From physical mobility to psychological mobilization: The benefits of changing location and caregiver in a mobile team for adolescent psychiatry

Abstract

We have developed a mobile team for adolescents with psychological difficulties that can intervene within 48 hours, if necessary. Practically, caregivers working in pairs go wherever the adolescents are (home, General Practioner’s office, etc.), travelling in a motorhome designed as a mobile office. This method allows us to approach more closely the adolescents and their families in the here and now that corresponds to our societal evolution. Most of the adolescents seen by the mobile team do not express any explicit demand but the demand is expressed by the professionals in direct contact with these adolescents in difficulty (school professionals, General Practitioners, etc.), who alert the mobile team and solicit the adolescents’ parents to call the mobile team. One characteristic of this mobile team is the mobility of setting (by changing locations, including the use of a mobile office, and caregivers, so that multiple representations are mobilized). Statistical analyses conducted on 520 adolescents followed by the mobile team showed that the first meetings tend to take place in the family’s home, subsequently transferring to the mobile office and finally in the community mental health centres. There is therefore a transition from the living space (a place that is part of the here and now ) to the caregiving space (a space of thought and for thinking ), with the mobile office serving as an intermediate step in this movement towards accessing care. Furthermore, there was a significant association between changes of locations and continuity of care. Thus, there were significantly more breakdowns in continuity when the consultations all take place in a single location (family home, mobile office, community centre). The results and their therapeutic implications will be discussed in this article, especially with regard to the key role played by physical movement in psychological mobilization, and by plurality of representations associated with different locations and caregivers.