« Santé Mentale en Population Générale : Images et Réalités (Smpg) » : Présentation de La méthodologie d’enquête

Abstract

Introduction Mental Health is a Public Health issue, however, access to relevant treatment often does not meet the population needs. Patients, their relatives, as well as Mental Health professionals are still victims of a high stigmatization process. Whatever the countries and the cultural settings, public beliefs and attitudes towards mental illness (insanity) and mentally ills (insane people) play a major role in the ranking of priorities given to Mental Health national prevention and care policies. This paper presents the methodology of the research-action entitled « Mental Health in General Population : images and realities (MHGP) » carried out by the World Health Organisation Collaborative Centre (Lille, France) and the Direction of research, studies, assessment and statistics (Drees) of the French Ministry of Health, in a sample of 36 000 French subjects over 18 years old, between 1999 and 2003. Objectives The MHGP Survey is an international multisite study aimed at : - Describing, in the general population, the representations attached to insanity, mental illness and depression, and the related care - Assessing the prevalence of major psychiatric disorders in the general population ; - Rising awareness about Mental Health issues among various social groups: social workers, local elected, care professionals, by including them in the research-action procedure ; - Promoting the development of Community Psychiatry, following WHO main Guidelines. Methods About 900 individuals were recruited in 47 centres in metropolitan France between 1999 and 2003 according to the following criteria: i) informed consent to take part in the study, ii) age over 18 yrs, iii) not residing in a care institution and not homeless. Subjects were selected by quota sampling stratified by age, gender, educational and occupational level with the general population of the general population of the centre as sampling frame. The quotas were defined on the basis of the 1999 national population census. The data was collected by 1700 nursing students using a 50-item structured questionnaire administered in face-to-face interviews ; mean length 40 minutes. The interviewers received a special 3-day training course. The assessment included a specially developed questionnaire enabling description of representations of insane, mentally ill and depressed individuals ; the Mini International Neuro-psychiatric Interview (Sheehan and Lecrubier) ; a specific questionnaire on care consumption in case of positive MINI diagnosis and a sociodemographic questionnaire. In each centre, a team of supervisors (psychiatric staff) coordinated the interviews and the data collection ; the local elected and the social and care networks were given information about the research and the results. The results of the local study were systematically presented to the general population, the local elected and the social and care professionals. Prevalence rates of mental disorders are very similar to those observed in other studies. Results on social representations and public beliefs in general population can compare with the international data available. MHGP research-action remains the first study of this scale on the topic of Mental Health in France, combining representations and prevalences description. It allowed the development of anti-stigma actions at a national and local level.