On May 28, 2021, in La Chapelle-sur-Erdre (Loire-Atlantique), Ndiaga Dieye wounds a municipal police officer with a knife, steals her service weapon and attacks her colleague. After a few hours on the run and kidnapping during his escape, the man was finally shot dead by the police.
A few weeks later, while investigators continue to shed light on the reasons for this attack, the anti-terrorism prosecution has still not taken up the case. If he had been reported as radicalized since one of his times in prison, Ndiaga Dieye would have acted more under the effect of his mental disorders than for religious or political reasons.
“Psychological degradation”
“At one point, it became difficult to discuss with him”, testifies his lawyer to AFP, assuring to have observed at his client “A psychological degradation as and when incarcerations”. What the Nantes prosecutor confirms: “We realized, during his incarceration, especially the last, that he had serious psychiatric disorders. ” Yet diagnosed with severe schizophrenia in 2016, Ndiaga Dieye was detained until last March.
If murders committed by patients are rare, this aggression questions the role of the prison institution in the prevention of these acts in the heaviest psychiatric cases. While these disorders affect a colossal number of prisoners in France, the prison seems to be content to punish, and no longer really to treat.
60% of the prisoners concerned
According to a study carried out in 2016 among new entrants to prison in Nord and Pas-de-Calais, 60% present at least one psychiatric disorder or a disorder linked to substance use, and 40% at least two. Compared to the outside world, inmates are three to eight times more often ill, and seven times more often schizophrenic.
“Even if the vast majority of people suffering from psychiatric disorders will never exhibit violent behavior, certain pathologies are associated with a risk of acting out, especially when they are associated with the consumption of psychoactive substances”, argues Thomas Fovet, psychiatrist and researcher at the Lille CHRU.
Some magistrates, and the psychiatric experts they consult, tend to consider that they can send a patient to prison for treatment. Camille Lancelevée Sociologist
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An explanation to which we should add the context of the evolution of health policies. “We have closed asylums and opened psychiatric hospitals for everyone, but many people do not have the means to be accompanied outside and fall through the cracks of the net”, adds sociologist Camille Lancelevée, from the University of Strasbourg.
Profiles of precarious and more often condemned individuals who sometimes find themselves guilty of crimes such as theft or acts of violence, and for whom prison becomes the place of reception by default. “Even mad people, people in great distress. Some magistrates, and the psychiatric experts they consult, tend to consider that they can send a patient to prison for treatment ”, adds the researcher.
Perverse effects
In fact, the resources allocated to the care of sick detainees have developed since the 1980s. Each region has its regional medico-psychological service to welcome detainees in a hospital environment during the day, and nine specially equipped hospital units provide care. the most severe cases, a little over 800 beds in total for the 70,000 prisoners.
Psychiatrist at Les Baumettes in Marseille, Éric Kania wonders about the perverse effects of such a care policy. “Twenty years ago, when I arrived in prison, I was appalled to see that there were so many mentally ill people. Today, we have adapted to this reality, we have organized the care to accommodate them, increased the number of psychiatrists and psychologists … But we can wonder if these improvements do not also allow society to incarcerate the mentally ill. “
A serious loss of landmarks and meaning
The development of psychiatry within the walls coincided with the deterioration of the public hospital outside. “Patients find themselves out of care. This sometimes leads to behavioral problems, offenses, and then imprisonment. To do prevention, we could have increased the resources in public hospitals ”, suggests the doctor.
Already, in 2006, the National Consultative Ethics Committee deplored “a move from the psychiatric hospital to the prison”, pointing out the danger that prison represents for the sick: “The incarceration of people with serious mental illnesses can only lead to a loss of bearings and meaning. “ Despite its medicalization, the prison hardly appears as a place of care adapted to the sick.
According to Éric Kania, the effects of living within the walls on pathologies vary from patient to patient. “For some who are wandering outside, the prison provides support. For others, it is a disaster: loss of family, home, employment and social barriers ”, he explains.
Untrained staff
“Prison is not a place of care”, recalls the psychiatrist Thomas Fovet. The prison way of life, in a place of anxiety and insecurity, can worsen the disorders from which prisoners suffer. The inappropriate behavior of some patients leads them to isolation or to sanctions, such as stays in disciplinary quarters.
“There is confusion for the prison staff, who, when they are not trained, do not distinguish what relates to the behavior of the prisoner or the medical case to be treated”, explains Camille Lancelevée. Placing patients in the backyard, in the worst conditions that prison can produce, does not improve their care.
From Les Baumettes, Eric Kania remembers the case of a delusional patient “Who broke everything in his cell and found himself regularly in disciplinary quarters for two weeks or a month”. To enable him to follow stable treatment, the medical team organized his transfer to a hospital unit where he is completing his sentence. An outcome that does not know all the patients attending the disciplinary quarters, where suicides are even more numerous than in cells. In France, a prisoner commits suicide every two or three days.
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