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Summary
Since 2020, the market for psychiatric clinics has seen significant trends and developments. The sector is experiencing a degree of concentration, with acquisitions and mergers such as the acquisition of two clinics by the C2S Group, and increased interest from investment funds, such as the acquisition of Inicea by Antin Infrastructure Partners. Despite varying densities of psychiatric beds across Europe - France being one of the leaders - there has been a steady decline in the number of beds in France (-13.9%). At the same time, full-time hospitalization dominates the activity of private clinics, accounting for over 77% of the market. Demand remains strong, with an increase in services for young patients and an expansion in part-time hospitalization. Notably, the COVID-19 pandemic has exacerbated mental health problems, particularly among students, with reports of a significant number, 11.4%, harboring suicidal thoughts. However, tariff adjustments have been implemented to alleviate financial pressures on the sector, with the first increase in tariffs for procedures and stays after years of reductions, indicating a willingness to support and potentially revitalize the sector
dynamics of supply and demand in the French psychiatric clinic market
Demand for psychiatric clinics in France has shown perceptible growth despite the decline in the number of available beds, reflecting a robust and pressing need for mental health services in the private sector. Notably, the market saw a significant increase in activity, recording a rise of around 16.71%. Considering the sum of full-time and part-time interventions, the market is valued at several billion euros, underlining its substantial economic footprint within the healthcare industry. Even with a significant reduction in the number of beds, the market continues to grow, reflecting an estimated valuation of between 7 and 8 billion euros. Demographic trends are interesting: services are expanding to meet the needs of younger patients, and part-time hospitalization is on the rise. The COVID-19 pandemic has also undeniably exacerbated mental health problems within the French population, particularly among students, who are experiencing worryingly high rates of suicidal ideation. This worrying trend testifies not only to the human toll of mental health crises, but also to the critical nature of accessible and effective psychiatric care.
At a regional level, the distribution of psychiatric beds in Europe presents a varied picture, with France leading the way in terms of bed capacity. The number of psychiatric beds in France stood at 82.69 beds per 100,000 inhabitants, although there are striking disparities between European nations, with some countries having far fewer beds available per capita. Assessing the patient profile of the French market, some 425,000 people received inpatient psychiatric care, with a further 2.1 million patients undergoing outpatient treatment options, suggesting a high and diverse demand across both care pathways. With a particular focus on children and adolescents, these younger patients make up a sizeable proportion of those requiring psychiatric support, with an overwhelming 65% of this group being male.
In summary, the French market for psychiatric clinics reveals a complex interplay between growing demand, regulatory changes and notable market value, all set against a backdrop of declining bed numbers and a growing need for psychiatric services tailored to different patient demographics
The private psychiatric clinic market in France is characterized by a series of key players, each contributing a variety of specialized services and care to the sector. These entities highlight their distinctive offerings, broadening the scope of the market while adapting to changing demands and regulations.
- Ramsay Santé is emerging as one of the leading groups in this field, with the strategic acquisition of Générale de Santé's Mèdipsy psychiatric clinics considerably strengthening its market presence. The group claims a significant share of the private hospitalization market, around 17%.
- Inicea, which was taken over by Antin Infrastructure Partners. Inicea gained momentum when it took over Korian's psychiatric business, underlining the trend towards market consolidation and the growing interest of investment funds.
- Groupe C2S has also distinguished itself by enriching its hospital network through strategic purchases, such as the acquisition of the Saint-Vincent and Saint-Pierre clinics. It continues to expand its influence, particularly in the Bourgogne Franche-Comté region.
- Groupe Sinoué is another distinguished entity focused on meeting regional needs. Identifying gaps in provision, such as in the Eure département, it inaugurated a clinic in Vernon, reflecting a determined effort to reduce disparities in psychiatric care coverage.
- Orpea, primarily known for its role in the care of the elderly, has subtly crossed over into the sphere of psychiatric clinics through its subsidiary Clinea, which offers services that can be at the crossroads of nursing homes and retirement homes.clinea offers services that can be at the crossroads of nursing homes and psychiatry, catering for a population that straddles different care requirements.
- CLINIQUES BERGMANES made a strong entry by acquiring six clinics, reinforcing the market dynamic. This move illustrates the continuous flow of new players who see the value of diversifying into the psychiatric clinic space.
- LA CHERY medical and health group reorganized their capital structures to extend their reach, including the acquisition of a psychiatric clinic, underlining the changes and expansions underway in private psychiatric care. The merger of the PASTEUR and BERGOUIGNAN clinics testifies to the flexibility and adaptability of market players as they strive to offer more comprehensive and varied specialties to their patients, underlining the spirit of collaboration within the industry.
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- Number of pages : 30 pages
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- Last update : 11/04/2023
Summary and extracts
1 Market overview
1.1 Presentation and definition of the market
There are different types of clinics: clinics specializing in surgery, follow-up care and rehabilitation centers, and psychiatric clinics. The latter are grouped together within the UNCPSY (Cliniques Psychiatriques de France)
The market for psychiatric clinics includes all psychiatric care units with private status These clinics, previously called "health centres", have an average of 60 to 80 beds, outside the public hospital psychiatric sector. The clinics represent a liberal alternative to hospitalizations within public structures
The European market shows very unequal situations between different countries in terms of the number of beds per capita, but also in the approaches and methods of care of patients
France is the second country in Europe in terms of capacity to receive psychiatric patients In France, there is a concentration of private actors A gradual decline in the number of beds (despite sustained demand) and a gradual reduction of public allocations .
The market is 90% made up of full-time adult hospitalizations, with children's hospitalizations accounting for just over 4% of hospitalizations. Between 2010 and 2018, clinic activity grew by around 16.71%.
However, according to our estimates, the market is growing and is worth several billion euros. Psychiatric clinics tend to expand their services to younger patients and the offers of part-time hospitalizations are in growth
The Covid crisis has also impacted the mental health of the French, especially students, of whom, according to a survey, 11.4 per cent of them had suicidal thoughts, which indicates a very alarming situation
1.2 Very unequal reception capacities in Europe
The observation of the number of psychiatric hospital beds in European countries shows a higher number of beds for two countries: France and Germany . However, these data must be qualified. On the one hand, because patient care is highly dependent on the type of social security system in force in a ...
1.3 The French market: decrease in available supply and market estimate
There are no precise data on the turnover of the private psychiatric clinic sector in France. However, it can be approximated using the volume of activity (***) and the average cost . It is thus possible to estimate its evolution over the period ****-****
First, the chart below highlights the number of psychiatric ...
1.4 Psychiatric impact of Covid-19
Many cases of psychotic disorders are appearing in **** so that the situation in France is alarming at the end of the health crisis
We hear a lot about the cases of depression caused by the crisis and the isolation of individuals, but in reality all sectors of psychiatry are affected. Whether ...
2 Analysis of the demand
2.1 The profile of patients hospitalized in psychiatry
Source: ****
Observation of the characteristics of patients followed in psychiatric institutions reveals several structural differences:
In children and adolescents The proportion of men is higher **% of the total number of patients treated in hospital and **% of those treated as outpatients in this category The share of partial hospitalization is higher than ...
2.2 The type of treatment depends on the individual being treated
Source: ****
There are significant differences in the type of disease depending on the gender of the individual
For hospitalization, among men, the three most frequent pathologies are
schizophrenia and delusional disorders (***) mood disorders (***) mental and behavioural disorders related to the use of psychoactive substances (***)
For women, there are:
mood disorders (***) schizophrenia ...
3 Market structure
3.1 Three types of players coexist in a market where full-time hospitalization clearly dominates
Distribution of the number of beds or places by type of actor France, ****, in % Source: ****
The following figures are for general psychiatry:
With nearly two-thirds of the market In terms of capacity, public establishments remain in the majority (***)
Private for-profit institutions represent only **% of capacity while private non-profit institutions (***) have an ...
3.2 A concentration of the private psychiatric clinic market
A dynamic of concentration of hospital players
A concentration movement can be observed in the private psychiatric clinic market The acquisition by Inicea of Korian's psychiatric activity in **** as well as the purchase the acquisition of the ** Médipsy psychiatric clinics from Générale de Santé by Ramsay Santé in ...
3.3 Unequal distribution of density and hospital places
Number of Psychiatrists by Region
France, ****, in number of units
Source: ****
Source: ****
Observation of the density of psychiatrists, but also of psychiatric hospital beds in metropolitan France reveals strong regional disparities.
It is partly to fight against this territorial divide that the Ministry of Health has announced a increase in the ...
4 Analysis of the offer
4.1 Costs in 2017 and structural trends
The unit of measurement used to assess the cost of care provided is the costs for work units (***) which is calculated from national data for public and private not-for-profit institutions.
These data show the unit costs of care activities and support functions in the following categories:
Cost per day of clinical ...
4.2 Price examples and downward pressure
Examples of prices charged
The prices charged by private psychiatric clinics are not always visible. As a comparison, we can show the prices charged in the Maison-Blanche Health Establishment, which takes care of the mental health of the population of the north and east of Paris.
Source: ****
However, we can note ...
4.3 Diversity of supply: the type of care structure depends on the patient's pathology and age
The type of care depends on The type of establishment
Of age
Patient autonomy
It can be assessed through * variables that make up the scale ADL (***) :
Dressing or grooming ; Movement and locomotion ; Power supply ; Continence; Behavior; Communication.
Each variable is then classified according to four rating levels:
Independence ; Supervision or arrangement ...
4.4 An evolving service offering
In order to develop the market, new care units are being created: gerontopsychiatry (***), eating disorders, care of adolescents and young adults, perinatal disorders, overwork syndromes.. The progression of ambulatory care While private for-profit establishments were totally absent from this type of service in **** (***) which is a private mental health establishment offering ...
5 Regulation
5.1 T2A has had a major impact on activity
One of the events that had the greatest impact on the activity of psychiatric clinics concerned activity-based pricing (***) for private clinics
Its application to psychiatric institutions had been postponed to **** . Its implementation has crystallized many critics [***] not all activities are valued in the same way
While some (***) are well paid, prevention ...
5.2 The role of the SRAs
The Regional Health Agencies are public institutions under the supervision of the Ministry of Health and Social Affairs
According to Ecohealth their role is to " to ensure unified management of health care in the regions, to better meet the needs of the population and to increase the efficiency of the system ...
List of charts
- Nombre de lits psychiatriques dans les hôpitaux de certains pays européens
- Nombre d'habitants pour 1 lit d'hôpital psychiatrique par pays
- Nombre de lits de soins psychiatriques dans les hôpitaux français
- Répartition du nombre de lits ou de places par type d'acteurs
- Répartition du nombre de journées par type d'acteurs
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Latest news
Orpea hopes to reinvent itself under the aegis of Caisse des Dépôts - 08/01/2024
- On December 19, 2023, Caisse des Dépôts et Consignations took control of Orpea with 50.18% of the capital.
- Orpea's share price fell by 99.7% in 2023.
- Orpea employs 76,000 people, including 45,000 caregivers, and more than 260,000 residents. Orpea plans to divest 500 million euros a year for three years.
Orpea launches a capital increase of around 3.9 billion euros - 13/11/2023
- Private nursing home group Orpea plans capital increase of around 3.9 billion euros
- Orpea's total debt exceeds 9 billion euros.
- Orpea's financial restructuring includes three successive capital increases, totalling 5.4 billion euros.
- On completion of the restructuring, a consortium led by Caisse des Dépôts, with Maif, CNP and MACSF, will own 50.2% of Orpea's capital, creditors will own 49.4%, while current shareholders will have 0.4% (if they decide not to participate in the capital increases).
Orpea: Ehpad occupancy rates recover - 07/11/2023
- Average occupancy rate for retirement homes in France in the third quarter of 2023: 84.4
- Year-on-year sales growth: +11.1
- Nine-month total sales: 3.9 billion euros
- Nine-month sales growth: +10.8
- Sales target for 2026: 6.4 billion euros
- Occupancy rate target (clinics and Ehpad) in 2026: 90.8
- Expected sales in 2023: 5.2 billion euros Expected occupancy rate in 2023: 84% (vs. 81.6% in 2022)
- Planned capital increases: 3.9 billion euros
- Share of capital held by the consortium led by Caisse des Dépôts in December 2023: 50.2%.
- Net debt at the end of 2023: 4.65 billion euros.
Trade unions accuse Orpea of being involved in speculative real estate activities. - 24/02/2022
- All of the company's real estate assets, located in several European countries and valued by Cictar at 7.4 billion euros, "were acquired and then sold off through complex arrangements involving companies in Luxembourg and the British Virgin Islands, most of which were never disclosed to shareholders or the public", the report states.
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