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Abstract
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Résumé
Les images du "fou ", du "malade mental" ou du "dépressif" dans la population française sont disparates. Le "dépressif" est plutôt vu comme une personne qui s'isole, le "malade mental" comme un individu déficient, au comportement ou au discours bizarre, tandis que le "fou" serait plutôt caractérisé par la violence. Ces images ne sont guère influencées par la connaissance concrète de la maladie mentale. Quant aux causes de celle-ci, une partie de la population considère qu'elle a une origine physique : la guérison est alors difficile et la prise en charge doit être hospitalière. Pour l'autre, elle a une origine non physique : la guérison est possible en ambulatoire. En revanche, pour la dépression, la cause est, pour la quasi-totalité de la population, d'origine non physique. Globalement, 41 % des Français soutiennent les hôpitaux psychiatriques. En fait, les opinions diffèrent assez largement selon les sites d'enquête. Elles ne sont guère influencées par l'image de la maladie mentale de la personne enquêtée. La façon d'organiser la sectorisation psychiatrique n'influence ni les images de la maladie mentale dans la population, ni les opinions vis-à-vis des structures hospitalières psychiatriques. On en déduit que ces images sont générées par d'autres facteurs, sans doute d'ordre culturels.
Introduction
The concept of policy management in psychiatry requires knowledge representations of the "mad", the "mentally ill" and "depressed" by the people. It is therefore to highlight the diversity of definitions that it attributes to individual psychiatric disorders, particularly by cultural norms typically associated with geographic locations. To do this, we successively study the forms of stigmatisations broadly, and then by site, and the causes of thereof. But this does not suffice for the design of any policy in this area must also take into account the attitudes and behaviours of the population vis-à-vis the existing psychiatric facilities globally and per site.
Design of study
The treatments were carried out using data from the socio-anthropological and epidemiological "Mental Health in the general population: images and realities" made by the French Collaborating Centre of WHO for research and training Mental Health (WHOCC, Lille, France) and the Directorate of Research, Studies, Evaluation and Statistics (DREES) with 40 000 people aged 18 and older in metropolitan France and in the departments of 'overseas between 1999 and 2003 1 [1,2]. The techniques used range from descriptive statistics to multivariate analysis (correspondence analysis and multiple ascending hierarchical classification).
Results
The images of the "madness", the "mentally ill" or the "depression" in the French population are disparate. Nevertheless, some characteristics are found with high frequency: the "depressive" is rather seen as an isolated person, the "mentally ill" as a mental defective with bizarre speech, while "crazy" would rather characterized by violence (delusions and violent towards others, beat his family, incest). The "mentally ill" is sometimes defined by these last criteria.
These images are not influenced by knowledge of a relative suffering from mental illness or a psychiatric episode experienced by the interviewee. The causes of mental illness (the "madness" and "mentally ill"), two contradictory trends have expressed. Some believe it has a physical origin, and in that case the healing is difficult and care must be hospitable. Others believe it was originally a non-physical (social), and in this case, recovery is possible, and care must be ambulatory. People surveyed in some sites have homogeneous opinions in this regard: Berk, Thuir or Guéret, the first opinion is mainly expressed, whereas the opposite trend was observed in Villejuif, Niort, Lille, Poitiers, Paris15, Paris10. In contrast, for depression, the cause is, for almost the entire population, non-physical.
Overall, 41% of French people support psychiatric hospitals, while 32% oppose, preferring ambulatory solutions. In fact, opinions differ so widely among survey sites. They are not influenced by the images of people surveyed vis-à-vis the "madness", the "mentally ill" or the "depression". The way of organizing psychiatric sectorization (taken care rather intra-hospital versus extra-hospital, number of agents, etc.) does not influence either the image of "mad", the "mentally ill" or "depression" in population, nor the opinions vis-à-vis psychiatric hospitals. We deduce that these images are generated by other factors, probably cultural factors.
Language: fr |