Paper short abstract:

The contribution focuses on the benefits found among users, as well as on the barriers (economic, political, cultural), the challenges and the expectations, encountered by the first French nationwide experimental program to provide an alternative to the hospital for psychotic crisis management.

Paper long abstract:

In 2019, 1 in every 8 people around the world were living with a mental disorder. The UN SDG 3 is to “ensure healthy lives and promote well‐being for all at all ages”. However, the UN has only been measuring the suicide mortality rate as mental health outcome indicator, which is totally insufficient. Indeed, the scarcity of reliable data at a global level is a major issue. This is coupled with a gap in governance, resources and services, affecting high-income countries as well. If we consider France, the mental health system is experiencing a chronic lack of human resources, and a crisis of efficacy and sense, which make it increasingly inadequate to meet demand. In response to this situation, in the city of Marseille, the first and still the only nationwide experimental program to provide an alternative to the hospital for psychotic crisis management, has been operating since 2017. Recovery-oriented, it offers a non-medical, community-based approach, in which peer workers play a prominent role. The contribution we propose - based on two years of ethnographic activities - focuses on the benefits found among users, as well as on the barriers (economic, political, cultural) and challenges that its implementation encounters. Similarly, we will question the expectations the program is generating, since it is seen as a milestone for a transition to a mental health care system no longer exclusively based on hospitals and the use of drugs, but more oriented towards a bio-psycho-social approach and more respectful of human dignity.