Cet article décrit les représentations sociales du fou, du malade mental et du dépressif, dans un échantillon représentatif de la population générale française.

Sur 36 000 personnes interrogées dans l’enquête « Santé mentale en population générale », plus de 75% associent les termes de fou et de malade mental à des comportements violents et dangereux. Plus de 75% des sujets associent le terme dépressif à la tristesse, l’isolement et le suicide. Les personnes jeunes et celles qui ont un niveau d’éducation et de revenu élevé catégorisent plus fréquemment les comportements violents et dangereux dans le champ de la maladie mentale plutôt que dans celui de la folie.

Les représentations influant sur les recours aux soins et les attitudes vis à vis des patients, les résultats interrogent sur la meilleure façon de lutter contre les archétypes du fou, ou du malade mental, afin de réduire l’exclusion des patients.

The aim of this study was to describe the representations of insane, mentally ill and depressive persons, in a representative sample from the French General Population.

Data were derived from the multicentric survey “Mental Health in the General Population: images and realities”, carried out in 47 French public sites between 1999 and 2003. A face-to-face questionnaire was used to interview a representative sample of French metropolitan subjects, aged 18 and over, non-institutionalized and homeless. These subjects were recruited using quota sampling for age, sex, socioprofessional and education levels, according to data from the 1999 national French population census. Representations of insane, mentally ill and depressive persons were explored by a specific questionnaire with open and semi-open questions. Psychiatric diagnoses were identified using the Mini International Neuropsychiatric Interview (MINI). A national database was then constituted by pooling data from all sites, weighted for age, sex, level of education, socioprofessional level and work status to be representative of the French general population.

Of the 36 000 individuals included in this study, over 75% associated the words «insane» and «mentally ill» with violent and dangerous behaviours and the term «depressive» with sadness, isolation and suicide. Young people, those with higher education and higher income level more frequently associated dangerous behaviours with mental illness rather than with insanity.

The study shows that the general population draws a clear line between the representation of insane and mentally ill on one hand, and depressive on the other hand.

Insane and mentally people are described as abnormal, irresponsible, unconscious, socially excluded, far from being curable, and to be cured against their will by psychotropic drugs and psychiatric hospitalisation. Whereas the depressive is perceived as a more familiar character, suffering, curable, who can be cured with psychotropic drugs and social support, but not to be hospitalized.

This study highlights the overwhelming representations of insanity and mental illness in the French general population. As those stereotypes strongly affect access to care and behaviours toward psychiatric patients, the results show the need to think over the best way to fight against stigma and discrimination, in order to reduce psychiatric patients’ social exclusion.