Cécile Delawarde

Prevention in mental health: Social representations from French professionals

Abstract In France, the last decade has been marked by an extensive development of public interventions in the field of mental health. The political investment in mental health has been the object of a public debate in which prevention was perceived by professional opinion leaders as a mean for politics to implement social control policies. However, it seems that the vigor of these condemnations has jeopardized the opportunity to initiate a debate on the ethical, sociological and epistemological foundations of prevention in mental health. Aim and method: EPIONE study was set up to meet the need for psychosocial research to evaluate the social representations of prevention in mental health professionals in charge of prevention, within the French context. Using one open-ended question (‘What do you think about prevention in mental health?’), representations from 616 professionals were analyzed through a computer-assisted process (Alceste software) and according to Denise Jodelet and Serge Moscovici models of social representations. Results: Results pointed out an important discrepancy between the political discourse and the social representations of professionals, who understand the field of prevention as intimately related to curative practices. Professionals do not seem concerned by preventive ‘top-down’ policies, which they perceive as technocrats’ issues. Finally, only a third of the total responses was related to the criticisms addressed to prevention, suggesting that mistrust toward prevention was not as developed among field professionals as it might seem when reading the most visible critical publications. Conclusion: We suggest that, in order to adapt public health and prevention policies, decision makers will have to rely on professionals’ background and on the field reality, as well as the epistemological, sociological and ethical problems raised by public prevention in mental health.

The public health dogma of evidence-based mental disorders prevention and mental health promotion: French professionals' beliefs in regard to parenting programs

Abstract In the last few years, various international public health organizations such as the World Health Organization or the European Commission have recommended the worldwide dissemination of evidence-based mental health prevention programs. This public health ideal, relying on new scientific disciplines, is at the origin of multiple controversies in a number of countries. This article contributes to bring a reflection on the ways political experts, researchers and practitioners have integrated these new preventive strategies. More precisely, the objective is to present and to discuss the results of a qualitative study on French professionals’ representations and theoretical perspectives with regards to evidencebased parenting programs. Results are based on ethnographical inquiries in French public health institutions and on 12 semi-structured interviews with professionals. The results demonstrate three ways to conceive parenting support, themselves attached to distinct anthropological, socio-political and interventional models.

Soutenir la parentalité : un nouveau défi économique et politique

Les recommandations actuelles des pouvoirs publics font etat d’une necessaire remise a plat des dispositifs d’intervention aupres des parents et des enfants. Considerant l’impact des nouvelles formes de famille sur les enfants, et sous couvert d’arguments economiques, elles appellent au developpement d’interventions efficaces et efficientes. Cet article examine, a travers une analyse de contenu des documents politiques francais et americains de 2007 a 2013, les fondements declares de ces nouvelles politiques de soutien a la parentalite, dans une perspective sociologique comparative. Les nouvelles structures familiales, les nouvelles modalites d’intervention et le rapport aux donnees scientifiques sont identifies comme les principales categories discursives de la periode etudiee.