The “spirit” of the psychiatry sector, between institutional psychotherapy and community-based mental health care

In this paper, I wish to show that the spirit of the psychiatry sector is still very much alive in France, thanks to a combination of institutional psychotherapy (IP) and community-based mental health care (CBMHC). These two ways of providing patients with psychiatric care therefore complement rather than rival each other, in a mental health care system that requires a political vision, use of an organizational theory, a set of therapeutic or rehabilitation techniques, and a specific goal, all at the same time. Drawing on a literature review conducted during my doctoral thesis, I compare the organizing principles of IP and CBMHC in order to show their similarities when it comes to inter-institutional partnership, freedom of movement for users, and the need to destigmatize mental health problems. I propose that local mental health councils (LMHCs) offer an example of a potential synergy between these two ways of providing care, because they work as meta-teams and require a political vision as well as use of a theory of the psychological mechanisms involved in interprofessional cooperation. I therefore suggest that the organization of mental health care can draw on the expertise on working as a team in care settings as gathered and formulated by IP, as well as on the political vision of CBMHC.