Du handicap revisité au handicap psychique : un nouveau concept qui pourrait faire date ?

RésuméL’objectif de l’article est de montrer que l’usage du concept de « handicap psychique », entériné en 2005 par la dernière loi de cadrage française sur le handicap, est à resituer dans une évolution plus globale : celle des conceptions sur le handicap en général, qui dépendent des politiques sociétales successives et qui se retrouvent dans les classifications internationales des handicaps. La loi de février 2005 qui a suscité l’engouement en France a peut-être donné trop d’espoir. Ce sera la question centrale de cet article. Car, force est de constater qu’en réalité, cette loi est un listing administratif nuancé des handicaps, et que, si elle propose une définition du handicap, celle-ci reste descriptive et limitée aux répercussions adaptatives et sociocomportementales des déficiences de la personne. De plus, cette loi ne reprend pas dans son texte le terme condensé de « handicap psychique ». Celui-ci dérive plutôt d’une interprétation de l’esprit de la loi qui se fonde sur les travaux parlementaires préparatoires. L’article propose d’éclairer ce contraste entre la loi elle-même et ses débats préalables pour dégager « le meilleur » des dispositions sur le handicap dit « psychique », en particulier ses apports pour les personnes malades.

This article aims to demonstrate that the use of the term “psychic handicap” as enshrined in the last set of French legal guidelines on disability, needs to be seen as part of a wider movement: namely that of attitudes to disability in general, following successive social policies and as expressed through international disability classifications. The law of February 2005, which caused the rush in France, maybe has given too much hope. This is the main issue this article seeks to address. For in reality, it is abundantly clear that this law is a thoroughgoing administrative list of disabilities, and whilst it may offer a definition of disability, it remains descriptive and limited to the adaptive and socio-behavioural repercussions of individual deficiencies. Moreover, the actual text of this law doesn’t use the compressed term “psychological disability”. This results largely from an interpretation of the spirit of the law based on its antecedents. This article intends to throw into relief the differences between the law itself and the debates, which preceded it, to release « the best » of dispositions on the “psychic handicap”, in particular its contributions for the sick persons. It seems that the 2005 law was influenced by scientific and medical thinking. It thus takes its inspiration from American disability terminology (CIH-1980 and CIF-2001) from which it attempts to combine contributions both between them and with those taken from international nosographies of mental health issues. Moreover, although it takes into account expert opinion–albeit from the great figures of traditional French psychiatry–the law continues to be influenced by American psychiatry which has, over the last few decades, given way to a quantitative, cognitivist and biological hegemony, to the detriment of the psychopathology of the afflicted subject. The tide is turning, but this will take time… Another important issue is that parliamentary reports made prior to legislation are driven by French political forces, and therefore addressed to the public to which they are answerable. In this regard, they are on the one hand largely inspired by current European thinking on disability, which may well be based on a fiercely egalitarian ideology, but which also recognises the subjectivity of those individuals in situations of psychological disability. On the other hand, these preparatory texts are clearly steered by user and family groups, as well as professionals within the medico-social sector who, for once, speak as one. It is perhaps paradoxical, but it seems that today, when it comes to psychological disability, it is generally the educational establishment which embodies psychodynamic thinking, whilst it is within the community clinic with those termed “mental” patients, that the qualitative approach to psychological problems, exiled from the hospital and healthcare sector, currently finds refuge… Moreover, whilst the term “psychological disability” is ultimately only useful as a catch-all term to help the wider public understand the various aspects of psychiatric patients’ socio-affective relations, the article highlights the deception of a broken promise: i.e. that a new concept opens up a new epistemological field which allows us to extend our practical and theoretical thinking on the issue. The article concludes that nevertheless, as with disability issues in general, our inability to conceptualise the intuitive compressed term “psychological disability” should lead us to admit that it is the usage of the term which will make it exist, make sense, condense…