A philosophy of care, a philosophy of action
A philosophy of care, a philosophy of action
Traditional psychiatry is mainly about studying and curing psychiatric illnesses. During the last 50 years, the evolution of the French healthcare system led us from a medical-based approach to a multi-faceted approach which takes into account the patient needs, choices and external resources.
In this new approach, patient-centred care takes his or her weaknesses and strengths into account, as well as his or her needs and resources. The traditional model, which remained focused on reducing symptoms and deficits, has shown his setbacks: based on what malfunctions, it generates victimization and stigmatization, does not take account of the personal responsibility and resources of the person, and does not consider what constitutes a usually satisfying life.
Significant progress has also greatly improved the prognosis and quality of life for patients. At the same time, care facilities have evolved and have opened up to the City, giving more space to early care and outpatient care. The concept of mental health has made it possible to go beyond the strict state of mental disorder and to identify determinants rarely used in the study of diseases. For the World Health Organization (WHO), mental health is “a state of well-being in which each person realizes his or her potential, faces the normal difficulties of life, works successfully in a productive way and can bring his or her contribution to the community.” (2013). Mental health is therefore more than the absence of mental illness or disorder. The Public Health Agency of Canada believes that “mental health is the ability of each of us to feel, think and act in ways that improve our ability to enjoy life and to take the challenges we face. It is a positive feeling of emotional and spiritual well-being.” (2014).
Positive mental health can, therefore, be perceived as a state of well-being, which results from a continuous and dynamic process, in constant evolution, and allows a person to make the best use of his or her potential and capacities daily. Taking an interest in actions or interventions that improve mental health appears, therefore, to be a broad target in the overall improvement of the person’s functioning. From the end of the 1990s, positive psychology became part of this new paradigm, offering a better understanding of human functioning, by integrating a fine analysis of the determinants and processes involved in the development and well-being of individuals, groups and institutions. (Gable & Haidt, 2005, Shankland, 2014).
Positive psychiatry, recently described, is of course inspired by the work of positive psychology. In fact, numerous studies have shown the positive impact of positive interventions on the state of well-being but also on the reduction of symptoms such as anxiety or on the improvement of physical health… In addition to conventional psychiatry, positive psychiatry, therefore, seeks to understand and promote well-being in a holistic approach. It takes into account, in addition to the biological determinants, positive psychosocial characteristics such as resilience, optimism, the feeling of self-efficacy, empowerment, social commitment, spirituality, and seeks to promote all interventions which strengthen these skills or promote these attitudes not only among the individual but also within the general population.
The school of positive psychiatry is particularly involved in actions concerning family support and social and environmental dimensions. It promotes the improvement of physical health in a global health concept and determines new clinical attitudes in several fields :