This article explores the allure of \"great men\" in medical history through a comparative account of the work and lives of Jean-Martin Charcot and his student and collaborator, Désiré-Magloire Bourneville, in late nineteenth-century France. While historians of science and medicine have self-consciously rejected Whiggish and hagiographic \"great man\" history, the fixity of certain historical actors within our social and cultural histories reveals the continued hold of these figures and what they stand for within the grand narrative. The privileging of institutional and intellectual contributions has been perpetuated in such a way that bottom-up experiences and contributions in realms such as public health have been neglected. I argue that the continued prominence of certain historical medical figures, like Charcot, over forgotten contemporaries, like Bourneville, is representative of the way that historians of science and medicine have implicitly privileged intellectual contributions over social, political, or structural contributions.
Résumé. Cet article explore l’attrait pour les « grands hommes » dans l’histoire de la médecine, en comparant la vie et l’œuvre de Jean-Martin Charcot et de son élève et collaborateur, Désiré-Magloire Bourneville, dans la France de la fin du XIXe siècle. Bien que le milieu de l’histoire des sciences et de la médecine ait plus ou moins rejeté les approches historiques fondées sur le whiggisme et l’hagiographie des « grands hommes », la permanence de certains acteurs historiques dans notre histoire sociale et culturelle révèle l’emprise que ces figures conservent sur les grands récits et le rôle qu’elles continuent d’y jouer. Le privilège accordé aux contributions institutionnelles et intellectuelles s’est perpétué, de telle sorte que les expériences et les apports provenant de la base dans des domaines comme la santé publique sont demeurés dans l’ombre. Je soutiens ici que l’attention reçue sans cesse par certains personnages de l’histoire de la médecine, tel Charcot, au détriment de leurs contemporains ayant sombré dans l’oubli, tel Bourneville, est représentative de la manière dont les historiens et les historiennes des sciences et de la médecine privilégient toujours, implicitement, les contributions intellectuelles plutôt que les contributions sociales, politiques ou structurelles.

OBJECTIVE: Socio-aesthetics is a practice born in psychiatric departments but has since developed particularly in the field of oncology. For our part, since January 2018, we have initiated an experiment of this type at the Espace Unit of the CHU in Nantes, a unit that takes care of young patients who find themselves in a situation of crisis and endangerment of themselves.
METHODS: The qualitative evaluation of the interest of a socio-aesthetic mediation (relaxation modelling, facial care, make-up) with young patients was carried out by a collection of their feelings.
RESULTS: Youth who expressed an overall judgment of socio-esthetic mediation appreciated it in 61% of cases. They express their satisfaction with words such as \"I liked\", \"I loved\", \"I\'m happy\", \"it was too good\", \"super good\" or \"great\".
CONCLUSIONS: This successful socio-aesthetic therapy practice experiment will continue with a quantitative analysis to demonstrate the relevance of this type of service to psychiatric patients.

Peer health mediators are now part of the psychiatric landscape. Their work has been extended to the medico-social, social and addiction fields. The French National Authority for Health advocates the integration of peers into institutions to support and encourage patients\' involvement in their care. Psychiatry has been a forerunner in this deployment. Its example could be useful beyond.

As peer support becomes more professional, it is becoming increasingly recognised and diversified. When a mental health patient-trainer works with psychiatric carers, the latter gain a better understanding of the patient\'s point of view. In addition, valuing their experiential knowledge can support peer helpers in their recovery. However, we mustn\'t forget that these are fragile people and that their past can come back to haunt them if they are not careful. Testimonial.

The concept of peer support is now firmly established in the psychiatric landscape. While taking into account the benefits that this approach brings to patients and teams, it is essential to consider the need to define a framework for the practice of peer support. This framework, which is essential for the development of the practice, will help to avoid overly fragile exposure, which is synonymous with difficulties for peer helpers and their teams.

Introducing patient partnership in mental health and psychiatry to initial training is an innovative way of promoting recovery, while at the same time highlighting the undeniable contribution of peer support within healthcare teams, in order to accompany the people concerned. This is why Croix-Rouge Compétence Auvergne-Rhône-Alpes is developing a specific training program for trainees.

Identifying and assessing somatic pain in people with schizophrenia remains a major public health issue for this vulnerable population. In France, Advanced Practice Nursing is developing, based on a practice built around clinical expertise. How can the clinical expertise of psychiatric and mental health APNs improve the identification and assessment of somatic pain in these patients, and thus help to improve their somatic health?

The deployment of case management and advanced nursing practice is shaking up the roles of the various professionals on mental health teams, and the usual organization of care in psychiatry. These changes can be perceived as either positive or worrying, depending on each individual\'s role and position. For the past 3 years, the mobile teams of the Centre rive gauche cluster at Le Vinatier hospital have been organized according to the principles of Flexible Assertive Community Treatment, and include an advanced practice nurse (APN) on their staff. The roles of the case manager and the APN have been rethought. A number of measures have facilitated the implementation of these new functions.

A 59-year-old man who had been presenting with a variety of neuropsychiatric symptoms for several weeks. Despite repeated visits to somatic emergencies, as well as a thorough work-up including complementary examinations and specialist opinions, no organic diagnosis was established. The patient was treated symptomatically with neuroleptics and benzodiazepines, which led to a significant improvement in symptoms.

OBJECTIVE: Ambulatory care without consent is widely used, but it is controversial, and its effectiveness has not yet been proven. The patient experience remains largely unstudied in France, particularly that of young patients, yet their adherence to care in the early stages of the disease is complex and has an impact on their prognoses. The aim of this study is to investigate the experience of young patients undergoing a program of care (POC) in order to suggest ways of optimizing their care and to enrich the debate on the use of POCs.
METHODS: Semi-structured interviews were conducted with 11 patients between ages 20 and 32, who were either undergoing a POC or had done so in the previous 5 years, followed by a semi-pragmatic phenomenological analysis of the resulting transcripts.
RESULTS: (1) The outpatient experience with restraints is contradictory, ranging from deprivation and intrusion to support and protection. (2) The POC is portrayed as a framework for developing awareness of disorders and acceptance of care. (3) Patients report a lack of information about care with restraints, even to the point of being unaware of its existence. Patient-psychiatrist interactions within the POC are complicated by the restraints, but remain perceived as a care relationship. (4) They report constraints in their daily lives in connection to the POC, which can complicate professional involvement.
CONCLUSIONS: The results support the importance of nurturing the therapeutic relationship within the POC and involving patients more in their care, starting with better information. They support the use of POCs as a temporary tool to be combined with work on adherence to treatment and support for social and professional reintegration.
METHODS: Psychiatry.
OBJECTIVE: Les dispositifs de soins ambulatoires sans consentement sont largement utilisés, mais ils sont controversés et leur efficacité n’est pas prouvée à ce jour. L’expérience des patients concernés reste très peu étudiée en France, et notamment celui des jeunes patients, or leur adhésion aux soins en début de maladie est complexe et a un impact sur le pronostic futur. L’objectif est d’étudier l’expérience de jeunes patients suivis en programme de soins (PDS) afin de proposer des perspectives pour optimiser leur prise en charge et d’enrichir la réflexion sur l’utilisation des PDS.
UNASSIGNED: Des entretiens semi-directifs ont été réalisés auprès de 11 patients de 20 à 32 ans suivis en PDS ou l’ayant été dans les 5 dernières années, puis une analyse phénoménologique de type sémio-pragmatique a été réalisée sur les verbatims obtenus.
UNASSIGNED: (1) L’expérience de la contrainte en ambulatoire est contrastée avec un vécu de privation de libertés et d’intrusion, mais aussi de soutien et de protection. (2) Le PDS est représenté comme un cadre permettant l’évolution de la conscience des troubles et de l’acceptation des soins. (3) Les patients rapportent un manque d’information sur les modalités de soins sous contrainte, pouvant aller jusqu’à la méconnaissance de l’existence de cette mesure. Les interactions patient-psychiatre au sein du PDS sont complexifiées par la contrainte mais restent perçues comme une relation de soin. (4) Ils rapportent des contraintes dans la vie quotidienne liées au PDS et qui peuvent compliquer l’insertion professionnelle.
CONCLUSIONS: Les résultats soutiennent l’importance de soigner la relation thérapeutique au sein du PDS et d’impliquer davantage le patient dans sa prise en charge, en commençant par une meilleure information. Ils soutiennent une utilisation du PDS comme un outil temporaire à associer à un travail sur l’adhésion aux soins et à un accompagnement à la réinsertion sociale et professionnelle.
UNASSIGNED: Psychiatrie.