« Rétablir par le réseau ». Enjeux et tensions issus de la réforme des soins de santé mentale « Psy107 » (Belgique)

Abstract

For several decades, international recommendations on public mental health policies have encouraged deinstitutionalization of the psychiatric field in favor of a "community" model of care. In this context and particularly since 2009, Belgium has experienced a vast project to reform the field of mental health. This article argues that under an apparent ideological neutrality, the rationality of this reform promotes a moral conception of the psychiatric patient and "good care". By analyzing the articulation of different aspects of the reform, in particular at the managerial, institutional and practical levels, the authors question its differentiated effects on territories and people, their ability to adapt to these new conceptions of mental health, depending on their resources.

Keywords

• rationalization
• public policy
• mental health
• deinstitutionalization
• autonomy
• patient