The prison inspector draws a report "overwhelming" the care of prisoners with mental disorders in a notice published Friday, pointing out that the crisis of psychiatry in France is particularly sensitive in prison.
"Heavy illnesses aggravated by confinement and isolation, increased risk of suicide and conditions of detention that disrupt access to care, undermine their effectiveness and ultimately deprive the criminal sanction of its meaning": situation is very dark for the general controller of places of deprivation of liberty (CGLPL), Adeline Hazan.
"Mental illnesses are a factor that aggravates the suffering of detainees, increases the burden on the prison administration and is aggravated by inappropriate prison conditions," she wrote.
The controller regrets that the studies on the subject are "old or partial". According to one of them, dated 2007, eight out of ten male offenders have at least one psychiatric disorder, and 24% of them have a psychotic disorder.
In a response to AFP, the Minister of Justice, Nicole Belloubet, announced the launch of two studies from 2020. One to assess "prevalence" of pathologies at the time of entry into prison, and a another on mental disorders among "short sentences" and on leaving prison.
Trainings will also be set up for the prison staff by medico-psychological services, added the Keeper of the Seals, who wishes to make the treatment of mental pathologies of prisoners a "priority", recognizing "certain difficulties".
The means for access to care are "insufficient", says Ms. Hazan. "The disturbing increase in the number of prisoners in prisons and the resulting chronic overpopulation have not been accompanied by a development of health facilities," she laments. "The demographic crisis of French psychiatry is felt more sensitively in prison than elsewhere," adds the controller.
The care of patients is organized on three levels: outpatient in health units in prison, day hospitalization and full hospitalization (including local psychiatric services).
Access to ambulatory care and day hospitalization "is very uneven" according to the place of detention, criticizes the controller. It also denounces an "insufficient" continuity of care, which leads some patients to enter "an endless cycle of hospitalization and return to detention after a recovery still incomplete".
The CGLPL considers that "a person suffering from a mental illness requiring long-term care (...) has no place in prison" but must "be referred to a health facility".
It recommends "the development of secure hospital facilities to ensure appropriate care, including long-term, for detainees with mental disorders".
Ms. Hazan also requests training of prison guards "in the detection and management of mental disorders of the criminal population". Currently, the care of people with depression or psychotic disorders "is not addressed" in their training, focused on safety.
© 2019 AFP