EK. Is there a flip side of the coin? Does improving care and living conditions have a perverse effect? Certainly. One may wonder if this does not legitimise and encourage the judicial institution to incarcerate people and sometimes leave them in prison whose place, one might imagine, is not behind bars. It also refers to a complicated philosophical debate, including the point of sending people to prison and who should or should not go there.
In this debate, the most extreme position is to say: the mentally ill are citizens like any other and prison is a public service that is addressed to all citizens, without exception. Offenders who suffer from mental disorders therefore have their place in the prisons. It is simply necessary to put in place the means and measures to take care of them, as is the case with other public services. This is, in my opinion, an untenable position.
The other position, equally extreme, would be to say that mentally ill people have no place in prison. Since ancient Rome, it has been considered that people who are mad should be recognised as not criminally responsible if they commit an offence. The place of these people is therefore not in prison but in the hospital. Furthermore, if a person develops psychiatric disorders in detention, he must be sent to the hospital.
I have the impression that we are trying in France, as elsewhere, to find a balance between these two positions. Obviously, it is sometimes very complicated. There is no denying that improving care and living conditions in prison can lead to an influx of patients.
Statements of criminal irresponsibility become, for example, exceptional. On the other hand, I don’t believe there are more mentally ill patients than before. I rather tend to think that they are being taken care of better, mainly thanks to the UHSA. Nevertheless, it is difficult to have a detailed analysis of the situation due to the lack of figures. This would require a new epidemiological study on the mental health of prisoners, similar to the last one, carried out in 2004. We currently only have figures on our activities but very little epidemiological data. In Marseille, it’’s honestly not our cup of tea. For years we have refused, for example, to write a diagnosis in medical records. There are several reasons for this refusal. First, we see this as labelling patients. Second, even if the diagnoses are to be made anonymous, it is not really clear how they could be used or manipulated by the wards.
This situation is changing. Unfortunately, we are increasingly forced to write down our diagnoses. However, giving the precise diagnoses is avoidable. It is therefore impossible to have detailed data on the number of mentally ill people or on the representation of different pathologies in detention.
