Autism self-help groups (SHGs) are designed as spaces of empowerment that promote inclusion, citizenship, and, by extension, the mental health of people with autism. The opportunity for self-management by the people concerned opens up strong prospects for (re)building their identity, enabling them to develop multiple skills, assert their autonomy, and become involved in various peer support, social participation, and creative initiatives. However, in practice, self-managed SHGs for autism come up against several obstacles, including a lack of specific support, limited institutional recognition, and the absence of qualitative evaluation of the effects on individual and collective trajectories. Autistic coordinators, who are often in precarious situations, have to take on a host of responsibilities without benefiting from the pooled resources available to traditional medico-social institutions. This reality raises questions about the ability of self-managed SHGs for autism to become genuine, sustainable drivers of public mental health. Beyond these observations, this article proposes to reflect on the role that these SHGs could play as places for health promotion and participatory research in the field of neurodiversity, as part of an approach that respects autistic self-normativity and the principle of health democracy: “nothing for us without us.&#8221.
INTRODUCTION:Stigma in psychiatry and mental health remains a major barrier to access to care, recovery, and social inclusion. It manifests through stereotypes, discrimination, and self-stigma, thereby exacerbating psychological distress and social inequalities. This article aims to analyze, in France and across Europe, the determinants of the effectiveness of protective factors against stigma in the fields of psychiatry and mental health. METHODS:We conducted a critical narrative review covering the period 2015–2025, based on a structured search of PubMed/MEDLINE, PsycInfo, Scopus, and Web of Science, supplemented by a review of grey literature (WHO, OECD, Eurobarometer, Santé publique France, and association reports). Study selection and quality appraisal were performed independently in duplicate using assessment tools adapted for quantitative and qualitative studies. RESULTS:Stigma mechanisms involve labeling, stereotyping, social separation, discrimination, and self-stigma. Consequences include delayed access to care, worsening psychological distress, social exclusion, and substantial economic costs. Public policies, media, and peer support emerge as central levers. Operational definitions, data traceability, and a comparative table of interventions are provided in the appendix. DISCUSSION:Despite progress, stigma persists. Harmonization of measurement instruments, longitudinal evaluations, and coordinated mobilization of stakeholders are required. CONCLUSION:The article highlights innovative strategies grounded in lived experience, paricularly peer support and the co-construction of policies.
INTRODUCTION:Local Mental Health Councils (CLSMs) offer a concrete and sustainable example of what public mental health, conceived as a common good, could look like. At the intersection of psychiatry, public health, and health democracy, they embody an intersectoral, territorially grounded, and participatory approach to mental health. METHODS:Drawing on a review of their origins, an analysis of policy documents, and empirical examples from Parisian CLSM—complemented by insights from other regions—this article proposes viewing CLSMs as empirical and imperfect agents of public mental health in practice. Far from being homogeneous, these mechanisms reflect both local specificities and the effects of the absence of a normative framework. RESULTS:This contribution highlights the structural tensions that hinder their consolidation, particularly with regard to institutional recognition, the sustainability of resources, and the effective participation of people with lived experience. DISCUSSION:Finally, it opens a discussion on the political, organizational, and ethical conditions required for a truly shared territorial governance of mental health.
INTRODUCTION:Supported Employment, based on the Individual Placement and Support (IPS) model, is increasingly implemented in France to promote the professional inclusion of people with mental health disabilities. This study examines its effects on employment outcomes and certain dimensions of mental health, as well as its implementation modalities. METHODS:The study is based on a mixed-methods approach combining quantitative and qualitative analyses at three levels: organizations (N = 27), employment specialists (N = 71), and service users (N = 1,027, including N = 67 followed longitudinally over one year). Qualitative data were collected through 27 group interviews and telephone interviews conducted as part of the longitudinal follow-up. RESULTS:An employment rate of 51% and a 6-month job retention rate of 62% were observed. Mental well-being increased among individuals who gained employment, while some dimensions of recovery progressed independently of employment status. Organizations showed a high level of fidelity to the IPS model, and employment specialists reported high levels of competency associated with employment outcomes. DISCUSSION:These findings suggest that Supported Employment is not limited to facilitating access to employment but may also contribute to broader recovery processes. They highlight the role of employment specialists and the importance of cooperation between mental health, social, and employment sectors. CONCLUSION:Supported Employment promotes professional inclusion and supports recovery trajectories in mental health. It constitutes a lever for improving public mental health.
INTRODUCTION:Mental Health Awareness Weeks (SISM, Semaines d’information sur la santé mentale) are an annual initiative aimed at promoting mental health among the general population across French territories. Through post-film discussions, exhibitions, and workshops, participants receive information, reflect on social representations, and identify individual and collective resources. These initiatives are led by diverse stakeholders organized within local SISM collectives. Given the growing number of events and participating groups, this study aims to analyze collaboration practices within these collectives in order to identify key factors associated with effective partnerships. METHODS:A quantitative study was conducted using a self-administered questionnaire analyzed with descriptive statistics. The instrument was developed following exploratory semi-structured interviews. RESULTS:We obtained 143 responses, primarily from peer support organizations and local authorities. The findings highlight the diversity of partnerships within the collectives. Collaborative work relies on regular meetings, coordination tools, and a climate of trust among members. Internal coordination is characterized by shared responsibilities and adaptive governance. These elements foster a sense of collective efficacy and pride regarding the perceived impact of SISM activities. DISCUSSION:Our findings align with the existing literature on health partnerships. The study identifies concrete facilitators of collaboration, including flexible leadership, in-person meetings, and both formal and informal opportunities for exchange, as well as the use of charters and action plans. Volunteer engagement is widespread, and co-construction with individuals experiencing mental health conditions contributes to reducing interprofessional silos across territories. CONCLUSION:Partnership dynamics within local SISM collectives contribute to mental health promotion across territories and may provide a model for other local stakeholder networks.
Suicide prevention is a major public health issue addressed by the French national VigilanS program, which focuses on maintaining contact after a suicide attempt. However, some groups, particularly individuals with post-traumatic stress disorder (PTSD), appear less receptive to this approach. Although still underrecognized in prevention strategies, PTSD is strongly associated with repeated suicide attempts. This article examines how PTSD may interact with VigilanS follow-up procedures and proposes enriching reflection through experiential knowledge by involving patient partners who have experienced both a suicide attempt and PTSD. Such an approach, still rarely used, may offer a promising way to better adapt interventions to the needs of those concerned.
INTRODUCTION:Black immigrant communities in Canada and Europe have faced disproportionate mental health challenges, further exacerbated by the COVID-19 pandemic. Structural racism, social isolation, and cultural stigma are among the key factors contributing to mental health distress in these populations. This scoping review aims to explore the mental health outcomes, experiences, and access to care among Black African immigrants in Canada and Europe after the COVID-19 pandemic, using an intersectional lens that considers the combined impact of race, migration, and minority status. METHODOLOGY:A total of 19 peer-reviewed studies published during the post-COVID-19 period (2021–2024) were included. These studies employed qualitative, quantitative, or mixed methods and focused on adult Black immigrants in Canada or the UK. Data were extracted on mental health prevalence, perceptions, and barriers and facilitators to care. RESULTS:Findings reveal high rates of depression, anxiety, and psychosis among Black immigrants, often linked to systemic racism, cultural stigma, and poor living conditions. Major barriers to care include mistrust of Eurocentric services, lack of culturally competent providers, financial constraints, and language barriers. Facilitators included strong community ties, religious support, and access to culturally sensitive professionals. CONCLUSION:The review highlights a critical need for culturally appropriate mental health services and community-based interventions. It also underscores the importance of policy changes and future research, particularly in underrepresented European regions and among groups experiencing intersectional marginalization.
INTRODUCTION:The prevention of mental disorders and the promotion of children’s psychological well-being are key public mental health priorities. In this context, the cocreation of school-based mental health literacy interventions emerges as a key lever for successful implementation. However, there are currently no established recommendations for developing this type of intervention with positive outcomes. The aim of this study was to propose a roadmap based on the description of the cocreation steps of a French school-based intervention. METHODS:A heterogeneous working group, including children aged 9–11, developed a multi-tool intervention based on the theoretical framework of the Child-Focused Mental Health Literacy Model. Multiple methodologies (questionnaires, literature review, semi-structured interviews, pedagogical sheets) were used to guide the development of the intervention. RESULTS:The cocreation process (2024–2025) combined a mental health survey of 254 children with a review of existing interventions. The data were synthesized into pedagogical sheets, validated by professionals, parents, and teachers, and subsequently used to develop educational tools. A sequence of six weekly sessions was designed and tested with children, whose feedback informed content adjustments and confirmed the relevance of the intervention. DISCUSSION:We described the cocreation process of a school-based intervention combining researchers’ scientific knowledge with stakeholders’ expertise. This approach brought together academic rigor and diverse empirical contributions and provided a practical roadmap for developing interventions in real-world settings. Children’s involvement was essential to adapt the content to their level of understanding and to incorporate their perspectives, taking into account their sensitivity and vulnerability regarding this complex topic. CONCLUSIONS:Cocreation appears to be an essential condition for the development of effective school-based mental health literacy interventions for children. The proposed roadmap aims to guide the different stages of the process for professionals wishing to engage in this still underexplored field of intervention.
For most somatic diseases, diagnosis and treatment are guided by biological knowledge. However, psychiatry’s biological basis is currently limited to a few rare genetic disorders, such as certain forms of autism with intellectual disability. For other mental disorders, no biomarkers have yet been validated to aid diagnosis. Likewise, most psychotropic medications in use were discovered in the 1950s and 1960s through chance observations or are derived from these early molecules. The first part of this article presents doubts expressed by leaders in American psychiatry regarding the ability of neuroscience to reliably inform mental health practices in the foreseeable future. Between these doubts and the promises of spectacular advances widely reported in the media, there is a considerable gap. The second part examines these media misrepresentations, their causes, and their consequences. The third part highlights the specificities of psychiatry, particularly regarding diagnostic practices. Finally, the fourth part discusses primary prevention policies that could help reduce the economic and social costs of mental disorders. While not exhaustive, these include reducing the rate of premature births and teenage motherhood, strengthening educational support for primary school children, limiting children’s screen time, and reducing income and wealth inequalities. Overall, mental health is not solely a biomedical issue; it is a broader public health concern.
INTRODUCTION:In response to healthcare desertification in the Centre-Val de Loire region, healthcare professionals have increasingly engaged in coordinated models of practice. While this involvement represents progress in healthcare organization, it may also lead to an unintended consequence: professional burnout. The objective of this study is to identify the influence of coordinated practice on the mental health, quality of life, and quality of working conditions of healthcare professionals involved in such models. METHODS:Twenty interviews were conducted with healthcare professionals from different specialties and with varying levels of involvement in coordinated practice. RESULTS:Coordinated practice transforms professional practices and representations, while also acting as a framework for learning and mutual recognition. However, it generates a significant mental workload, relational tensions, and a form of exhaustion associated with overcommitment. DISCUSSION:The findings of this study highlight changes in both practices and professional identities among healthcare providers engaged in coordinated practice. While this collective mechanism appears to be a driver for professional recognition and improved quality of working life, it also raises challenges related to burnout, collective expectations, and internal power dynamics. CONCLUSIONS:Coordinated practice represents a lever for improving quality of working life, strengthening the sense of usefulness, and fostering peer recognition. It provides a space for cooperation, skills enhancement, and collective support. Nevertheless, it may also be a source of tension, emotional fatigue, or even professional burnout when implicit expectations, social pressure, or unequal levels of involvement are not adequately balanced.
OBJECTIVE:Faced with an aging population and an increase in mental disorders among older people, the Resource and Evidence Center of the National Solidarity Fund for Autonomy, with the support of the Union of Gerontopoles of France, is developing an evidence-based prevention program. This review aims to identify effective primary prevention interventions to promote the mental health of independent older people living at home. It is part of the “Integrated Care for Older People” (WHO) approach. METHOD:A systematic review according to PRISMA recommendations was conducted in PubMed and Google Scholar (March–April 2025). Randomized controlled trials, systematic reviews, and meta-analyses (2021–2025) involving people aged 60 and over who were living independently at home were included. Methodological quality was assessed using AMSTAR-2 and the Cochrane tool. RESULTS:Of the 1,412 studies identified, 23 were selected after applying the inclusion criteria. Seven categories of interventions were identified, with higher effectiveness for physical activity and psychological interventions. Moderate-intensity physical activity programs (2–3 sessions/week for ≥12 weeks) were particularly effective in reducing depressive and anxiety symptoms. The multimodal nature of the interventions and their integration into community resources appear to be key factors in their applicability and effectiveness. CONCLUSIONS:The data support the development of a multimodal program that is accessible and rooted in local communities. The main challenge lies not so much in identifying effective interventions as in disseminating them, adapting them to vulnerable individuals, and ensuring their sustainability.
In Western countries, more than half of patients suffering from mental disorders are treated by primary care professionals without specialist psychiatric follow-up. General practitioners (GPs) therefore occupy a natural position as crucial front-line actors in the management of these problems. However, GPs currently face the same challenges as those posed by the concept of public mental health. Biopsychosocial care integrating somatic and psychological factors within a broad spectrum of health determinants, the importance of health promotion and prevention as a complement to curative care, a community-based approach, and a population-based vision are all key concepts shared by both fields. The large increase in needs, the lack of access to GPs, and care models that are still too often physician-centered make it difficult for GPs to respond to these challenges, often dealing with the most urgent issues, namely the predominant complaint. Solutions must be proposed to remove certain barriers that currently prevent them from carrying out these tasks properly. It is therefore necessary to implement a specific policy aimed at promoting training and ongoing practical support among providers. This also includes a policy of organizational transformation, both in terms of developing primary care teams that include professionals dedicated to mental health and, on a broader level, in terms of the healthcare system as a whole, to enable better collaboration between primary and secondary care.
The mental health of the French agricultural population represents a major public health concern, characterized by an increased vulnerability to suicide due to demanding working conditions, social isolation, economic pressures, and limited access to healthcare in rural areas. In this context, the deployment of the Farm Sentinel Model emerges as a relevant approach to suicide prevention, grounded in a community-based and collaborative framework. Led by the Mutualité Sociale Agricole (MSA), in collaboration with the Groupement d’Études et de Prévention du Suicide (GEPS), the Farm Sentinel Model aims to promote early identification and referral of individuals at risk of suicide through a network of sentinels drawn from, or closely connected to, the agricultural community. Embedded within a national program for prevention and support of agricultural beneficiaries in situations of distress, the model builds on the MSA’s strong territorial presence, its elected representatives, local MSA professionals, and its mutualist values. Sentinel training, developed by the GEPS and tailored to agricultural realities, constitutes a core component of the Farm Sentinel Model. A recent innovation involves the development of agricultural facilitators—non-clinical co-facilitators trained to enhance program ownership within rural communities through a peer-to-peer approach. As of December 31, 2024, more than 8,000 sentinels were active across rural areas in France. Despite persistent challenges, this collaborative and community-based model appears promising for reducing social and territorial inequalities in mental health and strengthening suicide prevention in agricultural settings.
INTRODUCTION:This study aims to assess the self-reported mental health among Ottawa’s French-speaking Black community in Canada by identifying associated sociodemographic factors, with the goal of informing public health interventions. Our study draws on three theoretical frameworks: public mental health, psychosocial determinants of health, and intersectionality. These frameworks allow us to examine how social determinants and social identities influence mental health status and access to services among Francophone Black individuals living in a linguistic minority context in Ottawa. METHODOLOGY:This is a cross-sectional study conducted among adults (≥18 years) who identify as members of the Black Francophone community and reside in Ottawa. Data were collected between June 2023 and December 2024 using an online questionnaire. Sociodemographic variables, self-reported mental health status, and perceptions of healthcare needs and access were assessed. Analyses included descriptive statistics and intergroup comparisons. RESULTS:A total of 126 Black French-speaking individuals in Ottawa completed the questionnaire. Of these, 40.6% reported poor self-perceived mental health. Participants with poor mental health were predominantly women (76.9%), young adults (43.6% aged 18–19; 41.0% aged 20–29) and single individuals (70.6%). Perceived stress varied significantly according to mental health status (p < 0.0001), with those reporting poorer mental health more frequently reporting high or extreme stress. DISCUSSION:The results highlight significant disparities in mental health and perceived stress within this population, reflecting the influence of intersecting social and demographic factors. These findings underscore the need to consider relevant cultural and linguistic determinants when addressing mental health inequalities. CONCLUSION:These findings demonstrate the urgent need to adapt public health policies and interventions to the cultural and linguistic realities of this population. Such an approach is essential to ensure equitable access to mental health care.
INTRODUCTION:Data on farmers’ psychological health at work and its determinants remain limited. This study aimed to describe the psychological health at work of farmers in the Grand Est region (France) and to identify the sociodemographic and psychosocial factors associated with it. METHODS:This study used data from questionnaires administered at baseline of the CAGRIMENT cohort. Psychological health at work was measured using a validated self-report questionnaire comprising two dimensions: psychological well-being at work and psychological distress at work. Scores range from 0 to 100 (best possible psychological well-being at work/worst possible psychological distress at work). Multivariate linear regression models were used to assess their associations with sociodemographic and psychosocial characteristics. RESULTS:Among the 1,084 farmers included (35.6% women; mean age = 49.2 ± 11.9 years), the mean psychological well-being at work and psychological distress at work scores were 66.6 (± 14.2) points and 27.1 (± 15.3) points, respectively. Psychological well-being at work scores were lower among women (β=-2.3; p=0.04), farmers in socially vulnerable situations (β=-8.0; p<0.01), and those who had experienced life events perceived as difficult (β=-6.5; p<0.01). Similar patterns were observed for psychological distress at work. CONCLUSION:These results provide a description of psychological health at work among farmers and highlight the need for actions to promote psychological health at work, particularly among women farmers, farmers in socially vulnerable situations, and those who have experienced life events perceived as difficult.
This article aims to highlight the scope of community-led interventions in LGBTQI+ mental health promotion, and to emphasize the importance of analyzing tensions between community health and public health policies. Sexual and gender minorities represent populations that are particularly vulnerable to psychological distress, while simultaneously being hesitant to seek out healthcare services due to fears of stigma or inadequate support. Faced with this reality, LGBTQI+ communities have historically come together to develop community-led peer support tools tailored to their specific needs, despite limited material resources and a hostile international political context. By operating at the forefront of these challenges, they serve as essential intermediaries in identifying mental health issues among LGBTQI+ populations, establishing foundational solutions, and driving systemic improvements through partnerships with healthcare professionals and institutions. However, the vulnerability of grassroots organizations can lead to exhaustion and burnout among its actors, who often lack formal training in mental health matters. The article concludes that public mental health policies must actively incorporate and financially support LGBTQI+ community- led interventions to develop culturally appropriate and socially equitable responses, as these local initiatives represent a critical gateway to public mental healthcare services.
INTRODUCTION:In France, the ‘medico-social’ sector is a cross-sectoral field of support for persons with disabilities. Within this sector, mental health support services are expected to address a wide range of needs, promote independence, and foster the social inclusion and participation of persons living with psychiatric disabilities. Given these missions and ambitions, the article examines the similarities and differences between this framework and the public mental health approach, and draws lessons for implementing this approach in France. AIM OF THE STUDY:Drawing on fieldwork conducted within two support teams located in a French metropolitan area—a Medico-Social Support Service (SAVS) and a Medico-Social Support Service for Adults with Disabilities (SAMSAH)—this study describes and analyzes medico-social support work through the lens of the ‘public mental health’ approach. RESULTS:The article shows that these services promote prevention, care, and health education initiatives and that they integrate various determinants of mental health (individual, familial, social, environmental) into their understanding of psychiatric disabilities. However, because of their close integration into users’ daily lives of users, these support practices can also lead to forms of control over the choices, lifestyles, and living arrangements of those individuals. Furthermore, this work faces significant challenges, such as the complex coordination of cross-sectoral actions and tensions regarding the assessment of users’ degrees of autonomy or dependency. It can therefore be argued that medico-social support is partly aligned with the public mental health approach, but that it still faces political, organizational, and social obstacles to fully implementing this model. CONCLUSIONS:Although these services adopt an approach akin to that of public mental health, their place within the policy and organizational landscape of psychiatry and mental health remains marginal due to their primary affiliation with disability policy. Indeed, these teams encounter difficulties in gaining recognition from mental health stakeholders and, consequently, in carrying out their work effectively. These difficulties also stem from the broad scope of their interventions and the specific cross-sectorial challenges they face. Furthermore, the scope of their missions and their embeddedness in user’ daily lives raise questions about their potential for social control.
INTRODUCTION:In a context characterized by growing vulnerabilities, fragmented trajectories, and overstretched specialized services, mental health now occupies a central place in the field of public health. This article examines the contribution of non-specialized services to public mental health in situations of cumulative vulnerability. METHODS:This article is based on an inductive qualitative study resulting from a collective research process conducted in preparation for a symposium devoted to “working together” in public mental health. A comparative analysis was carried out across four non-specialized settings: a collaboration between a community-based organization and a Mobile Psychiatry Outreach Team, medical respite care facilities, a community legal clinic supporting migrants, and a high school classroom. A syndemic approach was used to analyze the interconnections between vulnerabilities. RESULTS:The findings reveal trajectories characterized by repeated and cumulative disruptions, alongside everyday practices implemented by non-specialist actors. These practices fulfill essential functions of continuity, mediation, meaning-making, and support for agency. However, they also reveal the effects of fragmentation and saturation across service systems. DISCUSSION:Public mental health is largely produced within ordinary settings, at the interfaces between specialized services and everyday environments. This article invites a re-examination of public mental health by recognizing and supporting cross-cutting, territorially grounded practices operating within public action, as well as in everyday and civic life.
INTRODUCTION:This paper aims to analyze the pilot program for street psychologists in specialized prevention launched in 2018 in the Nord and Pas-de-Calais departments in France. The goal is to highlight the challenges and dimensions of this new cross-disciplinary and innovative approach. METHOD:The methodology is based on action research conducted in 2024 with seven street psychologists, as well as with young people receiving support and other professionals, as part of a qualitative study. RESULT:The results demonstrate that by internalizing the issue of mental health, specialized prevention is developing a new practice of “reaching out” by psychologists trained throughout their education to “let things come.” This new methodological challenge of coordinating “outside the walls” and “inside the walls” enables the deconstruction of negative perceptions of psychology in priority neighborhoods and involves both professional realignments between educators and psychologists centered on “transprofessionalism” and the optimization of care delivery methods. CONCLUSION:The arrival of street psychologists enables the sector to offer psycho-socio-educational services, establishing it as a major player in mental health policies. Nevertheless, while the effects on young people are clearly observable, the gains are fragile insofar as the precarious nature of the positions may jeopardize promising results.
