I cannot say who, the artist, the shrink or the citizen, conducted this interview with the candidates of the current election campaign on the subject of mental health. Obviously, I was hoping for an exchange that went beyond conventional speeches, the usual representations in the service of images. I had hoped to think and talk about mental health differently than the way we approach it everywhere, with this alarmist, rather “crisophobic” tone, a term that I borrow from the psychologist Camille Veit.
I am lucky to have these naive tendencies still possible in me and I must say that they rarely harm me. However, I never expected to talk about Winnicott with the outgoing Minister for Health and Social Services. You will therefore read here the snippets of two exchanges that did not disappoint me, the first with Lionel Carmant, from the CAQ, the second with Mélissa Généreux, from Québec solidaire. The next column will contain those from the interviews with the other three candidates.
We shrinks are interested in what is not apparent, in what is “underneath”, “prior”, “to be revealed”, so I will not insist much on the concrete solutions envisaged by the parties. To do this, I would invite people to watch the excellent debate organized by the Community Mental Health Coalition. Here, I will focus more on the origin of things, starting with a complex question: why is there so much psychological suffering in our society?
To this question, Lionel Carmant first answered with a “Wow! Okay…” which delighted me. Quickly, the outgoing minister, visibly interested, pointed to two major issues: the requirement of performance and the disintegration of the family net, which, in his eye as a neuropediatrician, make the lives of each other more complex, more stressful too. The reading of M.me Généreux, focused on the social determinants of mental health, is perfectly consistent with the vision of her party, which tries to act on them in order to make life more livable for as many people as possible.
When asked about the sources of the disintegration of public mental health services, the two did not mince words. While Mme Généreux points to the creation of megastructures, which she describes as “catastrophic”, Mr. Carmant is categorical: “What killed the network were the Lean methods. That of the Barette years? “Bold! Bolduc is the King Lean! explains Mr. Carmant. This intrusion of performance into the health and social services network has had a disastrous impact. That’s where the psychologists went. »
In this regard, both want to repatriate psychologists to the public network, speaking of salary increases and professional autonomy, without however neglecting the contribution of other mental health professionals. “They try to make me say that I don’t recognize interdisciplinarity and that I’m into interchangeability. But not at all ! I only think that we can also revalue all the expertise in the service of the population, ”alleges Mr. Carmant.
Mme Generous, she also protests about the conditions and salaries of community workers, who are sometimes lower than employees of fast food chains. It was when we talked about prevention that Winnicott arrived, this good Donald, who is almost unanimous among shrinks. The conceptual gifts that the psychiatrist and psychoanalyst gave us, such as the “mother-good enough” or the “transitional space”, are of great use to us, even to this day, when it comes to understand what constitutes us as members of the human species.
However, it is the concept of “containing function” that marked our discussions. Winnicott distinguishes, in the parents, the containing function (“ holding ) from that which is limited to the care provided, the “anti-excitation” (“ handling “). The revolution is to have advanced that, first and foremost, the human baby needs to be “contained”, read, heard and understood, long before being “appeased by gestures”.
In an era where the discourse on mental health is based on a mainly protective vocabulary, it seems urgent to ask the question of the places, real or symbolic, where, before having diagnoses, tools, techniques and drugs, people could first be welcomed, received, heard, contained.
It was the Mégantic rail tragedy that taught Mme Generous, when she was director of public health in Estrie, what the containing function was. There were no best practice guides, so she listened and listened to the community. “That’s how my posture as a politician was born. I am a facilitator, not an expert who tells communities how to heal themselves. »
For Mr. Carmant, mental health prevention must focus on parents, to support them, as early as possible, in the development of their parenting skills. We agree, but I insisted a bit on the importance of the containing function well before the implementation of new guides. “You don’t think parents need to be told how to do the ‘holding”? Mr. Carmant asked. To tell the truth, I believe that one must have been “contained” in order to know how to “contain”. “Ah… That’s super interesting! »
Once again, I was satisfied with the effect obtained.