Assistant spcialiste temps partag en psychiatrie / mdecine gnrale / addictologie 50% EPSAN G03 - 50% CH d'Haguenau

Assistant Spcialiste Temps Partag (ASTP)

The creation of a part-time specialist assistant position between two services aims to develop, structure integrated care practices, and propose a more adapted offer of psychiatric and addiction care for patients suffering from mental disorders followed in addiction structures. It can facilitate continuity and gradation of care with particular attention to patients in precarious situations, with psychiatric, addictive, and somatic comorbidities.

The assistant would carry out clinical, training, and research activities. This creation is part of a broader project of the psychiatry 67G03 pole of the EPSAN and the CSAPA of the CHG of Haguenau to enhance an outpatient offer of integrated care.

The project of an ASTP is based on solid foundations and a long-standing collaboration between our two services.

Missions of the ASTP:

• Assure a clinical activity:
• At the EPSAN in the service 67G03:
• This clinical activity corresponds to the levels of secondary and tertiary prevention, by ensuring:
• Consultations at the CMP of Haguenau: clinical and therapeutic evaluation, patient follow-up
• Participation in the follow-ups of patients of HDJ of Haguenau particularly for the care of patients with psychiatric and addictive comorbidities, participate in the therapeutic education program of the pole
• A liaison activity for the comorbid psychiatric and addictive issues at the SAU and the CSAPA of the CHG of Haguenau
• Favoring the fluidity of care pathways of patients with comorbidities by developing and organizing a coordination between the addictological device and the psychiatric structures
• Clinical meetings: participation in multidisciplinary medical-psycho-social staffs (bringing together doctors, psychologists, nurses, educators, social workers, and medical staffs)
• Participation in the general clinical activities of the psychiatry service 67G03
• Participation in the permanence of care of the EPSAN. If the candidate is a psychiatrist by training, he will participate in the on-call rotation of the EPSAN. If his training is general medicine, he may also participate in the on-call rotation in the Medicine pole of the CHG.
• At the CHG at the CSAPA:
• In external consultation:
• He is responsible for the medical and addictological evaluation of the patient, the prescription of medication in external consultation
• In multidisciplinary meeting: he participates in the elaboration of the care project in pluridisciplinarity.
• By his psychiatric specificity:
• He participates in developing the care of psychiatric comorbidities in liaison with the psychiatry liaison team of the CH of Haguenau the hospital structure of the EPSAN of Brumath and the different CMP
• Work the link with city associative structures, such as the GEM Azimut
• In HDJ:
• Participation in the HDJ program with the specificity of the psychiatric approach.
• In ELA:
• He can provide medical consultations to patients hospitalized in hospital services and in the emergency room with the specificity of the psychiatric approach.
• On the beds of weaning:
• The specialist psychiatrist or the specialist or general medicine doctor participates in the hospital care in collaboration with the doctors of the receiving services the 6 pointed beds of hospitalization of weaning.
• Pedagogical activities in the two services:
• Participation in the supervision of interns in the general psychiatry service 67G03 and at the CHG
• Participation in the teaching of addictions and psychiatric comorbidities to interns in the gastroenterology, internal medicine, and diabetology services as well as at the SAU and in the psychiatry service.
• Participate in research work:
• It is a question of participating in particular in clinical research works:
• Create a tool to help identify situations at risk and vulnerability factors in the context of the comorbid psychiatric and addictive problem.
• Create an addressing protocol for patients with comorbid problems.
• Create a structured tool for collecting requests coming from outside our two establishments.
• Create a tool for census of clinical situations in order to realize research cohorts for prospective studies.
• Develop an institutional time of the psychiatry - addiction network to think about the activity, the care device, the network work, the development of tools.
• Participation in national studies, publication of research activities in specialty journals.
• Participation in teaching activities:
• Participation in bibliography sessions on the psychiatric and addiction comorbid issues
• Participation in the CSAPA FST project. The ASTP will be an actor in the FST training with the PH of the service.
• Participation in weekly synthesis meetings with discussion of clinical cases, literature review or meeting with partners of the care pathway.
• Participation in the training of addictionology referents within the CH of Haguenau.
• Annual participation in teaching given for addictionology and psychiatric training in IFSI
• Participation in scientific meetings proposed by the actors of psychiatry and addiction on the national level.
• Participation in the monthly supervision meeting.
• Transversal activities:
• Participation in meetings organized for general practitioners and psychiatrists of the city and pharmacists to weave the city-hospital network on the subject of psychiatric and addiction comorbidities, in particular around the care of patients under opiate substitution treatment
• Favoring a continuity and gradation of the care offer in particular for patients in precarious situations, with psychiatric, addictive, and somatic comorbidities.
• Develop the existing links between the psychiatry liaison team of the pole 67G03 with the psychiatrists of the addiction service (addiction consultations without products and support to consultations for patients with psychiatric comorbidities) and propose integrated care practices.
• Collect the difficulties of care of patients in the city cabinet from the liberal doctors to construct with the liberal skills and practices and the hospital tools an optimized care pathway.
• Participation in the development of therapeutic education programs for patients on psychiatric and addiction comorbidities.
• Participation in the development of prevention programs in addictionology:
• In school environment
• Of projects of the city of Haguenau or of neighboring agglomerations supported by the ARS on the theme of the prevention in particular among the young.
• Of local associative initiatives
• Of prevention projects at the request of the companies

Context:

Epidemiological data show that patients cared for in psychiatry frequently have addictive disorders in addition to the mental pathology for which they are followed. It is therefore particularly important to identify and care for psychoactive substance consumption, even addictions in patients followed in psychiatry, not only to improve the prognosis of addictive consumptions, prevent or treat somatic complications, but also to improve the prognosis of the associated psychiatric disorder. For such care, the integrated approach seems the best adapted. It also offers a coordinated welcome and care for people with psychiatric and addiction comorbidities.

Presentation of the establishment 1, of the concerned service :

The general psychiatry sector 67 G03 serves a population of 75291 inhabitants according to the last INSEE census. The geographical territory of the sector covers the cantons of Haguenau, Woerth, Niederbronn-les-Bains and five communes of the canton of Wissembourg. It is a mixed urban and rural population, with more distant villages, for which the communication routes converge towards the city of Haguenau which is located in the center of the sector.

We also note an important number of social and medico-social structures implanted on the sector, structures with which we work in partnership.

Moreover, we also witness a progressive weakening of the density of liberal psychiatrists installed and in general, the offer of mental health care on the northern territory of the department.

The respect of the values and the policy of the sector is assured by a multidisciplinary team of the pole which also takes care to promote the quality of psychiatric care.

The clinical activity of the pole 67G03 groups different care:

Etablissement Public de Sant Alsace Nord