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Objectives

This paper introduces some epistemology about mental health developments and how it leads to reconsider the landscape of clinical practices.

Materials

From an epistemological point of view, the author reviews several writings about mental hygiene going back to the nineteenth century. It clarifies the common roots between mental hygiene and mental health. Then, the article examines the first World Health Organization's reports, that shed light on psychiatric and political issues in the middle of the twentieth century, which allows to reach out the foundations of mental health as a discursive practice.

Results

The review of the developments from “mental hygiene” to “mental health” highlights a general climate of redesign on many points: Mental health as a discursive space is characterized by an expansion of its address field. It is not only addressed to specialists, psychiatrist and psychiatric patients, but also, and above all, to every citizen. Psychic suffering, as far as mental illness, is part of a larger whole including what preserves or deteriorates the proper functioning of an individual, within society. Mental health is at the crossroads of financial, political, citizen's rights and social interests. Contemporary mental health relies on the objectives of prevention and promotion. Clinical practices are organized by some discourses with mental health as a key word. At the turn of 2000s, French psychiatry has been impacted by many shuffles in health policies. However, the roots of these restructuring are not new, as they update an old interest in safeguarding public health, funds and welfare. Psychic suffering and mental illness recently enter the field of “psychic disability”. It brought social benefits such as financial assistance from the state. It may also contribute to the campaigns of awareness-raising and destigmatization among the public opinion. However, financial and subjective effects do not perfectly match. In other words, the benefits listed above should not lead to desert the listening of the users’ experience in its singularity.

Conclusions

The developments of mental health point out a reorganization in the psychiatric field and open new clinical challenges. If the spaces of singularity and universal are in a permanent relationship, the political and economic sides cannot answer or evacuate the subjectivity posed by the subject and his suffering. It should lead to focus on a clinical practice driven by a subtle listening, which does not exclude psychopathology and recognizes the importance of alterity.  相似文献   
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In 1967, some hematologists who were inspired by Barbey d’Aurevilly’s novel, “A story without a name”, described the syndrome of Lasthénie de Ferjol: recurrent anemia resulting from voluntarily provoked hemorrhages. We used the same novel as a basis for studying the mother-daughter relationship. Madame de Ferjol is widowed, and lives a reclusive life with her only daughter, Lasthénie, until such time as a capuchin priest enters their life during Lent. This unexpected encounter with sexuality (Lasthénie becomes pregnant) has a marked effect upon the young woman; she withdraws into total silence, and displays self-mutilating behavior (provoked bouts of anemia) which leads to her death and to that of her unborn child. In this tale, we see a paradigm of the mother-child relationship that has already been observed in anorexia nervosa. Mother and daughter are caught up in a narcissistic dyad fom which neither is able to extricate herself. The mother remains in a pathological state of mourning, and we put forward the hypothesis that this dead mother is affected by a melancholic process in which her hatred is projected onto her daughter. Finally, we have attempted to examine the connections between hysteria and anorexia nervosa, as in this story rivalry between mother and daughter also plays a role, and in which sexuality—therefore involving a third party—is unmentionable.  相似文献   
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Mental disorders represent in France for the Social Security the second post of spending in consumption of care with 11,4 billion euro, that is 10,6% of the spending, behind the diseases of the circulatory system. They stay in the rank of the pathologies justifying the allocation of a disability pension, representing 26,7% of invalids. It is to say the importance of the psychiatric expertise for the Social Security. This type of expertises is particular among the expertises in psychiatry because the objective of the expertise is to establish an arbitrage between the position of CPAM's doctor and his regular doctor. Effectively, except legal flaw, the opinion of the expert imposes upon the parts (parties). The realization of the expertise and its editorial staff are detailed in their specificities. Problem specific of the psychiatry are approached as well as the functions (offices) of the expert which are well beyond arbitrator's role towards a function of teacher and intermediary.  相似文献   
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ObjectivesCOVID-19 outbreak can impact mental health including health care workers. The aim of this study was to assess the psychological impact of COVID-19 in French community pharmacists.Material and methodsWe carried out a postal-based survey to assess the psychological impact of COVID-19 in French owner community pharmacists based on three validated self-report questionnaires: Perceived Stress scale, Impact of Event Scale-revised and Maslach Burnout Inventory.ResultsThe sample consists of 135 community pharmacists. Twenty-three pharmacists reported significant post-traumatic stress symptoms (17%). High burnout symptoms were found in 33 (25%), 46 (34.9%) and 4 (3%) participants. Females scored higher than males for all questionnaires (P = 0.01).ConclusionsThis study is the first study which showed the psychological impact of COVID-19 in community pharmacists. Based on validated self-report questionnaires, up to 35% of pharmacists reported psychological disturbances. Interventions to promote psychological well-being of healthcare workers need to be developing.  相似文献   
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In 1856, the Christian psychiatrist B.A. Morel elaborated in the Rouen area the paradigm of the degeneration/regeneration an overall theory of the “hereditary insanity” and of physiological and psychological disorders. The degeneration may develop like a “physiological and moral malaria” within the population of a given territory resulting in complete sterility at the 4th generation. Departemental head doctor at Saint-Yon lunatic asylum, doctor B.A. Morel dissects mental illness as a biological and moral result of the defective development in environmental circumstances and pathological environments.  相似文献   
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