L’ambiguïté du mandat social de la psychiatrie

Abstract

Because psychiatry, like any medicine, is an art, the evolution of its assumptions and knowledge depends on its inclusion in a social context including power play and skill. Historically, the requirement of independence of psychiatry is based on a balance of power in favor of the statutory university neuropsychiatry and a report of knowledge that has its origins in exercise conditions specific to the nascent sectored practice. The Antipsychiatric quarrel of 1960s demonstrates particularly well identity tension between judgment on society and medical defence. Nowadays, the issue of social sanitarisation is testing the double figure against which the French psychiatric common culture is built: That of the asylum support meeting a social demand for exclusion of the mental illness, that the denial of a medical status of madness preventing a return to the sick hope of recovery and integration into the community. The emergence of the concept of psychosocial distress in the early 1990s, correlated with the development of public policies, especially those known as the integration and inclusion, and the deinstitutionalization movement that marks the psychiatric care system reactualize the nagging question of the social mandate of psychiatry, and with it, the relationship between professional psychiatric cultures and mental health policies.