The risks are well identified, as is the strong opposition of the personnel, which has manifested itself on numerous occasions. Nothing worked: the two mandated experts judged appropriate, in a long report, the transfer of the therapeutic activities of the Office médico-pédagogiques (OMP) to the HUG, either to its Service of psychiatry of the child and the teenager (SPEA). Their conclusion is in line with the wishes of the head of the Geneva Department of Public Education (DIP), Anne Emery-Torracinta. The issue is not as abstruse as the four acronyms placed in a single sentence, which reflect the technicality of the subject, suggest; it resides in the philosophy governing the care of pupils with special needs. Distinguish the educational from the medical or, conversely, favor an interdisciplinary approach. This reflection is part of the continuity of the scandal of abuse that occurred in the home for young autistic people de Mancy.
For Professor Kerstin von Plessen, head of the University Department of Child and Adolescent Psychiatry at the CHUV, and Dr Romain Lanners, director of the Swiss Center for Specialized Education, it is desirable to attach the ambulatory device of the OMP (psychiatry and psychotherapy), disseminated in ten centers distributed in the canton, near schools, at the offer of the HUG, in charge of child psychiatric cases which we will qualify as heavy. However, it would not be a question of completely leaving the bosom of the school, but of deploying “mobile teams” which would crisscross the establishments. Such an attachment could “improve the care of young people with mental health problems in Geneva”.
Fear of a “dismantling”
If the proposal should instil more coherence in the detection and management of psychiatric cases, it also has the effect of dissociating them from specialized pedagogy, which covers speech therapy, psychology and psychomotricity. This could produce the same inconsistencies that the splitting of OMP’s activities is supposed to remedy. This project aroused, and still arouses, strong opposition that its 1,100 employees have expressed on several occasions. They fear that this “dismantling” will reduce to nothing the long interdisciplinary tradition which has nourished the work of this office.
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In November, a therapist explained to the Temps, which had collected the testimony of seven employees exercising in care as in pedagogy, the difference in fundamental culture which separates the HUG from the OMP: “The HUG provide care, in the short term, with profitability requirements. These children require an approach focused on their long-term development, not a diagnosis.”
Among the risks associated with this transfer, the report highlights a possible “reduction in the quality of interventions with the child”, an “impoverishment” of care, a “loss of closeness with the families” and a “impact negative about networking”. But the experts evacuate this discussion by limiting them to grievances from employees. Above all, they see opportunities, such as better continuity of care, especially during school holidays, a probable reduction in “long waiting times” or a finer definition of priority cases.
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Transfer “indispensable, even inevitable”
For the experts, the affair is not free from risks either for the HUG, which will have to embark on a cultural revolution: a “new logic” and a “significant reorganization” which will “probably” lead to the departure of the people who enjoy being in the rear and who do not necessarily want to be at the front, on the “field”. Not to mention the distance that could “pejorate the anchoring of consultations” in the neighborhoods.
For further: In Geneva, Anne Emery-Torracinta bequeaths a weakened DIP
Despite everything, this transfer is “indispensable, even inevitable”, conclude the experts. In response, the PLR deputy Alexandre de Senarclens, who tabled a motion last fall asking for the abandonment of the split project, believes that this report only endorses the vision of Anne Emery-Torracinta, whose mandate comes in its term: “She bequeaths one more anti-personnel mine to her successor, to whom falls the mission of analyzing the dysfunctions of the OMP in the light of all the reports, some saying the exact opposite of the one who is submitted to us today.”
find our file dedicated to the Mancy affair.