Comment le témoignage de Juan peut-il influencer l’élaboration des politiques de la santé mentale ?

This is a valuable story about how to cope with social anxiety, perceived by Juan as an illness. One conclusion that jumps out is that people are very capable to judge what works best for them. Psychoanalysis did not work, CBT was very effective for Juan.

Juan also mentions the word ‘recovery’, although I am not sure whether he mentions this as a concept widely used these days to describe the aim to achieving one’s aspirations, or in the traditional sense as an improvement from an illness.

At the core of this piece is the importance of the user movement, and the conclusion that users gain great benefit from sharing their pain with each other. An important question is whether user involvement is a goal in its own right, offering stability, or a step towards integration into the community. At present Juan seems to be unable to work. Is the aim of full and paid employment desirable, and does close involvement with the user group encourage this? As so often, I doubt there are general answers, and every person may have different ambitions and challenges, and sometimes user movements are wonderful in their mutual support and generosity for people who experience so much stigma and discrimination. But we also have to guard that they do not become permanent places of withdrawal from society that reinforce discrimination, sometimes self inflicted. We need to offer opportunities for people, both to connect with soul mates and to find stability at work. People with mental health problems have to maintain their self-worth by interacting with the big world, while finding support from people with similar experiences.

Dr Matt Muijen, Regional Adviser, Noncommunicable Diseases and Environment, WHO/Europe