Peut-on réhabiliter le concept d’institution en psychiatrie ?

Abstract

Introduction“Deinstitutionalization” has penetrated French public policies in the field of mental health. Studying the polysemy of the term institution is thus once again necessary so that French psychiatry does not lose the sight of its history and can continue to innovate in the organisation of mental healthcare. MethodAs part of our doctoral research, we conducted a literature review of articles from several disciplines in the humanities and social sciences, as well as books and articles from the corpus of institutional psychotherapy (1952 to the late 1990s). ResultWhile sociology and institutionalist economics consider the institution primarily in its static sense, assimilating it to a set of rules governing behaviours, some philosophers and clinical psychologists, on the contrary, tend to rather consider the institution as a living ecosystem. DiscussionThe particular meaning of the term institution in French psychiatry, taken above all as a process and not as its result, has been challenged with the import of the meaning of the term in English, where it is more focused on the material edifice and, in psychiatry, confused with the psychiatric hospital itself. ConclusionIn the setting of a massive development of networks and partnerships between healthcare, medico-social and common law structures, we plead for a rehabilitation of the term institution, in order to theorize a “trans-institutional” psychotherapy connected to the principles and history of the sector system.