Access to prevention and more complicated care but, paradoxically, more resilience in the face of the disease. This is the observation of the results of a study, presented on August 20, conducted by the National Center for Scientific Research (CNRS), in partnership with several other academic, medico-social and associative players*, on the management of patients with mental disabilities with cancer. The objective: to define and observe the links ” Whether mental handicap maintains with suspected or diagnosed cancer experience – and more generally with somatic health. It is based on a double focal length: the analysis of health and disability trajectories, on the one hand, and that of the limits that characterize care and participation in social life. The public health issues that motivate it are high: mental handicap is recognized by Social Security as the first cause of invalidity-the number of French people who suffer from it-while cancer represents the first cause of mortality, she recalls in the introduction.
Populations exposed to specific vulnerabilities
The study notes later than within the general population, which leads to in fact A mortality in these people, moreover, more exposed to risk factors (lifestyles involving individual risky pipes, unobservance of treatments, etc.).
She points to several brakes on this care: absence of information and training on cancers in the staff who support them on a daily basis, invitations to screening which are addressed to tutors and not directly to people, anxiety in the face of exams. As for prevention, It is often confined to screening mere Or, when it is more voluntary, the messages transmitted are identical to those disseminated among the general population. And are therefore not suitable for these people with mental disability for whom, once they are integrated into a care path, claim more time. “” As a result, many obstacles make follow -up difficult and upstream the prevention process. These obstacles reside both in the difficulties for professional. The explanatory prevention issues and to explain the ins and outs of care by adapting their words to the faculties of users; that in difficulty of residents to grasp what cancer is and to assimilate the information communicated. ” Finally, These patients can be faced with ” awkwardness “Or to” violence »On the part of the caregivers (speech addressed only to guides, lack or too full of information, etc.). Added to it that they are sometimes perceived as ” disturbing For other patients.
The result is that ” With prevalences comparable to those of the general population, the screening is generally insufficient, the diagnostics generally late, the care little or prou inappropriate and the chances of less healing », Concludes the study. However, paradoxically, once diagnosed, these people have been generally more resilient than in the general population. “” Psychic handicap appears as a resource. And for good reason … diagnosed cancer comes to materialize “a real disease [qui] is only in their heads “. But the stake moves as soon as it is a question of grasping the prevention challenge which, obviously, cannot be reduced to screening She says.
Tracks to improve management
To reduce inequalities in access to care, the study identifies several levers:
- Develop adapted health information
- Strengthen coordination between somatic and psychiatric fields
- Train caregivers in the specifics of mental disability
- Create referents course to streamline the links between hospital services and medico-social structures.
Access the synthesis of the study results
*The Saint-Étienne University (Loire), Aix-Marseille University (Bouches-du-Rhône), the National Union of Families and Friends of sick people and/or psychic disabilities, the Bergonié Institute (Gironde), the Camille-Miret Institute (Haute-Garonne), the regional association for the safeguard of the child, the adolescent and the adult, the research and study association Inequalities, the Roussillon Occitanie Federation of multi -professional health homes, the federation of multi -professional coordinated exercise, and the agency Les Trois Petits (formerly Diode Agency).
