Prevalence of Psychiatric and Substance Abuse Disorders Among People in Precarious Situations in Cayenne

In French Guiana, the mental health care and support system (health, medical-social, social, associative and institutional structures) is structurally lagging behind.

The density of specialist professionals is low; the psychiatric private sector is absent.

In order to adapt care provision, it is necessary to gain a better understanding of certain target populations, in particular those with multiple vulnerabilities, who have specific needs and expectations.

As highlighted by the results of a number of studies already carried out in France and elsewhere in the world, psychaitric disorders and substance-related addictive disorders have a greater impact on people living in situations of extreme exclusion, precariousness and homelessness.

In 2017, in French Guiana, one person out of two lives below the poverty line, compared to 14.9% in France.

A recent study estimated the prevalence rate of psychiatric disorders in the general population of the CACL (Communauté d'Agglomération du Centre Littoral) in French Guiana (SMPG - Santé Mentale en Population générale - study in 2021). Nowadays, there is no recent study measuring the prevalence of psychiatric disorders specifically among populations in precarious situations, wandering and/or extreme exclusion on Cayenne Island.

The main hypothesis of the research would therefore be to observe a prevalence of psychiatric disorders and addictive disorders in the precarious population that is at least as high, if not higher, than in the general population of the CACL.

Another hypothesis of the research would be to find that the distribution of the prevalence of each psychiatric disorder is not identical to that found in the general population of the CACL (more addictive disorders and more psychotic disorders in the precarious population, more disorders linked to post-traumatic stress disorder in migrant populations).

Another research hypothesis would be to observe that the use of healthcare and the perception of health are different from those of the general population of the CACL, and that it is therefore necessary to develop appropriate human and structural resources.

However, it seems essential to know this prevalence in order to adjust the offer of care and adapt it as much as possible to the specific needs of this population.

Inclusion criteria

• Adults over 18 years old
• person who uses support services intended for people in situations of precariousness, extreme exclusion and/or wandering on Cayenne and its surroundings - person agreeing to participate in the study.

Exclusion criteria

• Person refusing to participate in the study
• Person presenting an acute state of decompensation of a psychiatric pathology and/or a state of crisis (agitation crisis, suicidal crisis) and/or confusion or presenting an acute intoxication to a substance preventing him/her from understanding and answering questions.
• Impossibility of having an interpreter for a person with no (or little) French