First drafted following an international conference in 2007, the Mental Health Promotion and Prevention Plan (PPSM) set itself the objective of creating a cross-border network involving Wallonia, Luxembourg, Lorraine (France) and Saarland (Germany) - in order to develop the professional tools capable of helping to prevent mental health disorders, but also to develop the autonomy and empowerment of patients and their environments. These pilot actions and scientific research have resulted in a collective work published by Harmattan (1) under the supervision of Laurence Fond-Harmant, doctor of sociological research at the CRP-Santé (Public Health Research Center) of Luxembourg.  The pilot-schemes and research resulting from this cross-border think-tank have had the benefit of an assessment by the researchers at APES-ULg (Health Education and Promotion Support), a unit of the Public Health Department of the University of Liege.

Drawn from the hospital and non-hospital sectors, the different professionals involved in the Mental Health Prevention and promotion plan (PPSM) shared the same vision of reforming the field of psychiatry as advocated by the World Health Organization (WHO) and the European Union. The Helsinki Declaration of the WHO (2005) stipulated that “if possible, large centralized psychiatric institutions should be closed and more appropriate alternatives should be put in place in the living environment”. With this de-institutionalization and community-based approach, the MHPP has engaged the collaboration of patients nominated to take part in this new approach to mental health as “users”, a title which underlines the possibility they have to assess, criticize and assist in the development of this system in which they are the first experimenters.

A cross-sectional assessment

The research and pilot schemes resulting from this cross-border think-tank benefitted from an assessment by the researchers from APES-ULg (Education Support and Promotion), a unit of the School of Public Health of the University of Liege. This assessment documented the results obtained by the different participants and was constructed in the form of research-action or rather “assessment action”, as Gaëtan Absil, its coordinator, explains. “We invited the different partners to ask themselves this very question of assessment. In that sense it was not a question of self-assessment linked to technique, but rather co-assessment based on methodology: who can be assessed? What questions should be asked? At what point should these questions be asked? The advantage is that by means of this approach, the participants interact, while negotiating the actual meaning of the plan. In other words, assessment does not serve only to evaluate but is also a powerful tool for learning about its own practices”.

This jointly-constructed questionnaire has also made it possible to institute a kind of cross-over effect for the participants in the plan both in terms of their quite distinct profiles (users, professionals in the areas of psychiatry, social science, research etc.) and their different geographical identities, each country being involved in the transformation of the mental health field to various degrees and under their own individual terms. “The participative assessment opens up the possibility of using the practice and experience of the participants as a starting point because as an assessor, I cannot gain a mastery of all the different contexts. The criteria then become mutual until a consensus is reached. It may be thought that working in this way is equivalent to drawing the target after the arrow has been fired, but in reality, we actually observe the opposite: the criteria and indicators developed are particularly demanding, to the point that the participants cannot always follow through with them, explains Gaëtan Absil.

(1) Prevention and promotion of mental health. An innovative cross-border alliance, under the direction of Laurence Fond-Harmant, Paris, L’Harmattan.
(2) World Health Organization, “Mental Health: meeting challenges and finding solutions”, European Ministerial Conference on mental health, the Helsinki regional office of the WHO for Europe, Copenhagen, 2005.