2023-12-04 18:23:16
Faced with accusations of “failure” in the psychiatric follow-up of the author of the Paris attack, psychiatrists are moved by an indictment “hot” in a case mixing jihadism and pathology, and denounce “a gross attack on an already mistreated profession”.
Gérald Darmanin highlighted, Monday December 4, a “psychiatric failure” in the follow-up to the young radical Islamist who carried out the fatal knife attack near the Eiffel Tower on Saturday evening in Paris, adding that “the doctors considered on several occasions that he was getting better”.
“The psychiatric community is starting to be moved by the Minister of the Interior’s comments. To speak of a failure of psychiatry is a rather crude attack on our profession, already mistreated”, Bernard Granger, professor of psychiatry at Paris Cité University, told Agence France-Presse. He deplores “a hot reaction where we are looking for those responsible”and point “the uncertainties still very great regarding the actions taken”.
A person “can act out despite well-taken treatment”
“It’s a little strong coffeeagrees Michel Triantafyllou, president of the union of public practice psychiatrists. Associating psychiatric disorders with the commission of terrorist acts is risky to say the least, not to say demagogic. »
For Jean-Pierre Salvarelli, vice-president of the union of hospital psychiatrists, “psychiatric overexposure serves as a way for politicians to absolve themselves of their responsibilities” facing the ills of society.
“What prevailed [chez l’assaillant] : jihadist ideology or mental pathology, which might also have been retriggered or aggravated in the light of events in the Middle East? »asks Alain Mercuel, coordinator of the mobile psychiatry and precariousness teams in Ile-de-France and psychiatrist at Sainte-Anne hospital.
Stopping the neuroleptic may have “favored the act because the individual was able to decompensate”but a person “can act out despite well-taken treatment”notes Alexandre Baratta, who works in a psychiatric intensive care unit in Sarreguemines.
In his unity, “three patients suffer from serious mental illnesses, have a great permeability to radical Islamism, would not necessarily act out but can be used” because their pathology makes them “vulnerable” et “more violent”, he explains. In case of “warning signs”the doctor can notify the sentence enforcement judge.
“Great contempt for the government”
The attacker in Paris, listed for Islamist radicalization (FSPRT), was “subject to a treatment order involving tight psychiatric monitoring and controlled by a coordinating doctor” until the end of the probation on April 26, 2023, following a new psychiatric assessment, explained the anti-terrorism prosecutor, Jean-François Ricard, on the evening of Sunday, December 3.
At the end of October, the attacker’s mother, seeing that her son “withdrew into itself”, had made a report to the police, who had tried in vain to have him examined by a doctor and hospitalized automatically, in the absence of problems, according to a source close to the case. The mother did not want to request forced hospitalization.
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The Minister of the Interior, Gérald Darmanin, demanded on Sunday that the authorities “may require an injunction for care” for a radicalized person being monitored for psychiatric disorders in order to prevent acts of violence.
“It is very difficult to treat people under duress, especially if the ideology is massive”underlines Alain Mercuel, from Sainte-Anne hospital. “The injunction for care can be useful, but is not a magic cure”considers Bernard Granger, who also mentions “implementation difficulties” (delay, lack of staff). And “the forced hospitalization procedure provides guarantees. We are not going to return to the letters de cachet of the Ancien Régime”.
Currently, psychiatric care without consent is possible at the request of the prefect in connection with a serious disturbance of public order, “if a medical expert has issued the treatment order and if a mental pathology requires treatment”specifies Michel David, former president of the French Federation of Psychiatry.
Several hospital players also point out the “decay of psychiatry”in deep crisis. “In 1999, the public hospital followed 1 million people. Today there are between 2.3 and 2.4 million patients, with fewer psychiatrists”, recalls Jean-Pierre Salvarelli. The main organizations of hospital psychiatrists have repeatedly denounced the “advanced disrepair” of the sector and the “great contempt for the government”.
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