N. Daumerie | Université Paris Descartes (original) (raw)
Papers by N. Daumerie
International Journal of Mental Health Promotion, 2009
A systematic review of the literature on health promotion as conveyed by the Ottawa Charter for H... more A systematic review of the literature on health promotion as conveyed by the Ottawa Charter for Health Promotion yielded two major findings: health promotion and recovery in mental health have many values and features in common, and health promotion and recovery in mental health do not refer very much to one another. A global model of public mental health is
L'information psychiatrique, 2013
Distribution électronique Cairn.info pour John Libbey Eurotext. © John Libbey Eurotext. Tous droi... more Distribution électronique Cairn.info pour John Libbey Eurotext. © John Libbey Eurotext. Tous droits réservés pour tous pays. La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que dans les limites des conditions générales d'utilisation du site ou, le cas échéant, des conditions générales de la licence souscrite par votre établissement. Toute autre reproduction ou représentation, en tout ou partie, sous quelque forme et de quelque manière que ce soit, est interdite sauf accord préalable et écrit de l'éditeur, en dehors des cas prévus par la législation en vigueur en France. Il est précisé que son stockage dans une base de données est également interdit.
The Lancet, 2009
Background Many people with schizophrenia experience stigma caused by other people's knowledge, a... more Background Many people with schizophrenia experience stigma caused by other people's knowledge, attitudes, and behaviour; this can lead to impoverishment, social marginalisation, and low quality of life. We aimed to describe the nature, direction, and severity of anticipated and experienced discrimination reported by people with schizophrenia. Methods We did a cross-sectional survey in 27 countries, in centres affi liated to the INDIGO Research Network, by use of face-to-face interviews with 732 participants with schizophrenia. Discrimination was measured with the newly validated discrimination and stigma scale (DISC), which produces three subscores: positive experienced discrimination; negative experienced discrimination; and anticipated discrimination. Findings Negative discrimination was experienced by 344 (47%) of 729 participants in making or keeping friends, by 315 (43%) of 728 from family members, by 209 (29%) of 724 in fi nding a job, 215 (29%) of 730 in keeping a job, and by 196 (27%) of 724 in intimate or sexual relationships. Positive experienced discrimination was rare. Anticipated discrimination aff ected 469 (64%) in applying for work, training, or education and 402 (55%) looking for a close relationship; 526 (72%) felt the need to conceal their diagnosis. Over a third of participants anticipated discrimination for job seeking and close personal relationships when no discrimination was experienced. Interpretation Rates of both anticipated and experienced discrimination are consistently high across countries among people with mental illness. Measures such as disability discrimination laws might, therefore, not be eff ective without interventions to improve self-esteem of people with mental illness.
Resume L’objectif de l’etude INDIGO est de decrire et analyser les modeles de discrimination touc... more Resume L’objectif de l’etude INDIGO est de decrire et analyser les modeles de discrimination touchant des personnes ayant fait l’objet d’un diagnostic de troubles schizophreniques, ainsi que la relation entre discrimination anticipee et vecue. Il s’agit d’une etude transversale menee sous la forme d’entretiens realises par des professionnels de la sante mentale. Sept cent trente-deux personnes ayant un diagnostic clinique de « troubles schizophreniques », dans 28 pays, ont participe a l’etude en remplissant l’echelle d’evaluation de la discrimination et de la stigmatisation (Discrimination and Stigma Scale [DISC]). L’article presente les principaux resultats internationaux et francais, une discussion methodologique et une ouverture sur les effets positifs collateraux de cette etude novatrice. On peut citer notamment : la reconnaissance des questions de stigmatisation et de discrimination et de leur vecu et perception par les usagers, des questionnements souleves par l’annonce du diagnostic, des reflexions sur la « designation » et « l’autodesignation », le developpement d’un reseau international de recherches et d’actions dans ce domaine. Seulement 10 % des personnes interviewees ont vecu leur discrimination de maniere positive. A travers tous les pays, les elements les plus recurrents pour lesquels la discrimination a ete vecue de maniere negative etaient : pour se faire ou pour garder des amis ; aupres de la famille ; pour garder un emploi ; pour trouver un emploi ; dans le cadre de relations intimes ou sexuelles. Deux tiers des personnes interviewees, dont la majorite ont declare ne pas avoir vecu de discrimination concrete, ont fait etat de discrimination anticipee.
Elsevier Masson, Jun 20, 2012
L'information psychiatrique, 2011
ipe.2011.0753 Auteur(s) : Jean-Luc Roelandt, Pierre-Henri Castel, Anne Lovell, Patrice Desmons, B... more ipe.2011.0753 Auteur(s) : Jean-Luc Roelandt, Pierre-Henri Castel, Anne Lovell, Patrice Desmons, Brigitte Chamak, Vincent Garcin, Massimo Marsili, Nicolas Daumerie, Nicolas Henckes La 11e version de la Classification internationale des maladies de l’OMS (CIM-10) est en cours d’elaboration au niveau international. Elle a demarre en mars 2007 et la conclusion des travaux est prevue pour 2012. Elle concerne bien evidemment aussi le chapitre V de cette classification traitant des troubles mentaux [...]
Cet article s'appuie sur le programme de recherche Graphit mene par l'Universite Lyon 2 e... more Cet article s'appuie sur le programme de recherche Graphit mene par l'Universite Lyon 2 et le CHS Saint-Jean-de-Dieu ; il aborde la question des « crises de culture » introduite par la conception de l'hyperactivite infantile soit selon une dimension comportementale soit dans la dimension transferentielle du soin. L'article souligne egalement les enjeux de societe qui sous-tendent ce debat et qui portent sur les representations que cette societe se fait de l'enfance. La conflictualite des modeles de soin represente un analyseur pertinent qui ne saurait se reduire a un danger a eviter. Les auteurs presentent dans cette perspective les resultats d'une enquete aupres de 27 cliniciens de reference psychanalytique recevant en theraoie des enfants « hyperactifs ».
L'information psychiatrique, 2011
L'information psychiatrique, 2013
Le processus de révision de la CIM-10 est dans sa phase finale. Après une rapide comparaison hist... more Le processus de révision de la CIM-10 est dans sa phase finale. Après une rapide comparaison historique des développements des deux principales classifications diagnostiques des troubles, nous présenterons trois exemples de résultats des groupes de travail de l’OMS pour la révision. La participation des experts francophones, professionnels, usagers ou aidants (famille. . .) a été très faible jusqu’à présent. L’OMS et les CCOMS francophones ainsi que le ministère belge de la Santé ont lancé un projet commun pour promouvoir le développement de la CIM-11 en francophonie dont le premier objectif est de recruter des participants francophones au Réseau mondial OMS de pratique clinique.
L Encéphale
Image of Madness was always strongly linked with the notion of "dangerousness",... more Image of Madness was always strongly linked with the notion of "dangerousness", provoking fear and social exclusion, despite the evolution of psychiatric practices and organisation, and the emphasis on user's rights respect. Mediatization and politicization of this issue through news item combining crime and mental illness, reinforce and spread out this perception. This paper presents a review of the litterature on social perceptions associating "dangerousness", "Insanity" and "mental illness", available data about the link between "dangerous states" and "psychiatric disorders", as well as the notion of "dangerousness" and the assessment of "dangerous state" of people suffering or not from psychiatric disorders. MAPPING OF SOCIAL REPRESENTATIONS: The French Survey "Mental Health in General Population: Images and Realities (MHGP)" was carried out between 1999 and 2003, on a representative sample of 36.000 individuals over 18 years old. It aims at describing the social representations of the population about "insanity/insane" and "mental illness/mentally ill". The results show that about 75% of the people interviewed link "insanity" or "mental illness" with "criminal or violent acts". Young people and those with a high level of education more frequently categorize violent and dangerous behaviours in the field of Mental illness rather than in that of madness. CORRELATION BETWEEN DANGEROUS STATE AND PSYCHIATRIC DISORDERS: in the scientific literature, all experts reject the hypothesis of a direct link between violence and mental disorder. Besides, 2 tendencies appear in their conclusions: on one hand, some studies establish a significative link between violence and severe mental illness, compared with the general population. On the other hand, results show that 87 to 97% of des aggressors are not mentally ills. Therefore, the absence of scientific consensus feeds the confusion and reinforce the link of causality between psychiatric disorders and violence. OFFICIAL FIGURES BY THE MINISTRY OF JUSTICE: according to the French Ministry of Justice, there is a lack of significative data in general population, that would allow the accurate evaluation of the proportion of authors of crimes and offences presenting a "dangerous state", either of criminological order or related to a psychiatric disorder. FROM "DANGEROUSNESS" TO "DANGEROUS STATE": the vagueness of the notion of "dangerousness" aggravates the confusion and reinforce the negative social representations attached to subjects labelled as "mentally ills". A way to alleviate this stigmatisation would be to stop using the word "dangerous", and rather use those of "dangerous states". Assessment of dangerous states is complex and needs to take into account several heterogeneous factors (circumstances of acting, social and family environment...). Besides, it is not a linear process for a given individual. Those risk factors of "dangerous state" lead to the construction of evaluation or prediction scales, which limits lay in the biaises of over or under predictive value. The overestimation of dangerousness is harmful, not only to individuals wrongly considered as "dangerous", but also to the society which, driven by safety concerns, agrees on the implementation of inaccurate measures. A FEW TRACKS FOR REMEDIATION: the representations linking "mental illness" and "dangerousness" are the major vectors of stigma, and deeply anchored in the collective popular imagination. They are shared by all population categories, with no distinction of age, gender, professional status or level of education. To overcome those prejudices, one has to carefully study their basis, their criteria, document them with statistical data, look for consistency and scientific rigour, in the terminology as well as in the methodology. Moreover, one has to encourage exchanges about this topic, between users, relatives, carers, local elected, politicians, media and health professional.
L Encéphale
The INDIGO study (INternational study of DIscrimination and stiGma Outcomes) aims at assessing th... more The INDIGO study (INternational study of DIscrimination and stiGma Outcomes) aims at assessing the impact of schizophrenic disorders diagnosis on privacy, social and professional life, in terms of discrimination. In the general population, and even among health and social professionals, erroneous negative stereotypes (double personality, dangerosity) lead to high social distance. And this has an impact on various parts of daily life: employment, housing, compliance, self-esteem… About a tenth of the adult population suffers from mental disorders at any one time. These disorders now account for about 12% of the global impact of disability, and this will rise to 15% by the year 2020. People living with schizophrenia, for example, experience reduced social participation, whilst public images of mental illness and social reactions add a dimension of suffering, which has been described as a "second illness". Stigmatizing attitudes and discriminatory behavior among the general p...
Le processus de révision de la CIM-10 est dans sa phase finale. Après une rapide comparaison hist... more Le processus de révision de la CIM-10 est dans sa phase finale. Après une rapide comparaison historique des développements
des deux principales classifications diagnostiques des troubles, nous présenterons trois exemples de résultats des groupes de
travail de l’OMS pour la révision. La participation des experts francophones, professionnels, usagers ou aidants (famille. . .)
a été très faible jusqu’à présent. L’OMS et les CCOMS francophones ainsi que le ministère belge de la Santé ont lancé un
projet commun pour promouvoir le développement de la CIM-11 en francophonie dont le premier objectif est de recruter
des participants francophones au Réseau mondial OMS de pratique clinique.
Pratiques Psychologiques, 2009
During the last 20 years, the psychiatric care organisation has undergone important shifts by tra... more During the last 20 years, the psychiatric care organisation has undergone important shifts by transfer of devices and professionals from hospital to the city. At the same time, the position/status of people living with mental health problems changed from the patients alienated by their pathology to the position of citizens actors of their health. The daily practice of mental health
Encephale-revue De Psychiatrie Clinique Biologique Et Therapeutique - ENCEPHALE, 2010
Image of Madness was always strongly linked with the notion of « dangerousness », provoking fear ... more Image of Madness was always strongly linked with the notion of « dangerousness », provoking fear and social exclusion, despite the evolution of psychiatric practices and organisation, and the emphasis on user's rights respect. Mediatization and politicization of this issue through news item combining crime and mental illness, reinforce and spread out this perception. This paper presents a review of the litterature on social perceptions associating « dangerousness », « Insanity » and « mental illness », available data about the link between « dangerous states » and « psychiatric disorders », as well as the notion of « dangerousness » and the assessment of « dangerous state » of people suffering or not from psychiatric disorders.
L'Encéphale, 2010
Cet article décrit les représentations sociales du fou, du malade mental et du dépressif, dans un... more Cet article décrit les représentations sociales du fou, du malade mental et du dépressif, dans un échantillon représentatif de la population générale française. Sur 36 000 personnes interrogées dans l'enquête « Santé mentale en population générale », plus de 75% associent les termes de fou et de malade mental à des comportements violents et dangereux. Plus de 75% des sujets associent le terme dépressif à la tristesse, l'isolement et le suicide. Les personnes jeunes et celles qui ont un niveau d'éducation et de revenu élevé catégorisent plus fréquemment les comportements violents et dangereux dans le champ de la maladie mentale plutôt que dans celui de la folie. Les représentations influant sur les recours aux soins et les attitudes vis à vis des patients, les résultats interrogent sur la meilleure façon de lutter contre les archétypes du fou, ou du malade mental, afin de réduire l'exclusion des patients.
L'Encéphale, 2010
L'image de la folie est associée depuis toujours à la notion de « dangerosité ». L'enquête « Sant... more L'image de la folie est associée depuis toujours à la notion de « dangerosité ». L'enquête « Santé Mentale en Population Générale : images et réalités (SMPG) » a permis de décrire les représentations sociales du « fou » et du « malade mental » chez les français de plus de 18 ans. Les résultats de cette enquête avancent que près des trois quarts des enquêtés associent « folie » et « maladie mentale » à « des actes criminels ou violents », confirmant la persistance des préjugés liant trouble psychique et danger, en dépit de l'évolution de la psychiatrie, des pratiques et du respect des droits des usagers en santé mentale. Cet article présente une revue de la littérature mettant en évidence l'absence de consensus scientifique sur le lien de causalité entre « trouble psychique» et « violence ». D'autre part, l'insuffisance et le manque de diffusion des données quantitatives officielles sur la proportion dans la population générale des auteurs d'infractions présentant un « état dangereux », entretiennent les représentations sociales liant dangerosité et trouble psychique. Ces stéréotypes sont renforcés par la médiatisation de faits divers associant « crime » et « maladie mentale ». Pourtant, moins d'un homicide sur 20 est commis par une personne atteinte de maladies mentales graves. Les pistes de remédiation à cet amalgame consisteraient à rapprocher davantage les images des personnes souffrant de troubles psychiques de la réalité des faits concernant leurs «états dangereux », avec le concours primordial de la recherche scientifique.
L'Encéphale, 2012
The INDIGO study (INternational study of DIscrimination and stiGma Outcomes) aims at assessing th... more The INDIGO study (INternational study of DIscrimination and stiGma Outcomes) aims at assessing the impact of schizophrenic disorders diagnosis on privacy, social and professional life, in terms of discrimination. In the general population, and even among health and social professionals, erroneous negative stereotypes (double personality, dangerosity) lead to high social distance. And this has an impact on various parts of daily life: employment, housing, compliance, self-esteem… About a tenth of the adult population suffers from mental disorders at any one time. These disorders now account for about 12% of the global impact of disability, and this will rise to 15% by the year 2020. People living with schizophrenia, for example, experience reduced social participation, whilst public images of mental illness and social reactions add a dimension of suffering, which has been described as a "second illness". Stigmatizing attitudes and discriminatory behavior among the general population against people with severe mental illness are common in all countries. Globally, little is known of effective interventions against stigma. It is clear that the negative effects of stigma can act as formidable barriers to active recovery. The INDIGO study intends to establish detailed international data on how stigma and discrimination affect the lives of people with a diagnosis of schizophrenia. The first aim of the INDIGO study is to conduct qualitative and quantitative interviews with 25 people with a diagnosis of schizophrenia in each participating site, to elicit information on how the condition affects their everyday lives, with a focus upon sites in Europe. The second is to gather data for all participating countries on the laws, policies and regulations which set a clear distinction between people with a diagnosis of mental illness and others, to establish an international profile of such discrimination. A new scale (Discrimination and Stigma Scale [DISC]), used in a face-to-face setting was developed. Interviewers asked service users to comment on how far their mental disorder has affected key areas of their lives, including work, marriage and partnerships, housing, leisure, and religious activities. For country-level information, staff at each national site gathered the best available data on whether special legal, policy or administrative arrangements are made for people with a diagnosis of mental illness. These items included, for example, information on access to insurance, financial services, driving licenses, voting, jury service, or travel visas. The INDIGO study is conducted within the framework of the WPA global program to fight stigma and discrimination because of schizophrenia. French interviews occurred in two sites (Lille and Nice) on a sample of 25 patients. First, expressed disadvantages are high for several items (all relations, work and training, housing). In addition, we wish to highlight three specific points: almost half of the participants (46%) suffer from not being respected because of contacts with services, 88% of them felt rejected by people who know their diagnosis, and 76% hide/conceal their diagnosis. Positive experienced discrimination was rare. Two thirds of participants anticipated discrimination for job seeking and close personal relationships, sometimes with no experienced discrimination. This study, one of the rare in France adopting the point of view of a stigmatized group, revealed the numerous impacts of a diagnosis of schizophrenic disorders on everyday life. Comparisons between French and international results confirmed that the situation is not different in France, and even highlighted the extent of the stigmatization in the country.
by Nerea Palomares, Tine Van Bortel, N. Daumerie, H. Zaske, J. Van Weeghel, Roumen Milev, I. Goldie, Jaap van Weeghel, Jibril Abdulmalik, Alp Üçok, and Lily Peppou
The Lancet, 2009
Background Depression is the third leading contributor to the worldwide burden of disease. We ass... more Background Depression is the third leading contributor to the worldwide burden of disease. We assessed the nature and severity of experienced and anticipated discrimination reported by adults with major depressive disorder worldwide. Moreover, we investigated whether experienced discrimination is related to clinical history, provision of health care, and disclosure of diagnosis and whether anticipated discrimination is associated with disclosure and previous experiences of discrimination.
International Journal of Mental Health Promotion, 2009
A systematic review of the literature on health promotion as conveyed by the Ottawa Charter for H... more A systematic review of the literature on health promotion as conveyed by the Ottawa Charter for Health Promotion yielded two major findings: health promotion and recovery in mental health have many values and features in common, and health promotion and recovery in mental health do not refer very much to one another. A global model of public mental health is
L'information psychiatrique, 2013
Distribution électronique Cairn.info pour John Libbey Eurotext. © John Libbey Eurotext. Tous droi... more Distribution électronique Cairn.info pour John Libbey Eurotext. © John Libbey Eurotext. Tous droits réservés pour tous pays. La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que dans les limites des conditions générales d'utilisation du site ou, le cas échéant, des conditions générales de la licence souscrite par votre établissement. Toute autre reproduction ou représentation, en tout ou partie, sous quelque forme et de quelque manière que ce soit, est interdite sauf accord préalable et écrit de l'éditeur, en dehors des cas prévus par la législation en vigueur en France. Il est précisé que son stockage dans une base de données est également interdit.
The Lancet, 2009
Background Many people with schizophrenia experience stigma caused by other people's knowledge, a... more Background Many people with schizophrenia experience stigma caused by other people's knowledge, attitudes, and behaviour; this can lead to impoverishment, social marginalisation, and low quality of life. We aimed to describe the nature, direction, and severity of anticipated and experienced discrimination reported by people with schizophrenia. Methods We did a cross-sectional survey in 27 countries, in centres affi liated to the INDIGO Research Network, by use of face-to-face interviews with 732 participants with schizophrenia. Discrimination was measured with the newly validated discrimination and stigma scale (DISC), which produces three subscores: positive experienced discrimination; negative experienced discrimination; and anticipated discrimination. Findings Negative discrimination was experienced by 344 (47%) of 729 participants in making or keeping friends, by 315 (43%) of 728 from family members, by 209 (29%) of 724 in fi nding a job, 215 (29%) of 730 in keeping a job, and by 196 (27%) of 724 in intimate or sexual relationships. Positive experienced discrimination was rare. Anticipated discrimination aff ected 469 (64%) in applying for work, training, or education and 402 (55%) looking for a close relationship; 526 (72%) felt the need to conceal their diagnosis. Over a third of participants anticipated discrimination for job seeking and close personal relationships when no discrimination was experienced. Interpretation Rates of both anticipated and experienced discrimination are consistently high across countries among people with mental illness. Measures such as disability discrimination laws might, therefore, not be eff ective without interventions to improve self-esteem of people with mental illness.
Resume L’objectif de l’etude INDIGO est de decrire et analyser les modeles de discrimination touc... more Resume L’objectif de l’etude INDIGO est de decrire et analyser les modeles de discrimination touchant des personnes ayant fait l’objet d’un diagnostic de troubles schizophreniques, ainsi que la relation entre discrimination anticipee et vecue. Il s’agit d’une etude transversale menee sous la forme d’entretiens realises par des professionnels de la sante mentale. Sept cent trente-deux personnes ayant un diagnostic clinique de « troubles schizophreniques », dans 28 pays, ont participe a l’etude en remplissant l’echelle d’evaluation de la discrimination et de la stigmatisation (Discrimination and Stigma Scale [DISC]). L’article presente les principaux resultats internationaux et francais, une discussion methodologique et une ouverture sur les effets positifs collateraux de cette etude novatrice. On peut citer notamment : la reconnaissance des questions de stigmatisation et de discrimination et de leur vecu et perception par les usagers, des questionnements souleves par l’annonce du diagnostic, des reflexions sur la « designation » et « l’autodesignation », le developpement d’un reseau international de recherches et d’actions dans ce domaine. Seulement 10 % des personnes interviewees ont vecu leur discrimination de maniere positive. A travers tous les pays, les elements les plus recurrents pour lesquels la discrimination a ete vecue de maniere negative etaient : pour se faire ou pour garder des amis ; aupres de la famille ; pour garder un emploi ; pour trouver un emploi ; dans le cadre de relations intimes ou sexuelles. Deux tiers des personnes interviewees, dont la majorite ont declare ne pas avoir vecu de discrimination concrete, ont fait etat de discrimination anticipee.
Elsevier Masson, Jun 20, 2012
L'information psychiatrique, 2011
ipe.2011.0753 Auteur(s) : Jean-Luc Roelandt, Pierre-Henri Castel, Anne Lovell, Patrice Desmons, B... more ipe.2011.0753 Auteur(s) : Jean-Luc Roelandt, Pierre-Henri Castel, Anne Lovell, Patrice Desmons, Brigitte Chamak, Vincent Garcin, Massimo Marsili, Nicolas Daumerie, Nicolas Henckes La 11e version de la Classification internationale des maladies de l’OMS (CIM-10) est en cours d’elaboration au niveau international. Elle a demarre en mars 2007 et la conclusion des travaux est prevue pour 2012. Elle concerne bien evidemment aussi le chapitre V de cette classification traitant des troubles mentaux [...]
Cet article s'appuie sur le programme de recherche Graphit mene par l'Universite Lyon 2 e... more Cet article s'appuie sur le programme de recherche Graphit mene par l'Universite Lyon 2 et le CHS Saint-Jean-de-Dieu ; il aborde la question des « crises de culture » introduite par la conception de l'hyperactivite infantile soit selon une dimension comportementale soit dans la dimension transferentielle du soin. L'article souligne egalement les enjeux de societe qui sous-tendent ce debat et qui portent sur les representations que cette societe se fait de l'enfance. La conflictualite des modeles de soin represente un analyseur pertinent qui ne saurait se reduire a un danger a eviter. Les auteurs presentent dans cette perspective les resultats d'une enquete aupres de 27 cliniciens de reference psychanalytique recevant en theraoie des enfants « hyperactifs ».
L'information psychiatrique, 2011
L'information psychiatrique, 2013
Le processus de révision de la CIM-10 est dans sa phase finale. Après une rapide comparaison hist... more Le processus de révision de la CIM-10 est dans sa phase finale. Après une rapide comparaison historique des développements des deux principales classifications diagnostiques des troubles, nous présenterons trois exemples de résultats des groupes de travail de l’OMS pour la révision. La participation des experts francophones, professionnels, usagers ou aidants (famille. . .) a été très faible jusqu’à présent. L’OMS et les CCOMS francophones ainsi que le ministère belge de la Santé ont lancé un projet commun pour promouvoir le développement de la CIM-11 en francophonie dont le premier objectif est de recruter des participants francophones au Réseau mondial OMS de pratique clinique.
L Encéphale
Image of Madness was always strongly linked with the notion of "dangerousness",... more Image of Madness was always strongly linked with the notion of "dangerousness", provoking fear and social exclusion, despite the evolution of psychiatric practices and organisation, and the emphasis on user's rights respect. Mediatization and politicization of this issue through news item combining crime and mental illness, reinforce and spread out this perception. This paper presents a review of the litterature on social perceptions associating "dangerousness", "Insanity" and "mental illness", available data about the link between "dangerous states" and "psychiatric disorders", as well as the notion of "dangerousness" and the assessment of "dangerous state" of people suffering or not from psychiatric disorders. MAPPING OF SOCIAL REPRESENTATIONS: The French Survey "Mental Health in General Population: Images and Realities (MHGP)" was carried out between 1999 and 2003, on a representative sample of 36.000 individuals over 18 years old. It aims at describing the social representations of the population about "insanity/insane" and "mental illness/mentally ill". The results show that about 75% of the people interviewed link "insanity" or "mental illness" with "criminal or violent acts". Young people and those with a high level of education more frequently categorize violent and dangerous behaviours in the field of Mental illness rather than in that of madness. CORRELATION BETWEEN DANGEROUS STATE AND PSYCHIATRIC DISORDERS: in the scientific literature, all experts reject the hypothesis of a direct link between violence and mental disorder. Besides, 2 tendencies appear in their conclusions: on one hand, some studies establish a significative link between violence and severe mental illness, compared with the general population. On the other hand, results show that 87 to 97% of des aggressors are not mentally ills. Therefore, the absence of scientific consensus feeds the confusion and reinforce the link of causality between psychiatric disorders and violence. OFFICIAL FIGURES BY THE MINISTRY OF JUSTICE: according to the French Ministry of Justice, there is a lack of significative data in general population, that would allow the accurate evaluation of the proportion of authors of crimes and offences presenting a "dangerous state", either of criminological order or related to a psychiatric disorder. FROM "DANGEROUSNESS" TO "DANGEROUS STATE": the vagueness of the notion of "dangerousness" aggravates the confusion and reinforce the negative social representations attached to subjects labelled as "mentally ills". A way to alleviate this stigmatisation would be to stop using the word "dangerous", and rather use those of "dangerous states". Assessment of dangerous states is complex and needs to take into account several heterogeneous factors (circumstances of acting, social and family environment...). Besides, it is not a linear process for a given individual. Those risk factors of "dangerous state" lead to the construction of evaluation or prediction scales, which limits lay in the biaises of over or under predictive value. The overestimation of dangerousness is harmful, not only to individuals wrongly considered as "dangerous", but also to the society which, driven by safety concerns, agrees on the implementation of inaccurate measures. A FEW TRACKS FOR REMEDIATION: the representations linking "mental illness" and "dangerousness" are the major vectors of stigma, and deeply anchored in the collective popular imagination. They are shared by all population categories, with no distinction of age, gender, professional status or level of education. To overcome those prejudices, one has to carefully study their basis, their criteria, document them with statistical data, look for consistency and scientific rigour, in the terminology as well as in the methodology. Moreover, one has to encourage exchanges about this topic, between users, relatives, carers, local elected, politicians, media and health professional.
L Encéphale
The INDIGO study (INternational study of DIscrimination and stiGma Outcomes) aims at assessing th... more The INDIGO study (INternational study of DIscrimination and stiGma Outcomes) aims at assessing the impact of schizophrenic disorders diagnosis on privacy, social and professional life, in terms of discrimination. In the general population, and even among health and social professionals, erroneous negative stereotypes (double personality, dangerosity) lead to high social distance. And this has an impact on various parts of daily life: employment, housing, compliance, self-esteem… About a tenth of the adult population suffers from mental disorders at any one time. These disorders now account for about 12% of the global impact of disability, and this will rise to 15% by the year 2020. People living with schizophrenia, for example, experience reduced social participation, whilst public images of mental illness and social reactions add a dimension of suffering, which has been described as a "second illness". Stigmatizing attitudes and discriminatory behavior among the general p...
Le processus de révision de la CIM-10 est dans sa phase finale. Après une rapide comparaison hist... more Le processus de révision de la CIM-10 est dans sa phase finale. Après une rapide comparaison historique des développements
des deux principales classifications diagnostiques des troubles, nous présenterons trois exemples de résultats des groupes de
travail de l’OMS pour la révision. La participation des experts francophones, professionnels, usagers ou aidants (famille. . .)
a été très faible jusqu’à présent. L’OMS et les CCOMS francophones ainsi que le ministère belge de la Santé ont lancé un
projet commun pour promouvoir le développement de la CIM-11 en francophonie dont le premier objectif est de recruter
des participants francophones au Réseau mondial OMS de pratique clinique.
Pratiques Psychologiques, 2009
During the last 20 years, the psychiatric care organisation has undergone important shifts by tra... more During the last 20 years, the psychiatric care organisation has undergone important shifts by transfer of devices and professionals from hospital to the city. At the same time, the position/status of people living with mental health problems changed from the patients alienated by their pathology to the position of citizens actors of their health. The daily practice of mental health
Encephale-revue De Psychiatrie Clinique Biologique Et Therapeutique - ENCEPHALE, 2010
Image of Madness was always strongly linked with the notion of « dangerousness », provoking fear ... more Image of Madness was always strongly linked with the notion of « dangerousness », provoking fear and social exclusion, despite the evolution of psychiatric practices and organisation, and the emphasis on user's rights respect. Mediatization and politicization of this issue through news item combining crime and mental illness, reinforce and spread out this perception. This paper presents a review of the litterature on social perceptions associating « dangerousness », « Insanity » and « mental illness », available data about the link between « dangerous states » and « psychiatric disorders », as well as the notion of « dangerousness » and the assessment of « dangerous state » of people suffering or not from psychiatric disorders.
L'Encéphale, 2010
Cet article décrit les représentations sociales du fou, du malade mental et du dépressif, dans un... more Cet article décrit les représentations sociales du fou, du malade mental et du dépressif, dans un échantillon représentatif de la population générale française. Sur 36 000 personnes interrogées dans l'enquête « Santé mentale en population générale », plus de 75% associent les termes de fou et de malade mental à des comportements violents et dangereux. Plus de 75% des sujets associent le terme dépressif à la tristesse, l'isolement et le suicide. Les personnes jeunes et celles qui ont un niveau d'éducation et de revenu élevé catégorisent plus fréquemment les comportements violents et dangereux dans le champ de la maladie mentale plutôt que dans celui de la folie. Les représentations influant sur les recours aux soins et les attitudes vis à vis des patients, les résultats interrogent sur la meilleure façon de lutter contre les archétypes du fou, ou du malade mental, afin de réduire l'exclusion des patients.
L'Encéphale, 2010
L'image de la folie est associée depuis toujours à la notion de « dangerosité ». L'enquête « Sant... more L'image de la folie est associée depuis toujours à la notion de « dangerosité ». L'enquête « Santé Mentale en Population Générale : images et réalités (SMPG) » a permis de décrire les représentations sociales du « fou » et du « malade mental » chez les français de plus de 18 ans. Les résultats de cette enquête avancent que près des trois quarts des enquêtés associent « folie » et « maladie mentale » à « des actes criminels ou violents », confirmant la persistance des préjugés liant trouble psychique et danger, en dépit de l'évolution de la psychiatrie, des pratiques et du respect des droits des usagers en santé mentale. Cet article présente une revue de la littérature mettant en évidence l'absence de consensus scientifique sur le lien de causalité entre « trouble psychique» et « violence ». D'autre part, l'insuffisance et le manque de diffusion des données quantitatives officielles sur la proportion dans la population générale des auteurs d'infractions présentant un « état dangereux », entretiennent les représentations sociales liant dangerosité et trouble psychique. Ces stéréotypes sont renforcés par la médiatisation de faits divers associant « crime » et « maladie mentale ». Pourtant, moins d'un homicide sur 20 est commis par une personne atteinte de maladies mentales graves. Les pistes de remédiation à cet amalgame consisteraient à rapprocher davantage les images des personnes souffrant de troubles psychiques de la réalité des faits concernant leurs «états dangereux », avec le concours primordial de la recherche scientifique.
L'Encéphale, 2012
The INDIGO study (INternational study of DIscrimination and stiGma Outcomes) aims at assessing th... more The INDIGO study (INternational study of DIscrimination and stiGma Outcomes) aims at assessing the impact of schizophrenic disorders diagnosis on privacy, social and professional life, in terms of discrimination. In the general population, and even among health and social professionals, erroneous negative stereotypes (double personality, dangerosity) lead to high social distance. And this has an impact on various parts of daily life: employment, housing, compliance, self-esteem… About a tenth of the adult population suffers from mental disorders at any one time. These disorders now account for about 12% of the global impact of disability, and this will rise to 15% by the year 2020. People living with schizophrenia, for example, experience reduced social participation, whilst public images of mental illness and social reactions add a dimension of suffering, which has been described as a "second illness". Stigmatizing attitudes and discriminatory behavior among the general population against people with severe mental illness are common in all countries. Globally, little is known of effective interventions against stigma. It is clear that the negative effects of stigma can act as formidable barriers to active recovery. The INDIGO study intends to establish detailed international data on how stigma and discrimination affect the lives of people with a diagnosis of schizophrenia. The first aim of the INDIGO study is to conduct qualitative and quantitative interviews with 25 people with a diagnosis of schizophrenia in each participating site, to elicit information on how the condition affects their everyday lives, with a focus upon sites in Europe. The second is to gather data for all participating countries on the laws, policies and regulations which set a clear distinction between people with a diagnosis of mental illness and others, to establish an international profile of such discrimination. A new scale (Discrimination and Stigma Scale [DISC]), used in a face-to-face setting was developed. Interviewers asked service users to comment on how far their mental disorder has affected key areas of their lives, including work, marriage and partnerships, housing, leisure, and religious activities. For country-level information, staff at each national site gathered the best available data on whether special legal, policy or administrative arrangements are made for people with a diagnosis of mental illness. These items included, for example, information on access to insurance, financial services, driving licenses, voting, jury service, or travel visas. The INDIGO study is conducted within the framework of the WPA global program to fight stigma and discrimination because of schizophrenia. French interviews occurred in two sites (Lille and Nice) on a sample of 25 patients. First, expressed disadvantages are high for several items (all relations, work and training, housing). In addition, we wish to highlight three specific points: almost half of the participants (46%) suffer from not being respected because of contacts with services, 88% of them felt rejected by people who know their diagnosis, and 76% hide/conceal their diagnosis. Positive experienced discrimination was rare. Two thirds of participants anticipated discrimination for job seeking and close personal relationships, sometimes with no experienced discrimination. This study, one of the rare in France adopting the point of view of a stigmatized group, revealed the numerous impacts of a diagnosis of schizophrenic disorders on everyday life. Comparisons between French and international results confirmed that the situation is not different in France, and even highlighted the extent of the stigmatization in the country.
by Nerea Palomares, Tine Van Bortel, N. Daumerie, H. Zaske, J. Van Weeghel, Roumen Milev, I. Goldie, Jaap van Weeghel, Jibril Abdulmalik, Alp Üçok, and Lily Peppou
The Lancet, 2009
Background Depression is the third leading contributor to the worldwide burden of disease. We ass... more Background Depression is the third leading contributor to the worldwide burden of disease. We assessed the nature and severity of experienced and anticipated discrimination reported by adults with major depressive disorder worldwide. Moreover, we investigated whether experienced discrimination is related to clinical history, provision of health care, and disclosure of diagnosis and whether anticipated discrimination is associated with disclosure and previous experiences of discrimination.