A French recovery-oriented mental health service based on housing

Abstract

Introduction: The article aims at examining the various forms of mental healthcare services' organization based on housing, in a context influenced by the innovative experiments of the deinstitutionalization struggles of the 1970's. a Housing service, having operated for decades to facilitate social integration, is currently focusing on promoting patients' autonomy in their own apartment. an orientation to recovery has been adopted in the assistance of more autonomous patients who have not suffered any long-term hospitalization: they are considered as contractual users of the service. Method: an ethnographic approach applied to a case study, combined with the tools of the sociology of engagement regimes, aims at analyzing how an instance of non-compliance affects the capacity-oriented organization of the service, through the apartment. Results: In the case that we have observed, the user's refusal triggers an assessment procedure and a series of tests implied by the capacity-support approach of the service which eventually leads to the re-orientation of the assistance from the apartment to a medical facility. Conclusion: The medical objective has been prioritized over social integration. We explore alternative ways to maintain the apartment as a therapeutic and social integration tool.