Vulnerable people ‘more isolated than ever’ during France’s coronavirus lockdown

Two joggers go past a homeless person in France, the kind of vulnerable member of society whom social worker Johann Douaze has devoted his career to helping.
Two joggers go past a homeless person in France, the kind of vulnerable member of society whom social worker Johann Douaze has devoted his career to helping. © Sylvain Thomas, AFP

Despite the coronavirus pandemic raging across the globe, France’s social workers continue to do their jobs supporting vulnerable people. One such worker, based in the town of Roanne in central France, expressed anxiety about the impact of confinement on the often fragile people with whom he is working.

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Johan Douaze has been working in an accommodation and social reintegration centre since 2013. These organisations, known by the anacronym CHRS in France, help people in precarious situations to find housing, especially after evictions or difficult separations. In the Roanne area they assist around 200 people, including former prisoners, whom Douaze helps to reintegrate into society.

But as France prepared for its third week under lockdown – which started on March 17 and has now been prolonged until at least April 15 – Douaze was worried: “We support people who are psychologically fragile or even psychotic, and thanks to the coronavirus confinement measures they are more isolated than ever. Our mission is to not forget them.”

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Being able to go outside is especially important for the people he works with.

“Wandering about usually allows them to keep everything together and not go crazy. And then they’re told to stay at home – they’re asked to do things that make no sense to them.”

‘Hard to get people hospitalised’

“They don’t take stock of what’s happening,” Douaze explained. “The days pass, not everybody behaves as they should, and anxiety builds. We don’t have enough staff on the front line to help them and we’re afraid that they’ll find themselves completely alone. We only spend 2 percent of our time with those we have to take care of; the other 98 percent of the time they’re left alone with their anxiety. It’s hard enough when everything’s going well. So it’s all very complicated.”

In response to the lockdown measures, the CHRS has changed the way it works, to protect both its staff and the people for whom they’re responsible. “We’ve adapted our way of working so that it’s now just one person per day, per department,” Douaze said. “Every day, we try to call each person we’re caring for. We stick to it, and when it feels like the system might break, we act.”

But he still feels helpless. Resources in the French healthcare system have been reallocated to fight the coronavirus, effectively making cuts to the CHRS – for example, the psychiatric reception service has been closed.

“It’s hard right now to get people hospitalised; they only take really urgent cases,” Douaze explained. “We’ve got a woman in one of our accommodation centres who’s going through a severe depressive episode; she no longer eats, she doesn’t wash anymore, she doesn’t leave her room and she insults her roommates. But psychiatric services can’t intervene – not until the situation has become very serious indeed.”

One face mask per day

Douaze also decried the lack of resources he and his colleagues are provided to protect themselves against the coronavirus. Every day they have to meet people who might be carrying the disease. “When I arrived for work this morning, I only had one mask for the whole day, even though I’m out visiting people,” he said. 

“We’re in a state of war and the situation requires many social workers to be mobilised so that public services continue; that’s what we’re doing and it means a lot to us. But we need to have the resources that allow us to be present on the ground. As things stand, we’re moving towards a situation in which social workers decide they can no longer be out and about, to the detriment of the people we’re looking after.”

“We must have the means to protect our staff, otherwise people will jump ship. The country can’t forget the people caring for invisible members of society,” Douaze continued – although he emphasised that nursing staff must be the No. 1 priority when it comes to the distribution of masks and hand sanitiser.

“For many of us it’s hard, but we can at least understand what’s going on,” he said. “A lot of these people are completely adrift and some have ideas in their heads – for example, that all of this is essentially a conspiracy to force the Yellow Vest protesters to stay a home.”

Long-term policy problems

Like many others who work with vulnerable people, Douaze is calling for solutions that take into account their specific needs and circumstances.

“For instance, the people we look after usually receive money every two or three days to help them manage their finances. But in this crisis, some get all of their money for the month in one go, and they’re unable to manage it – sometimes they spend everything and end up up with nothing. Meanwhile, some shops refuse cash as a precaution against the coronavirus, preferring bank cards instead. But many vulnerable people don’t have cards, so they lose out.”

“Many of the people we support also receive food aid every day. But for some, this isn’t happening anymore because there isn’t enough food and there aren’t enough people to distribute it. The state needs to organise these food supplies and ensure that it reaches those in need.”

Looking at the broader context, Douaze argued that France is now “paying the price for trends in psychiatric policy that have been going on for years”.

“They got rid of hospital beds; instead they wanted to send staff to people’s homes. But that doesn’t work at all in the current lockdown situation,” he explained. “When the policy was to favour hospitalisations, there was less risk of a crisis breaking out as it is now. We’re worried that if no solutions are found for vulnerable people, the safety net will have ceased to exist.”

Douaze was also worried about domestic violence amid the lockdown. “A hotline has been set up for women abused by their husbands, which is great. But there are other things that need to be done: We’ve got people who are confined at home with people they should not be confined with. In these situations, we have to hope that as little happens as possible.”

This article was adapted from the original in French.

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