The Evaluation of Therapeutic Residential Care for Adolescents and Young Adults in France: A Systematic Review

Abstract

Early psychosocial rehabilitation of young people presenting mental disorders is a major challenge. In France, the therapeutic residential care called “soins-études,” combining care and educational provision, in the Fondation Santé des Etudiants de France (FSEF) can have a role in this rehabilitation. After recalling the history and the concept underpinning soins-études in psychiatry, we performed a systematic review of the literature based on the PRISMA statement via a search for quantitative studies on soins-études facilities. Eleven quantitative studies on 10 different samples of young people hospitalised in psychiatry in FSEF were identified between the opening of the first unit in 1956 and 2016. The young people involved were mostly aged 16–20 years, which reflects the curricula covered in the FSEF establishments. These young people generally presented severe chronic psychiatric disorders. Their previous care trajectory had lasted for more than 3 years and 24–55% of them had attempted suicide at least once. Their stays lasted more than 6 months. Depending on the severity of the disorders, 44–63% of the young people were considered to have improved at discharge. The contribution of soins-études appears valuable for these young people, since there was a clinical improvement for 54–74% of them 1–15 years after their hospitalisation, with resumption of schooling, professional training or entry into employment in 60–75% of the cases. These results are compared with data in the international literature concerning therapeutic residential care, and lines for future research are identified.

Psychosocial Exoskeletons

“…Broadly, many therapeutic interventions provide psy-exoskeletal supports (Hirot et al, 2021). Patients unlikely to improve quickly or sufficiently through exploratory psychotherapies may benefit from adjunctive assistance in the forms of direct advice, psychological practices and “skills,” app and Web-based assistive tools, human helpers, and prescribed affiliations and environments.…”

Admission and goodbye letters from adolescents with anorexia nervosa in a day hospital

“…The treatment + schooling programme (10) offers two lines of approach to care provision, each an asset for the other: schooling and the associated healthcare. Schooling is one of the main motivations for our admission requests.…”

“…It is central to the work carried out during care in our unit, complementing somatic, nutritional, psychiatric and psychological care. With this objective in mind, teams in the Fondation Santé des Etudiants de France (FSEF; French Student Health Foundation) receiving adolescents ask them to write a motivation letter to be included in their admission application le (10), a process shared by other units specialised in care provision for eating disorders (11). The reason for this letter is that their commitment to care is determined by their being involved, concerned and active in their recovery process (11).…”