« No crisis, be cooperative! »: The conditions of taking into account the patients’ voice in a psychiatric unit[« Pas de crise, soyez coopérative ! » : les conditions de prise en compte de la parole des patient·e·s dans une unité psychiatrique]

Attempts to (re)enhance the value of the expression linked to the emergence of a « contemporary patient » in the health system raise specific issues in psychiatry, partly linked to the particular status that this word occupies and to the plurality of ways of framing patients. Moreover, this requirement may come into tension with current developments in hospitals and psychiatry, which are faced with major recruitment difficulties and management pressures. Our article aims to shed light on the concrete conditions of reception of patients' speech in the daily life of a psychiatric hospital unit. The survey on which it is based, based on observations and interviews, shows that life in the unit is punctuated by numerous requests from patients, producing a "background noise" that does not always make them audible. Dedicated spaces for exchanges between professionals and patients, in particular the caregiver-patient meeting, allow for the emergence of criticism from the patients concerning the availability of the professional team. This criticism gives rise to debates that are sometimes heated, but which also produce a critical reflexivity on the part of professionals about their practices and the organisation of work in psychiatry. The relational dimension of psychiatric work is discussed by the caregivers, both as the heart of their mandate and as a revelation of the aporias of its exercise.