France have been for a long period of time a place where users where very despised by the medical and natonal authorities. As users where invilved since the seventies in the psychiatric anglo-saxon & german sector, they only start to get a voice in the nineties with the creation of Fnapsy and Advocacy. The “total” recognition only happened in 2005.
As we celebrate the 15 anniversary of French recognition of psychic handicap law, the creation of Mutual Help Groups (Groupes d’Entraide Mutuelle-GEMs) appeared to be one of the main and the cheapest success of this important law. By many respect GEMs seems to be one of the few achievment of the 2005 lawn which have laminated by the 2011 securitarian laws and the lack of money. Most of means of accessibility and citizenship are worse in 2020 than in 2005 and the constraint in psychiatry is getting worse and worse every year with the generalization of forced ambulatoriy treatments.
Mutual self-help groups (GEM : Groupes d’Entraide Mutuelle) 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 100 000 persons a year and hosting 25 000 regular members. Half of these groups are piloted 100% by users NGOs but are still funded by the French Governmental Health Autorities 78 000 Euros each for a 40 million Euros global financial package, which is one of the main civil society project in France.
Over 500 NGO created these past 15 years wellcoming 100 000 people every year
Thanks to this initative, French psychiatry users groups which were much less developped than in the others countries, are now leading the path of the psychiatry revolution in the world, while the UK clubs endured shortage of money and the german one a very cacophonic experience. England psychiatry survivors groups have been for a long time the leader of Europe, with more than 600 local groups. But half of them have closed these past 3 years, because of the monetary funds reorganization, goign rather to big entities than to local groups.
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. GEMs 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.
These groups certainly do fight against isolation, yet they tend, above all, to become bridges allowing users to progressively leave the psychiatric care system and the society itself to forecast new forms of social organization.
GEMs 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 GEMs, 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 GEMs 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 GEMs, 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 GEMs have enabled a few hundred thousand people to come out of their isolation and relive life.
But …..and this is an enormous but,there is a still growign gap between this beautifull experience and the general psychiatric system in France du mainly to the lack of strong representativeness of psychiatry survivor in the governmental and non-govenrmental organizations. In this respect, France appear not to be the leader, but one of worse country to live in with a psychiatric baskground.
About the author :
Through the PHD I’m actually working on 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,…).