Health professional’s social representation about ederly subject with mental health disorders: a pilot study on 790 health professionals

Process of Deinstitutionalization of Aging Individuals With Severe and Disabling Mental Disorders: A Review

“…A third category of results highlighted the presence of an argument linking the difficulties of the deinstitutionalization process to the phenomenon of stigmatization of APSDMHD. While the stigmatization of older people with mental health problems has been highlighted by many selected studies ( 8 , 22 , 25 , 42 , 44 , 57 , 58 ), many authors point out that APSDMHD are subject to a double stigma based on both the stigma of aging and the stigma of mental illness ( 8 , 22 , 42 , 49 , 59 ). Recently, the systematic review conducted in English and French by Clesse et al was able to recall that aging individuals with mental disorders are perceived as “unsightly and ugly,” “carriers of difficult and/or violent behavior,” “perceived as a cost to society” and “with diminished or declining cognitive abilities” ( 8 ).…”

“…Present in the general population, the impact of this double stigmatization would be just as pronounced at the professional level. Thus, some works recall that within the psychiatric field, health professionals adopt a pessimistic and nihilistic stance induced by the idea that this population is “incurable” ( 22 , 42 ), “unaware of its environment” ( 55 , 59 ) and by long-term hospitalization ( 55 ). Outside the psychiatric field, these individuals are also negatively perceived by certain medical specialties fearing that they will have to manage complex situations correlated to the diagnoses, bed availability/problems and the difficulty of reorienting this population ( 14 , 22 , 46 ).…”

“…Similarly, some authors recall the difficulties encountered by non-psychiatric institutions by highlighting the resistance of professionals who consider the APSDMHD to be inadequate to these services because of their behavior ( 34 , 38 , 60 ). More recently, a French study of 790 health professionals working with individual carrying psychiatric disorders showed that these professionals had the same representation as the general population ( 59 ). These professional attitudes can then lead to the hasty idea that these individuals supported by psychiatry present major adaptation difficulties and lead to professional counter-attitudes ( 42 ), apprehension ( 42 ), or even the emergence of discrimination in state, institutional and professional support ( 8 , 12 , 14 , 59 ).…”

The French Integrative Psychosocial Rehabilitation Assessment for Complex Situations (FIPRACS): Modelization of an Adapted Assessment Method Toward Long-Term Psychiatric Inpatients With Disabling, Severe and Persistent Mental Illness

“…LTHIDSPMI) who have been influenced by the iatrogenic consequences of institutionalization. Indeed, given that institutionalized subjects tend to present adaptive processes that are highly inferior to their actual abilities, the practitioners in the field inherently influenced by their specific professional representations may thus underestimate the competencies of certain individuals or subsets of the population (15)(16)(17). The completion of the FIPRACS can hence represent a tool allowing better equity in psychosocial rehabilitation support.…”

“…In some institutions, some inpatients can also be pressured by teams to engage in a deinstitutionalization program where the supported accommodation could not be adjusted to their psychoaffective symptoms, their desires/expectations, and their neurocognitive potentials. Finally, certain patients such as the aged-LTHIDSPMI can be victims of stigmatization and excluded from deinstitutionalization programs (15)(16)(17).…”