Les évolutions et orientations récentes en matière de santé publique ont conduit à une réduction du nombre et des capacités d'accueil des grands hôpitaux psychiatriques traditionnels. La mise à la disposition du corps médical de produits psychotropes actifs et toujours mieux tolérés a permis d'améliorer la qualité des soins apportés au patient. De plus, la pression sociale tend actuellement à remettre dans le tissu social les individus qui auraient été, en d'autres temps, exclus par leur maladie mentale. Mais le stress lié à des possibilités d'insertion souvent précaires et la large diffusion dans le public de produits psychodysleptiques contribuent à favoriser les rechutes. Les périodes de rémission raccourcissent. Les psychiatres assistent ainsi à un nouveau phénomène: un grand nombre de malades sortent rapidement après leur admission et retournent à l'hôpital peu après leur sortie, ce phénomène a été baptisé le syndrome de la porte tournante (ou de la porte tambour). Notre intervention se propose de le décrire dans ses diverses composantes et à évaluer sa réalité en 2006.

The recent evolution of the public health system has led to a drastic decrease in the capacity of public psychiatric hospitals to receive patients. As patients can benefit from new drugs with better efficacy and higher safety, it has become possible for those who once were banished from the general population because of their symptoms, to live and to be accepted again in the city. But at the same time, the stress of social rehabilitation, precariousness of shelter and drug abuse behaviour contribute to constant relapses. Remission periods become shorter. Consequently the psychiatrists attend to a new phenomenon: A great number of patients are hospitalised for short periods, and return back to the hospital a few days after their exit. This phenomenon is called the revolving door syndrome. Our intervention aims to describe it and all its components and to estimate its reality in 2006. This paper is the result of a team work and the same crue as been working ten years ago on this subject, concerning the same topics. Inpatients with mental disease have specific and complex needs concerning their health but also concerning their material conditions for survival. The paradox is that solutions do exist and follow up is systematically proposed. However hospitalization seems to be the only solution that some patients can accept. Thus, the main question seems to be relative to the methods of follow-up. The patients do not always find the social and occupational support that the hospital provides.