Delaporte, Jean-François

Toward a psychiatry without care? Critical extrapolations from the American non-care paradigm. - 2025.


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Based on the philosopher Alexandre Monnin’s analysis of the “non-care” model in medicine in the United States, this article offers a critical examination of changes in French public psychiatry over the past twenty years. It reveals an insidious transformation: underfunding of institutions, implicit patient triage, the push for patient autonomy, and the rise of expert platforms and algorithmic management. These dynamics are redefining care as a conditional, fragmented process focused on assessment and compliance with predictive standards, rather than on a lasting clinical relationship. Though it is not yet possible to speak of an explicit shift toward non-care, as these logics gradually intertwine, serious questions arise about the future of the ethical, clinical, and institutional principles that have shaped French public psychiatry since the second half of the twentieth century.