• A policewoman was attacked near Nantes by an individual suffering from severe psychiatric disorders and having radicalized in prison.

  • A case which raises the question of prison psychiatric management.

  • For François Bès, coordinator of the investigation unit of the International Prison Observatory (OIP), the prison is unable to offer good follow-up to people with psychiatric disorders.

Friday, a municipal policewoman was attacked and injured by a radicalized man in La Chapelle-sur-Erdre, near Nantes. The individual died of his injuries following an exchange of gunfire with the gendarmes. The public prosecutor confirmed that his radicalization had been reported in 2016 during his detention and that he "clearly presented serious psychiatric problems". The Interior Ministry explained to him that the individual "was recognized as diagnosed as severe schizophrenic" and was under medical treatment.

A point that raises the question of the incarceration of people with psychiatric disorders.

François Bès, coordinator of the investigation unit of the International Prison Observatory (OIP), explains to

20 Minutes

the flaws of the prison system in monitoring and psychiatric care.

Does the prison have sufficient means to manage the psychiatric disorders of its prisoners?

A quarter of prisoners in France present with psychiatric disorders. All penitentiary establishments have a health unit dependent on the sector hospital and must have a psychologist and a psychiatrist. However, it is a very low workforce in view of the prison population, and all the budgeted positions are not filled. Some prisons cannot provide any psychological follow-up for their detainees, while others are clearly understaffed.

There are specialized structures, the Specially Adapted Hospital Unit (USHA), to manage the sickest inmates.

But there is only one structure of this kind per region in France, places are very rare while the needs are great.

Make no mistake about it, psychiatric care is clearly less good in prison than outside.

The premises are unsuitable, the staff insufficient.

How is the management of these disorders going?

From the moment people are imprisoned, they are managed according to the severity of the disorders presented. If a case requires hospitalization, for example during a psychotic crisis, it is taken to the nearby psychiatric hospital. But the conditions of hospitalization are often deplorable, people are in isolation and treated like everyone else, these are violent stays.

One of the problems with prison is that psychological disorders are managed in a disciplinary manner, and will result in penalties.

There is no health management of the psychiatric disorder.

In fact, some people remain imprisoned for eternity because of their "bad behavior" in cells, in fact due to their disorders.

Prison is pathogenic in itself, it causes degradation of the psychological state of people, and creates or aggravates psychiatric disorders.

A stay in prison is not without consequences on the state of mental health, moreover the suicide rate there is seven times higher than in normal population.

Due to prison overcrowding, there is also cell sharing between prisoners with and without psychiatric disorders ...

For sick people, this is not without consequences: they are vulnerable and will suffer more violence, bullying and pressure from able-bodied prisoners who will identify them as weaker.

For able-bodied prisoners, it can also be a very difficult cohabitation, and many of them ask to change cells.

Aren't severe psychiatric disorders supposed to not go to jail?

The law provides for it but is hardly applied. Since 2014, there is the possibility of suspension of sentence for the most severe psychiatric patients, but to our knowledge, only one inmate has benefited from it. Incarceration of the strongest psychiatric disorders is potentially dangerous for everyone, in addition to posing many ethical problems. What meaning in the execution of the sentence for prisoners who are not even aware of where they are?

With the abolition of asylums in the 1970s, there was hope of better managing psychiatric disorders with prevention and more humane hospitalizations.

But prevention was never put in place and the closure of thousands of hospital beds made it impossible to get a good hospitalization.

Usually, and this is the tragedy, people with psychiatric disorders do not see care until they have had a problem with the law.

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  • Psychology

  • Troubles

  • Inmates

  • Psychiatry

  • Jail

  • Nantes

  • Society