Online and telephone psychological consultations 24/7 begin in France

Photo of M Jean-Pierre Camard by Michael Cosgrove

Flesh & Stone interviews the pioneer of telephone psychological consultations in France. M Jean-Pierre Camard describes how the new service is organised, its goals, who uses it and why.

While it's common in the United States and Canada, telephone counseling of patients by psychologists has only recently become an option in France due to a mix of strict legislative controls and the public’s perception of how health care should be dispensed.

Jean-Pierre Camard is the founder of jeconsulteunpsy.com, an internet gateway created four months ago which aims to make psychological counseling more readily available to the general public. Once a client has subscribed to the site he or she has permanent access to any one of forty-five qualified psychologists who respond to a wide range of enquiries, ranging from teenage drug issues to marital and even more serious problems, around the clock. The cost of consultations is around $85 (€60) per half-hour.

M Camard has set up his service in a country in which most basic health care is free – that which is not the case for more specialised disciplines like psychology – and in which waiting lines for consultations can be relatively long. These conditions mean that he has had to adapt his service to these realities, as he explained in our interview.

What inspired you to set up your service in what is, after all, a country which is not used to online and telephone assistance in matters of health?

The idea came to me after I realised the large extent to which the French consult online personalised horoscope and future-telling sites. They consult these sites partially for the advantages that complete anonymity and relatively rapid access to results have to offer. I thought that those principles could be adapted to psychological consulting; even more so given that those who seek counseling often want immediate access to an interlocutor.

Did you take onboard any of the practices and experiences that have evolved over the years in the United States?

Not exactly. I did most of my research into how to organise things in Canada, which has been influenced by the pioneers of the discipline, who are of course to be found in the USA. My initial reaction was shock at the sheer number of online and telephone consultants available in Canada. Another revelation was that people over there find it normal to pay for access to psychological help, whereas in France people are not at all used to being obliged to pay for health care. That was a major element in deciding how to organise our services. The fact is that the French are not used to taking the financial initiative when it comes to health issues.

Are those who dispense consultations qualified as psychologists and within which deontological framework do they operate?

All psychological counseling is done by fully qualified personnel whose credentials and qualifications are verified. How does the caller know that? Because all personnel possess what in France is called “Adeli Code” affiliation. Only fully qualified and trained psychologists can be certified in this way and all the details of their Adeli affiliation and training can be consulted not only on the site but also by contacting the authorities who administer Adeli. Concerning their operational framework, their professional status obliges them to work within the ethical bounds and practices set out by the health authorities and their professional organisations. That means that they do not work according to criteria linked to other objectives because their professional peers – and most notably their syndicate – are there to make sure that standards are maintained.

Who contacts your organisation for telephone counseling and for which reasons?

The majority of private individuals who consult us are women and their average age is around 40 years old. The reasons for their calls are varied, and range from child-related schooling and drug problems, marital problems including violence, pressure in the work environment and, of course, depressive states with less-readily identifiable origins. A non-negligible factor here is the anonymity and spontaneity of the consultation. Our biggest source of calls, however, comes from companies wishing to offer psychological counseling to their employees. The recent spate of suicides at France Télécom and Rénault – both multinationals – and the suicide rate in France in general, have led the government to consider legislation which will oblige companies to offer counseling. Those companies who use our services are those who are organising themselves with that future legislation in mind.

Related: French society confronted by extremely high suicide rates

Marketing efforts designed to attract business to telephone psychological services are quite common in the USA and Canada. Those efforts include billboard campaigns and leaving publicity in the waiting rooms of general practitioners. Do you use that kind of support?

No, we don’t. The press has been very interested in our work and has given us a lot of visibility, but apart from that we mostly use articles and ads in specialised health magazines like “Psychology Magazine” which is France’s biggest reference in this field. We have also been invited to do radio and TV interviews, but we don’t envisage using other means at this time.

Would your consultants call an ambulance or emergency services without the caller necessarily knowing if they considered it to be urgently necessary?

Again, this is down to deontological practice, and they surely would. That said, getting emergency services to come out to resolve family and other what could be termed as “daily life” issues is another matter and I do not consider that their response would always be positive.

Certain psychologists who are critical of telephone counseling in France have called it “fast-food therapy.” What would you say to them?

It doesn’t seem to be a viable comparison. For example, a mother who urgently needs to consult a psychologist about how to deal with a devastating discovery concerning their child’s drug abuse may feel that they need to speak to someone now, and not after waiting for weeks for an appointment with a psychologist in his office.

Finally, you are pioneers in this discipline, and as such the public’s reaction to your initiative must have been difficult to predict. Do you consider that the number of people availing themselves of telephone counseling is what you thought it might be?

We are quite surprised by the ease and frequency with which people are calling us, as well as the reaction of the press and other health care professionals. For things to really catch on here, however, we will have to wait for a change in people’s perception of how responsible they should be for their health without relying on traditional services.

Thank you very much M Camard for taking the time to talk to us.