« Santé mentale et discriminations » : un thème d’actualité pour les Semaines d’information sur la santé mentale (SISM)

International audienc

De l´autostigmatisation aux origines du processus de stigmatisation. A propos de l´enquête internationale « Santé mentale en population générale: images et réalités - en France et dans 17 pays

The archetype of the �mad� represents the paradigm of the stigmatization process and the history of madness appear as an attempt to make it disappear by their medicalization for the benefit of the concept of �mental illness �. The SMPG international survey results show the failure of the medicalization of madness to reduce stigma. This investigation describes the social representations associated to the archetypes of the �mad�, the �mentally ill� and the �depressed�. Made in France (67 sites) and in 17 countries (20 international sites), she describes the variants and invariants of these three archetypes. It describes the factors of significant stigmatization for the group � mad / mentally ill �: non-responsibility, non-controllability, medicalization, poor prognosis and dangerousness. Regardless of the country, the hard core of representations combining madness and danger is rooted in the collective imagination and the �mentally ill� bears the attributes of a �mad� medicalized. Conversely, the �depressive� label seems more acceptable and less exposed to stigma. Very few people recognize themselves in the collective representation of the �mad� or the �mentally ill�, even those who have diagnosed mental disorders. Therefore, how to exit to the dichotomies madness/reason, us /them that are at the base of the process of stigmatization, if for all the people, and even people who have mental disorders, mad it is the other? This may be the role of the patients themselves to combat the stigma and self-stigma in the years to come.L�archétype du « fou » représente le paradigme du processus de stigmatisation et l�histoire de la folie apparaît comme une tentative de la faire disparaître en la médicalisant au profit de la notion de « maladie mentale ». Les résultats de l�enquête internationale SMPG nous montrent l�échec de la médicalisation de la folie à réduire la stigmatisation. Cette enquête décrit les représentations sociales associées aux archétypes du « fou », du « malade mental » et du « dépressif ». Réalisée en France (67 sites d�enquête) et dans 17 pays (20 sites internationaux), elle décrit les variants et invariants de ces trois archétypes. Elle décrit les facteurs d�une stigmatisation importante pour le groupe « fou / malade mental » : non responsabilité, non contrôlabilité, médicalisation, mauvais pronostic et dangerosité. Quel que soit le pays, le noyau dur des représentations associant folie et danger est enraciné dans l�imaginaire collectif et le « malade mental » porte les attributs d�un « fou » médicalisé. A l�inverse, l�étiquette « dépressif » semble plus acceptable et moins exposée à la stigmatisation. Très peu de personnes se reconnaissent dans la représentation collective du « fou » ou du �malade mental�, même celles qui ont des troubles mentaux diagnostiqués. Dès lors, comment sortir de la dichotomie folie/raison, eux/nous à la base du processus de stigmatisation, si pour tout le monde, et même les personnes qui ont des troubles, le fou c�est l�autre? Ce sera peut-être le rôle des patients eux-mêmes de lutter contre la stigmatisation et l�auto stigmatisation dans les années à veni

Community mental health service: an experience from the East Lille, France

Over the past 30 years in the Eastern Lille Public Psychiatric sector, there had been progressive development of set up in community psychiatry. This innovative set up conforms to WHO recommendations. The essential priority is to avoid resorting to traditional hospitalisation, and integrating the entire health system into the city, via a network involving all interested partners: users, carers, families and elected representatives. The ambition of this socially inclusive service is to ensure the adaptation and non-exclusion of persons requiring mental health care and to tackle stigma and discrimination. It gives a new perception to psychiatry that is innovative and experimental, and observing human rights, i.e. citizen psychiatry. This experiment also provides lesson to India for effective implementation of its national mental health program

Psychiatr Rehabil J

Mental health care has been identified as a major source of mental illness stigmatization. Detailed information about these stigmatization experiences is thus needed to reduce stigma in mental health practices. The study aimed to (a) identify the most relevant stigmatizing situations in mental health care encountered by users with schizophrenia and their families; (b) characterize the relative importance of these situations in terms of frequency, experienced stigmatization, and associated suffering; and (c) identify contextual and individual factors associated with these experiences. An online survey was conducted in France among users and family members to characterize situations of stigmatization in mental health care and identify associated factors. The survey content was first developed from a participative perspective, through a focus group including users. A total of 235 participants were included in the survey: 59 participants with schizophrenia diagnosis, 96 with other psychiatric diagnoses, and 80 family members. The results revealed 15 relevant situations with different levels of frequency, stigmatization, and suffering. Participants with a diagnosis of schizophrenia experienced more situations of stigmatization, with a higher frequency. Moreover, contextual factors were strongly associated with experienced stigmatization, including recovery-oriented practices (negatively associated) and measures without consent (positively associated). These situations, as well as associated contextual factors, could be targeted to reduce stigmatization and related suffering in mental health practices. Results strongly underscore the potential of recovery-oriented practice as an instrument to fight stigma in mental health care. (PsycInfo Database Record (c) 2023 APA, all rights reserved)