris area has a much higher density of GPs and specialists than the national mean, there are considerable variations within the region itself, with the central area having up to four times as many GPs or psychiatrists as the outer suburbs. On the other hand, although the number of mental health medical acts and the number of people receiving mental health care have been rising dramatically over the last 15 years, Paris has considerably less adult psychiatry beds and day care places per head of population than the rest of France.


CONCLUSIONS
Current planning targets include a more equitable distribution of mental health care service provision for the rapidly evolving urban population, early prevention of psycho-affective disorders, suicide and drug and alcohol misuse and the creation of low threshold services for adolescents in difficulty.
Greacen
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Laboratoire de recherche, établissement public de santé Maison-Blanche, 3-5, rue Lespagnol, 75020 Paris, France. tfreacen@ch-maison-blanche.fr
Finkelstein
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D000293:Adolescent; D000328:Adult; D002391:Catchment Area, Health / Q000706:statistics & numerical data*; D002648:Child; D003156:Community Mental Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data / Q000639:trends; D003631:Day Care, Medical; D019538:Health Care Surveys; D006301:Health Services Needs and Demand / Q000639:trends; D006742:Hospital Bed Capacity; D006801:Humans; D001523:Mental Disorders / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D010297:Paris / Q000453:epidemiology; D011567:Psychiatric Department, Hospital; D019037:Urban Health Services / Q000458:organization & administration*