Organisation of psychiatric care in Gabon during the COVID-19 epidemic

Gabonese psychiatry is facing a crisis, which results in a decrease in material and human resources. Hospital beds are closed and consultations are mainly on an out-patient basis. This article shows how health care workers are coping with this pandemic, and the challenges of maintaining the therapeutic alliance. It presents a synthesis of works on confinement, COVID-19 and mental disorders. Clinical observations reveal that the COVID-19 epidemic has strengthened the dysfunctions observed in care. In rural areas, there is a suppression of follow-up at home. In general, this health crisis had an impact on the purchasing power of patients. What caused a difficulty of payment of the psychiatric consultations in liberal, a difficulty of access to the expensive psychotropic drugs, thus favouring a non-observance of the care, and a decompensation of the psychiatric picture. In urban areas, there is a considerable decrease in out-patient consultations. There is still concern about the inter- and post COVID-19 psychiatric care. This pandemic calls on leaders leading to a reorganisation of the psychiatric care system (decentralisation of establishments throughout the country, training of qualified nursing staff, fall in the prices of expensive psychotropic drugs). The establishment of helplines in psychiatric facilities, the opening of hospital beds, COVID-19 devices in public and private facilities for patients with mental disorders are essential. (C) 2020 Elsevier Masson SAS. All rights reserved.