Rethinking Community Lives and Supports for the Persons with Mental Disorders Beyond the Difference in Social Positions: An Introduction of Practice of “Trialogue” in France

Background: As deinstitutionalization has pervaded in most industrialized countries, persons with mental disorders have been greatly encouraged to live in the community. On the other hand, they still have difficulties, especially in choosing the mental health services or participating in social activities according to their will. These difficulties are often caused by a discrepancy between the persons with the mental disorder, their families, and medical professionals in the attitudes toward “desirable” community lives and supports for these persons.

Aim: To resolve this discrepancy, this study introduces a new communicative activity, which is called “trialogue” in France. In this activity, the persons with the mental disorder, their family, and the medical professionals exchange their opinions about mental health services from their points of view to think better supports and lives. First, I introduce its outline. Second, I investigate how the gap between participants’ attitudes toward desirable community lives and actual supports are filled (or not filled) through this program.

Methods: I conducted participant observations of trialogue and semi-structured interviews with its organizer from 2016 to 2017 in urban areas in southern France. This field research is still ongoing and this study is an interim presentation. With these two kinds of qualitative data, I have analyzed the kinds of participant interactions that influence change in or maintenance of each participant’s attitudes toward the theme they discussed about.

Results: In the process of trialogue, diverse opinions were expressed and shared freely regardless of their differences in position. This atmosphere of trialogue allowed the participants to examine their attitudes objectively, which sometimes enhanced their tolerance for different attitudes of other people.