Job retention for people with bipolar disorder: A qualitative analysis.

At least half of people with bipolar disorder, whose global prevalence is greater than 1% of the general population, do not have a stable occupation. The objective of this study is to identify the factors perceived by bipolar people as having an impact on retention in employment. Semi-directed individual interviews were offered to subjects with bipolar disorder, of working age, who had been seen by three different hospital departments in the south of France. These people had to be medically stable and have at least one occupational experience. Each interview was recorded and transcribed manually and then analyzed according to a thematic classification of verbatims. Nineteen people participated in the interviews. Three major themes identified were classified into intrinsic (working routine and working environment) and extrinsic (external aids) factors for the bipolar person. The majority believe that working regular hours is a balancing factor. For everyone, night work and stress factors can lead to relapses. All stressed the need to destigmatize the disease. Most believe that it is necessary to develop employment support organizations specific to mental illnesses. This research helps to inform people with bipolar disorder about the occupational factors that help balance their condition. Personalized multidisciplinary care pathways involving occupational medicine must be developed in order to promote the balance of the disease and job retention.

Caring for patients with mental disorders in primary care: a qualitative study on French GPs' views, atittudes and needs.

Background: Patients suffering from mental health disorders have complex care needs, associating poorer physical health status and depreved social condition. Given their central role in primary health care, GPs should be highly involved in providing global and cooperative care to these patients in partnership with mental health specialists. Objective: To understand the GP's views, attitudes and needs in the care of patients with mental disorders. Methods: We led a qualitative study from June to July 2017, with semi-structured interviews led on GPs' activity in Marseille (France). We performed an inductive thematic content analysis, using Excel software. Results: We interviewed 22 GPs. The GPs felt comfortable providing total care for their patients with anxiety and depression (most of the time perceived as 'minor cases'), whereas they felt uncomfortable and poorly integrated in the care of patients with psychotic symptoms (often perceived as 'severe'). They wanted to improve communication with psychiatrists. Conclusion: The GPs seemed to assess the complexity of the cases and therefore their ability to deal with them, based on the type of their patients' psychiatric symptoms. For the 'severe patients', they felt they didn't have a significant role to play as a family doctor, while it has been shown that these patients have poorer physical health and need more coordinated care than other patient groups. An improved communication between GPs and mental health providers could reduce the difficulties for GPs in the care of people with mental health disorders and make possible a whole patient-centred approach.

[Peer support in a patient organization in psychiatry. Experience and practices]. / Le soutien par les pairs dans une maison des usagers en psychiatrie. Expérience et pratiques.

Mental health patient organizations have only recently found a place among mental health stakeholders. Their activities at an individual level are based on a range of activities involving peer support, including mutual help groups or MHGs (similar to consumer-run organizations). A qualitative study based on an ethnographic approach was conducted in a patient organization at the Centre Hospitalier Sainte-Anne, where volunteers working in patient organizations receive visitors. The study examines the experiences and practices of patient organization members acting as peer helpers in order to reflect on what patient organizations are able to contribute to people receiving psychiatric treatment. The results show that peer helpers in the patient organization or mutual help groups share the experience of recovery and promote peer support. These practices are in line with the demands of people with mental disorders expressed at different stages of their treatment. Four main components of the process of peer-support were identified. This study shows the specificity of this kind of practice in relation to the current range of resources in mental health.