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l'Information Psychiatrique. Volume 83, Number 8, 655-62, octobre 2007, stigma (1)

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Author(s) : Jean Louis Senon, Cyril Manzanera, Mikael Humeau, Louise Gotzamanis

Summary : Dangerous states, delinquency and mental health: representations, insecurity and public fear fuel the stigmatisation of the mentally illRepresentations of violence and mental illness are indissociable from the currents bearing down on contemporary democratic societies. Fears and insecurity have been on the increase since the mid 1970s with the collapse of a welfare state built on wage-earners and social assistance in the years following the last world war. The increase in long-term unemployment, the difficulties experienced by young people trying to break into the job market, the high unemployment rate of seniors and the breakdown of social protection, all reinforce the fear of the future. Insecurity became the number one priority for politicians, and legislators introduced a multitude of laws on social order, announcing a policy of zero tolerance which made mental patients into easy scapegoats, all the more so as their insertion became more random. All the same, psychiatric teams must be aware that those suffering from serious mental disorders represent a significantly higher risk for violence or homicide than general population, disregarding substance abuse. This risk is increased by any break in treatment, if the patient has a personal history of violence, in the 20 weeks following discharge, in the case of substance abuse, non compliance, acute paranoid symptoms, associated TPA or cerebral damage. However, it is important not to confuse crime and mental illness\; for example, while in industrialised countries, the homicide rate is between 1 and 5 per 100,000 inhabitants, serious mental disorders are only responsible for 0.16 cases of homicide per 100,000 inhabitants, and mental illness only concerns 1 homicide out of 20.

Keywords : violence, mental illness, insecurity, fears, penal policies