English Abstract : Mutual self-help groups (GEM : Groupes d’Entraide Mutuelle), meeting and self-help centres managed by users, have become essential partners for rehabilitation and for the fight against social isolation. They were created in 2005 through government funding (French Mental Health Plan 2005-2008) and run by users themselves in autonomy most of time. In 2019, 500 groups were in activity, wellcoming 40 000 personns, out of which half of these groups were piloted 100 % by users NGOs. These groups certainly do fight against isolation, yet they tend, above all, to become bridges allowing users to progressively leave the psychiatric care system.
Action Plan :
1. The thesis object
2. A proposal : To give a strong practical orientation to the thesis
3. First approach : Observe the GEM
4. Institutional analysis of GEM development
5 The “Professionals” of the GEM : Presidents, Facilitators and Sponsors
6 The GEM, Therapeutic Clubs and ClubHouse comparison
7. State of the art literature on GEM literature
8. Bibliography -1 on GEM -2 on Psychiatry
9 Postface by Jean Baptiste Gouil Lucas Fontaine
Gemmology at Work
After two years of investigation in the world of asylar and drug psychiatry, I have been preparing a thesis on the sociology of psychiatry since last July. Carried out since the summer of 2018, this thesis aims at the sociological study of the 500 or so GEM existing throughout France, these new places created by a 2005 law where some 30,000 people suffering from mental disorders meet every year. Mutual Aid Groups are self-managed associations and places open 35 hours a week created by the 2005 Law on Psychic Disability to combat the isolation in which a very large number of people who have suffered from psychological disorders live. To sum up briefly by using the official terminology : Mutual aid groups (MEGs) are mechanisms for preventing and compensating for the restriction of participation in social life organised in the form of associations. They welcome people with similar health problems, who put them in a situation of fragility and offer them the opportunity to participate in the organization of multiple leisure activities. GEM are undoubtedly the most significant structural evolution in psychiatry in the last 40 years. Never before have we seen so many people being cared for and such a deployment of structures. We could almost talk about a real Copernican revolution in psychiatry. This new object outside the medical institution. This could help us to move from the dictatorship psychiatry we know too often today to a more democratic form where each of the actors has the freedom to take his destiny in hand.
Understanding the GEM
This thesis will aim to get to know them better (and make them better known) and to provide them with a federative & productive basis : from wherever they come, how they operate, what are the particularities of each one, how they fit into local life, collaborate with each other, organize themselves in their own way, launch their own activities… I am also interested in the evolution of concepts from the 2005 law to the new specifications set up in 2016, fault lines, ideological clashes… I carry out a field survey and participant observation on the GEM of the Hauts de France region, while regularly visiting the GEM of other French regions.
This thesis will of course also cover, if only to compare them, other forms of community management of psychological disorders, such as Therapeutic Clubs and ClubHouses. Of course, I am closely studying the very important literature codifying the implementation of GEM or the case studies of GEM that have already been carried out (about twenty research papers on specific GEM, cities or regions). The role of the various GEM actors, whether presidents, salaried facilitators or sponsors/managers, will also be examined.
The first field work will be to observe the GEM through direct observation in the field of their daily functioning or during their meetings (called InterGEM) to build their sociology. It will also largely be done remotely via the Internet using the networking and collaborative work force of this tool. I have also started to implement a Twitter/Facebook/LinkedIn/Blogger strategy based on Open-Science (the progress of my book and thesis gives rise to the publication of bibliographical and other references (life of structures, conferences, publication of articles…) at the rate of about 3 publications per day and one subject for discussion. Having become a “friend” with about forty GEM and having “enjoyed” others as much, I receive daily information about their activities and gradually begin to get in touch with everyone. More than a simple observation tool, the Internet can also become the tool of a real Action-Research if we consider that the purpose of this thesis, apart from its purely sociological aspect, is to allow GEM to better communicate with each other and get to know each other better. This will be done in a massive way from September 2019 with the launch of a collaborative website and the establishment of discussion forums.
The thesis aims
In the end, the main idea of this thesis will be that GEM not only help people with mental disabilities but also help society as a whole to renew itself in a more inclusive and supportive way. To paraphrase Oury, who said that institutional psychotherapy was there to treat the hospital, we could say that GEM, by an astonishing paradigm shift, treat society by showing it the way to new forms of organization, more human and more collaborative, outside of marketing and excessive consumption in a society where work is gradually disappearing… The GEM, a place of welcome for souls in distress where it is sometimes enough to play cards (but is it not precisely the principle of a GEM to do what one wants) can also become a place of life and self-organization where new human communities and new forms of organization of social life are recreated, useful for everyone (creation of the GEM vegetable garden which allows a certain food self-sufficiency, humanitarian actions, animation of local life (participation in Knowledge Exchange Networks – RES – and Local Exchange Systems),
If at first glance we can find some GEM a little gloomy and not very welcoming, by attending their weekly meetings, living there from day to day and participating in daily group meals, we realize that there are also real dynamics that are taking shape. In fact, GEM members, from isolated in their own corner to meeting GEM, often lead a richer and more diversified life than a large majority of French people (they go out several times a week, have varied leisure activities, meet up every day with friends…). Over the past 15 years, the GEM have enabled a few hundred thousand people to come out of their isolation and relive life.
Through this study I want to build the sociological object GEM, perhaps a little like what I did in my “Que Sais-Je” on psychological assistance services by telephone (N° 2692 1992). It will also make it possible to analyse from an original angle the evolution of psychiatry over the past 10 years (greater patient voice and power…) and the tensions between the actors at work in it (professionals, professionals, professionals, users, families).
About the author
Graduate of EHESS (CREDA, Centre de Recherche sur les Dysfonctionnements de l’Adaptation) and holder of the DEA of EHESS « Anthropologie Sociale et Culturelle » 1992. My DEA thesis on psychological assistance services by telephone (directed by François Raveau, jury composed of Alain Touraine, Robert Castel and Michel Maffesoli), was published as Que Sais-Je (N° 2682), a few days after his defense. Co-founder in 1990 of the French monthly magazine « Sciences Humaines », I was its paid journalist for 2 years. I also published another book in 1995 on a related subject, the Citizen Band (the tribe of Cibists 1995 which received the “Communication & Will” award) and about a hundred journalistic articles in this field of activity (Human Sciences, International Journal of Medicine, Telephone Journal, L’impatient, Sciences & Future…)
After 25 years spent in the worlds of Internet and journalism and 7 years travelling the world, I have dedicated myself for two years to humanitarian action with the French Red Cross, Secours Catholique and Trucks du Cœur (aid to the excluded and migrants).
Complete professional profile: https://www.linkedin.com/in/adminet/