Les psychologues sont les acteurs les plus consultés, avec les psychiatres, pour un problème de santé mentale, après les médecins généralistes (MG). Ils sont les acteurs privilégiés par les patients pour une psychothérapie. Les données publiées sur leur activité sont rares.

Décrire l’activité des psychologues libéraux (démographie, environnement professionnel, modalités d’exercice, outils psychothérapeutiques utilisés, motifs de recours des patients/sujets, interactions).

Un questionnaire auto-administré a été adressé par voie postale aux 1 128 psychologues libéraux de la région Midi-Pyrénées en 2017.

Parmi les 434 répondants, les psychologues utilisaient en moyenne entre trois et quatre outils. Leur approche principale était : thérapies d’orientation analytiques pour 42,2 % des psychologues, thérapies cognitivo-comportementales (16,8 %), thérapies humanistes (10,1 %), thérapies intégratives (9,7 %), EMDR (6,7 %), thérapies systémiques (4,6 %), hypnose (2,3 %). Les psychologues recevaient en moyenne 17 patients par semaine ; le tarif moyen affiché était de 44 euros. Les troubles anxiodépressifs et leur retentissement social et professionnel étaient les principaux motifs de recours. Six patients sur dix venaient d’eux-mêmes chez les psychologues.

Notre effectif représentait un large échantillon socio-démographiquement représentatif, malgré un possible biais de sélection et une probable influence sur les réponses de l’ancrage régional universitaire de l’approche psychanalytique. Les psychologues constituent une ressource accessible d’acteurs en santé mentale, malgré la diversité de leurs formations et de leurs pratiques, et pourraient contribuer à un meilleur accès aux psychothérapies, dans l’intérêt des patients et pour une meilleure prise en charge interprofessionnelle coordonnée en santé mentale.

Despite their wide differences in practices, psychologists are among the qualified professionals able to provide psychotherapy in primary care. Along with psychiatrists, they are (after GPs) the professionals most consulted for psychological disorders, and their demographics mean they are readily accessible. They are the first actors that patients would choose to see for psychotherapy in France. Patients consider that psychologists have more time than their GP and are better trained to handle their psychological problems. While the French National Authority for Health has just issued inventory and recommendations to improve coordination between the various care providers in the management of adult patients with mental disorders, published data on the activity of psychologists in France remain scarce.

To describe the professional activity of private psychologists in the Midi-Pyrénées region of southwest France (demography, work-related information, professional environment, number of patients, fees, psychotherapeutic tools used and practice specificities, patients’ referrals and reasons for consultations, interactions with GPs).

This was a cross-sectional descriptive study. A self-administered questionnaire, based on relevant elements from a narrative review of the literature, was sent by post in February 2017 to all 1128 private psychologists of the Midi-Pyrénées region of southwest France. Questionnaire replies were collected by post between February and April, 2017, anonymously. A descriptive analysis was carried out.

The response rate was 38% (n=434 out of 1128). Among the 434 respondents, psychologists used on average between 3 and 4 psychotherapeutic tools, among which their main approach was: psychoanalysis and psychodynamic therapies for 42.2% of psychologists, cognitive-behavioural therapies (16.8%), humanist therapies (10.1%), integrative or holistic therapies (9.7%), EMDR (6.7%), systemic therapies (4.6%), hypnosis (2.3%), other (7.6%). Psychologists received an average of 17 patients per week and the average fee for a session was 44 (±8) euros; 67% (n=289) of the psychologists provided care for children, 71% (n=309) for adolescents, 38% (n=163) for couples, and 23% (n=99) for groups. The most frequent reasons for a consultation with a psychologist were depression, anxiety or stress disorders, and their social and professional impacts. 62% (n=267) of psychologists were in a group setting in at least one of their practice; 18% (n=80) worked in group practice with one or more physicians. Psychologists reported poor professional interactions/communication and exchange of information with GPs. Out of 10 new patients, 2 were referred by a GP, 2 by another health care professional, and 6 came of their own initiative. Our study sample was comparable to the reference population of psychologists of the same region regarding sex (P=0.61), age group (P=0.39) and type of activity (P=0.07).

A large sociodemographically representative sample of 434 psychologists is the main strength of this study; limitations are a possible selection bias and a probable influence on the responses of the university's regional anchoring of the psychoanalytical approach. We did not find any publication describing the modalities of the psychologists’ professional activities. Psychologists are a large and accessible resource of mental health professionals, despite the diversity of their training and practices; they could provide better access to and use of psychotherapy for the benefit of patients, and better collaborative practice in mental health care. This reflection and the framework of a collaboration to be defined are particularly justified in the context of current medical demographics, the appetite for pluriprofessional work, and the experiments and research work abroad that encourage these proposals.