While pursuing a diploma in "addiction and perinatality," Dr. Perrine Millet was shocked by the percentage of sexual violence histories among individuals suffering from addictions.
“What struck me,” she recalls, “was this complete lack of knowledge I had at the very end of my career about the serious consequences on overall health, not just mental health, but of course physical health as well. In fact, what psychologists refer to as psycho trauma is a psychophysical trauma.”
Since 2013, the WHO has clearly identified the consequences of violence experienced in childhood and adolescence, or violence currently being experienced, on overall health: cardiovascular, endocrinological, reproductive and sexual health, addictions…
“However, this is absolutely not taught to us, neither in initial training nor in continuing education,” laments Dr. Perrine Millet. “This is the missing link; it is the link in the chain to systematically identify and screen women and children, and even men, who have been victims of violence or who are currently victims of violence.”
However, patients do not spontaneously bring this up during consultations. The Haute Autorité en santé established a recommendation for best practices in 2019 to systematically question all patients, with or without warning signs. Three years later, it found that only 2.5% of volunteer doctors automatically ask the question.
A screening that would allow for better consideration of all factors that may influence the patient's health and help her improve.
That is why Dr. Perrine Millet found it wise to create an institutional training program on the medical consequences of violence. “In this diploma, and in the short courses organized by Un maillon manquant, we take care of the health of caregivers because it is impossible to welcome all this violence if we do not take care of ourselves, but we also address the violence of care in obstetric gynecology.”
Today, there are 350 graduates trained by the association and 23 professionals, including general practitioners, emergency doctors, gynecologists, midwives, physiotherapists, and nurses, who have become trainers in turn.
Un maillon manquant also provides educational kits for healthcare professionals for free on its website.
