In October 2020, the Psychiatric Society of Luxembourg issued an alarming statement. The current shortage of psychiatrists would only deteriorate with retirements and few applicants. Is there such a thing as a robust society without robust psychiatry? A dive into the ongoing crisis and its impact.
At the head of the Luxembourgish Society of Psychiatry, Pedopsychiatry (the branch of psychiatry that treats children and adolescents ed.) and Psychotherapy (SLPPP) is Psychiatrist Paul Hédo, who works at the Centre Hospitalier de Luxembourg (CHL). Doctor Paul Hédo is an optimistic individual – "If I wasn’t, I wouldn’t be here." – but his optimism sometimes wavers in the face of current developments.
He is grateful that the minister of health, Paulette Lenert, is very cooperative in regard to issues of mental health. But it is clear that urgent action is needed now. According to the LAIR (État des lieux des professions médicales et des professions de santé au Luxembourg) report issued in 2019, 81 per cent of adult psychiatrists and 63 per cent of child psychiatrists will retire between 2019 and 2034. In 2020, the press release noted this disturbing fact: "Some colleagues are forced to provide patients with up to 10 unpaid 24-hour shifts per month alongside their usual work." In contrast, "over a year, a third of the population is affected by a mental illness", according to the Ministry of Health.
Two years after the statement, we sat down with Doctor Paul Hédo to discuss the current situation. The shortage has not gone away, in hospital psychiatric services, there are still unfilled positions and an acute lack of beds. The number of beds per 100.000 inhabitants has steadily declined since 2004 when it was at 109, going down to 78 beds in 2016 and only 74 in 2018 according to Eurostat. To make matters worse, whether looking at the number of psychiatrists or beds in relation to the population, Luxembourg is a specific case where the statistics rarely represent reality accurately. "The number of beds was calculated on the population of the country thirty years ago, and not even on the number of affiliates", adds Doctor Hédo. Indeed, many cross-border workers are affiliated with the CNS and rightly use Luxembourg’s medical services, but this is not reflected in the offer. The staff issue is manifold.
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