Europe 1 with AFP / Photo credit: DIMITAR DILKOFF / AFP 17:22 p.m., December 03, 2023

On Saturday in Paris, a knife-wielding terrorist killed a German tourist and wounded two others. Already known for psychological disorders and radical Islamism, the man was arrested by the police. On the other hand, this case shows the complex link between "ideology" and "psychiatry".

As in the case of the deadly knife and hammer attack in Paris on Saturday night, characterizing the nature of the acts committed by radicalized people is complex when mental disorders and ideological motivations are mixed. "As is often the case in these cases, an ideology, an impressionable personality and unfortunately psychiatry are intertwined," Health Minister Aurélien Rousseau said on Sunday. "Even if we have largely strengthened in recent years the links between (the) psychiatrists and the authorities who follow these radicalized people, it does not allow us to know what is the day and time of the passage to the act," he added on France 3.

A "treatment" without hospitalization

Near the Eiffel Tower, a man stabbed to death a German-Filipino tourist before wounding two other people, traumatized but "in good health," according to the minister. Arrested, The terrorist, born in France in 1997 of Iranian parents, is of French nationality and known to the justice for radical Islam and psychiatric disorders, police sources. The Anti-Terrorist Prosecutor's Office (PNAT) has opened an investigation. In particular, the medical follow-up of the author, whose "profile is very unstable, very impressionable", will be dissected, according to a security source to AFP.

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The Minister of Health confirmed that the terrorist had been subject to psychiatric "monitoring", a "treatment" without hospitalization, since he was released from prison in 2020, according to sources close to the case, after a conviction for a planned attack in 2016.

Psychiatric Expertise

Initial evidence shows that the "follow-up" did take place at the outset. But the authorities are still examining the continuation of the terrorist's career, who then moved to "another department", said the minister, who is taking part in the security meeting in Matignon with his colleagues from the Interior and Justice on Sunday afternoon. Less than 24 hours after the attack, Denis Leguay, president of the federation Santé Mentale France, remains very cautious about the possible explanations for the terrorist's act, in a context of war between Israel and Hamas and tensions in France.

"We can wonder about the influence of everything that is happening in the news, which is abundantly relayed and which can act on the behavior and the good psychic balance of this kind of person presented as fragile," he told AFP. But in the specific case of Saturday's attack, "it is too early to express ourselves because we do not know what psychological state he is in at the moment, we have to wait for a psychiatric expertise."

However, the psychiatrist points out what can be perceived as a paradox: "This man would be followed by the psychiatric care system but at the same time, he has in the recent past been incarcerated and therefore considered responsible for his actions." "It is therefore difficult today to qualify his acts without knowing more about his mental state at the time he committed them," he concludes.

"Determination"

For emergency doctor Patrick Pelloux, interviewed on BFMTV, "we must avoid saying as soon as there is an attack: It's the fault of psychiatry". "I understand that we want to take cover to say: It's the fault of the other, but there is the determination of the terrorist, in this case, it's very structured. He thought carefully about how he hit" his victim, "where to hit," added the doctor, who was present at the scene of the attack on Saturday. This tragedy highlights the recurrent difficulty for the justice system to draw the line between a terrorist act and a common crime, especially when the perpetrator suffers from mental disorders and acts in a solitary manner.

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To varying degrees, the psychiatric issue has intervened in several attacks that have been seized by the anti-terrorist justice system in recent years, such as at the Paris police prefecture (October 2019) or Rambouillet (April 2021). On the other hand, the PNAT has ruled out other cases, such as that of a man registered for Islamist radicalisation, known for mental disorders, who had threatened police officers in Metz with a knife in January 2020.

According to the penal code, the PNAT must take action if offences are committed "intentionally in connection with an individual or collective enterprise with the aim of seriously disturbing public order through intimidation or terror". On the one hand, this implies premeditation and, on the other hand, its attachment to a political or ideological movement, for example through a claim or the imitation of a mode of action.