Mental Health : Care in the Face of Taboos

This webinar replay is available in French only. Thank you for understanding.

A look back at the 14th edition of the Fondation l’Instant Recherche webinar, which brought together online on Monday 30 March two psychologists, Irène Bogicevic and Thierry Liscia, and a sociologist, Jean-Marc Goudet, to discuss the changing landscape of mental health issues in France and around the world, and the responses being provided, particularly by humanitarian and social organisations.

A major public health issue

Migration and population displacement are among the French Red Cross Foundation’s priority research areas. These phenomena represent a major humanitarian challenge both within and between states, mobilising numerous aid organisations and more spontaneous initiatives. The experiences of exile have become more complex in recent years, due to more restrictive migration policies, creating new areas of vulnerability. The social sciences have been heavily involved in seeking to better understand and document these experiences and the public and private responses to them. More broadly, the Foundation also supports research into the experiences of exile and situations of economic, administrative, social and emotional precariousness, which only worsen in a context of non-reception, when waiting, uncertainty about the future and the urgent need for food, shelter and safety are prolonged.

Exile is not limited to a mere geographical displacement: it involves the transfer of meanings, identities, memories and practices embedded in material objects. These objects, often inconspicuous or ordinary, become essential witnesses to the migratory experience. Sociologists, anthropologists and archaeologists agree that these artefacts are concrete markers of the bonds that link individuals to their history, culture and host environment. From this perspective, the object of exile is at once a trace of the past, a tool for rebuilding identity and a vessel for a living memory, often torn between here and elsewhere.

The discussion

Irène Bogicevic, psychologist and head of the Mental Health and Psychosocial Support programme at the French Red Cross, Thierry Liscia, clinical psychologist and psychotherapist, and finally Jean-Marc Goudet, sociologist and public health doctor, began by addressing the thorny issue of defining mental health. Like any broad concept, the definition of mental health has evolved across scientific disciplines, authors and eras, and can take on different meanings depending on the stakeholders involved, which makes its application complex. Although it is not without its flaws, the speakers nevertheless agree on the World Health Organisation’s definition of mental health, namely ‘a state of well-being in which an individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community’.

The ensuing discussion focused on addressing mental health challenges. How can we improve mental health? What do we know about the conditions for the success of interventions aimed at overcoming psychological trauma, or even preparing for it (if that is possible)? And what role might social workers and practitioners in international solidarity play in these efforts? These were the key questions driving the debate, which examined psychological trauma and its psychosocial treatment through the prism of 1) cultural context; 2) temporality (during and outside times of crisis); and finally 3) the role of citizens.

Although the subject of mental health is receiving increasing media attention, there are still taboos surrounding this health issue, and although mental health disorders are very common, they are all too often stigmatised, which prevents some people from seeking treatment. In addition to this taboo, which appears to be a cultural constant, we also know that one of the challenges is to adapt mental health responses to the specific needs of different groups. All of this raises the question of how cultural context influences the way people cope with psychological trauma and the appropriate psychosocial treatment to provide.
Jean-Marc Goudet explained how to take cultural context into account, drawing on his research experiences on mental health issues in very different settings: in schools in France, and subsequently in rural areas of Bangladesh and Senegal. In particular, he highlighted the complexity of addressing women’s mental health, which requires the prior deconstruction of gender stereotypes.
Thierry Liscia explained how he had worked in very different cultural contexts during his many years at the French Development Agency (AFD), where he helped to set up the Crisis and Conflict Unit and to introduce and develop the theme of mental health and psychosocial support in the AFD’s post-crisis projects.
Irène Bogicevic presented the work of the Red Cross and Red Crescent Movement, which offers a wide variety of mental health and psychosocial support services and programmes. In particular, she explained the highly complex task of the Red Cross and Red Crescent Movement’s Centre for Mental Health and Psychosocial Support, based in Copenhagen, in proposing relevant and appropriate approaches at Movement level for the 191 National Societies, including the French Red Cross, which works with populations from very different cultures.

The discussions continued on another important aspect of the psychosocial management of psychotrauma: the timing of intervention (before, during or after a crisis). Noting the limited consideration given to mental health by humanitarian and development actors – an issue also addressed by the journal Alternatives Humanitaires in its March 2023 issue dedicated to mental health – Thierry Liscia explained why he is convinced that mental health must nevertheless be regarded as a fundamental lever for development programmes. His remarks on how mental health could be better and more systematically integrated into development projects and policies provided an excellent transition to Irène Bogicevic, who explained in detail what the French Red Cross does in the field of mental health before, during and after a crisis (training in psychological first aid, psychosocial support, awareness-raising and prevention, etc.).

The importance of the role of citizens

The round table concluded with a discussion on the role of citizens, the importance of training them and the various training courses available. When faced with someone’s distress, one can feel powerless, unsure of what to do. What can each citizen do at their own level to be attentive, to find the right words or gestures, to help someone speak? Just like life-saving first aid, all of this can be learnt and can have a significant impact. But how can one learn? On this subject, Irène Bogicevic presented the psychological first aid training and the French Red Cross’s ‘Tous acteurs de la santé mentale’ programme. Thierry Liscia emphasised the importance of training, referring in particular to the “Premiers secours en santé mentale France” (PSSM France) course. Finally, Jean-Marc Goudet discussed how preventive measures can be implemented with local communities to mitigate the impacts of psychological trauma.

Watch the replay here (in French only) :

The speakers

Irène BOGICEVIC is a psychologist, head of the Mental Health and Psychosocial Support (SMSP) programme at the French Red Cross, and a researcher in psychology and public health.

Jean-Marc GOUDET is a sociologist and public health doctor. After completing a sociology PhD examining mental health issues in schools in France, he shifted his research focus to the health impacts of climate change in Bangladesh and Senegal. His latest project, supported by the French Red Cross Foundation, explores the impact of extreme temperatures on the mental health of mothers and children in rural areas of northern Senegal.

↗ View Jean-Marc Goudet’s profile

Thierry LISCIA is a clinical psychologist and psychotherapist. He worked for many years at the French Development Agency (AFD), where he helped to set up the Crisis and Conflict Unit and to introduce and develop the focus on mental health and psychosocial support within the AFD’s post-crisis projects. During his many years living abroad, he has carried out several projects, notably in community mental health in Lebanon with the National Mental Health Programme and Médecins du Monde France.

↗ Find out more about Thierry Liscia’s work