Skip to main content
Log in

Confinement and Psychiatric Care: A Comparison Between High-Security Units for Prisoners and for Difficult Patients in France

Culture, Medicine, and Psychiatry Aims and scope Submit manuscript

Abstract

This paper examines the uncertain meaning of confinement in psychiatric care practices. Investigating the recent expansion of high-security units in French public psychiatry, for patients with dangerous behavior (units for difficult patients) and for suffering prisoners (specially equipped hospital units), we aim to understand psychiatry’s use of confinement as part of its evolving mandate over suffering individuals with violent behavior. Although historically the epicenter of secure psychiatric care for dangerous individuals shifted from the asylum to the prison, a review of public reports and psychiatric literature demonstrates that psychiatrists’ attempt to reclaim confinement as part of therapeutic practice underpinned the recent development of new units. Institutional-level analysis emphasizes psychiatry’s enduring concern to subordinate social defense motives to a therapeutic rationale. Analyzing local professionals’ justifications for these units in two emblematic hospitals, the paradoxical effects of a security-driven policy arise: they allowed the units’ existence, yet prevented psychiatrists from defending a genuine therapeutic justification for confinement. Instead, professionals differentiate each unit’s respective mission, underlining the concern for access to care and human dignity or defending the need for protection and safety from potentially dangerous patients. This process reveals the difficulty of defining confinement practices as care when autonomy is a core social value.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Notes

  1. This research is part of CONTRAST, a larger project focusing on the new regulations of coercion in treatment situations and funded by the Agence Nationale de la Recherche.

  2. Over the course of the 18th century, alienists established themselves as a profession by seeking to differentiate the mad from the criminal (Castel 1977; Foucault 1981). The notion of irresponsibility for reason of insanity was introduced in 1810 in the French Penal Code (Guignard 2005). Special hospital settings for the insane were created in 1838; the status under which patients were admitted was based on their incapacity to govern themselves (Eyraud 2008). Inmates who were considered both insane and dangerous have been the object of concern since the beginning of psychiatry’s history; they trigger persistent debates and policy propositions throughout the 19th century (Renneville 2003). In 1902, French alienists distinguish between two categories of problematic patients in the asylum (Pactet et Colin 1902). On the one hand are the “criminels aliénés,” or criminally insane patients, so named to emphasize the precedence of the criminal activities and the fact that they belong in the prison, although they are in need of treatment. On the other hand, the “aliénés criminels,” or insane patients prone to criminal activities, within and outside of the asylum, are primarily in need of care and are the responsibility of alienists. There is considerable debate among professionals about the delimitation of these categories, especially regarding criminals who have been judged irresponsible by reason of insanity, as well as about the adequate setting where they should be confined and receive care.

  3. Circulaire du 12 décembre 1905, dite «Chaumié».

  4. Circulaire n° 109 du 5 juin 1950 relative aux services spéciaux pour malades difficiles.

  5. These units are located in Montfavet Hospital in 1947, in Sarreguemines Hospital in 1957, and in Cadillac Hospital in 1963. There were 400 beds for the whole country. The ratio is thus of five UMD beds for 1,000 hospital beds in 1990 and reaches 9 p.1000 in 2000 after nearly half the hospital beds had closed.

  6. In later years, various planning and policy reports advocated for local closed units as a way to compensate the opening of the hospital as well as the decreased staffing. An official Bulletin in May 9th, 1974 on psychiatric care planning mentions «the opportunity of having small intensive care units, which could be closed if necessary» (Circulaire DGS/891/MS 1 du 9 mai 1974 relative à la mise en place de la sectorisation psychiatrique). Yet, only a few have persisted or actually been created in the 2000s.

  7. In the course of the 20th century and particularly after World War II, prisoners’ access to mental health care was organized. At first, the Ministry of Justice opened local consultation centers in some prisons with mental health professionals working under the authority of the prison director. These experiments were established gradually as prison authorities and psychiatric services underwent various waves of reform (Circulaire AP 67-16 du 30 septembre 1967, règlement intérieur des CMPR du 28 mars 1977). A 1986 decree defines the comprehensive set of mental health care services in prison, including consultation as well as “day hospital” (Décret du 14 mars 1986 portant création des SMPR, arrêté du 14 décembre 1986). For details, see Senon (2006) and Rollin, Laurent et Brahmy (2005).

  8. Loi du 18 janvier 1994 et Décret n° 94–929 du 27 octobre 1994 relatifs aux soins dispensés aux détenus par les établissements de santé, circulaire n° 45 du 8 décembre 1994 relative à la prise en charge sanitaire des détenus et à leur protection sociale.

  9. Psychiatric care in prison has developed mainly as outpatient care delivered in custody to a voluntary detainee. When hospitalization is needed, the prisoner is involuntarily committed and transferred to a regular hospital unit where he under medical authority; a strict distinction between patient and prisoner statuses is maintained.

  10. This concern develops in several directions. While concern is renewed about the danger posed by people suffering from mental illness, especially in its consequences on mental health professionals’ workplace violence, public policies are equally concerned with the abuse patients experience in health care settings (Velpry 2014).

  11. An official report on patient’s dangerousness (Lopez et al. 2006) lists seven such local initiatives.

  12. In 2005, these local preoccupations will participate in creating a national “Observatory on violence” attached to the Department of Health, whose mission is to collect all the violent events happening in hospitals and to help prevent them. More broadly, in the perspective of designing a public policy regarding “Violence and Health” issues (Turz 2006), a national committee will be dedicated to “Violence and mental health.”

  13. The European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) and a national independent authority, the General Inspection of Places of Deprivation of Liberty (CGLPL) regularly visit and publish reports regarding psychiatric detention (CPT 2010; CGLPL 2012).

  14. The danger posed by mental health patients has been abundantly discussed between criminologists and psychiatrists during most of the 20th century, especially in the relation of the latter to the justice system as experts (Protais 2014). These discussions subsided in the 1970s.

  15. Within the psychiatric community, this renewal is tied to the policy of “dehospitalization.” In his introductory address at the 8th joint meeting of prison and UMD psychiatrists, the psychiatrist Bourgeois emphasizes the adverse consequences of opening the hospital to justify the choice of dangerousness as the annual theme: “The closing of psychiatric units and the reduced number of hospital beds, which are usually described as a progress for psychiatry, seem to correlate with a rise in criminal violence among the mentally ill.” (De Beaurepaire et al. 2004, 155).

  16. This attempt is reminiscent of the import of the US-risk literature in the UK, described by Rose (1998). They will also go toward risk and actuarial assessment of dangerousness, but later and more timidly (LeBianic 2011).

  17. In addition to the secured units within the hospital being finally called “Intensive Care Psychiatric Units,” seclusion rooms were renamed “Intensive care rooms.” The same term is used in the 1986 decree defining UMDs. As early as 1991, psychiatrists from one of the then four UMDs described the evolution of the unit’s therapeutic project as becoming “a place where intensive care is delivered to psychotic individuals who are often severely affected and, for most of them, in an acute state.” (Castandet 1991, 406).

  18. Circulaire DHOS du 16 juillet 2007.

  19. Le Vinatier and Villejuif are both vast hospitals situated in urban areas, where real estate pressure is high and the need to justify space occupation thus pressing. For hospitals located in more rural settings, though, the new security units can be an opportunity to avoid closure.

  20. Various funding plans in that period addressed the decay of old hospitals. They are defined along two rationales. One aim is to improve and renovate the hospital buildings and campus; the other is to comply with new requirements concerning norms of security and functioning. These new norms in health institutions concern fire hazards, health hazards, emergency care… (Ministère de la santé, 2007).

  21. Covering more than 100 ha at the start of the 20th century, the land devoted to psychiatry has progressively been sold or used for other purposes. The estate’s “sound management” (gestion avisée) is nonetheless one of the head of prison psychiatry, Dr. Lamothe’s arguments when explaining the choice for implanting this first UHSA in Le Vinatier (Lamothe, Projet de soin, 2007). He also underlined the importance of having local politicians’ support, as is the case in Villejuif.

  22. The regional health authorities’ director ordered a report regarding « treatment for potentially dangerous patients » , which concluded with the need for a UMD for « difficult—and potentially dangerous—patients requiring long term specialized care » . They evaluated the local need to be 50 patients per year (Lombard et al. 2008, p. 19).

  23. Or “rétention de sûreté,” which provide that persons found guilty of sexual or particularly violent offenses could be detained after they have served their sentence, if they are found at risk of dangerousness or of recidivism.

  24. Other actors than hospital staff point to a risk of mixing security and care in the UHSAs. In a 2011 report on a visit of Le Vinatier’s UHSA, the European Committee for the Prevention of Torture’ recommended that prison staff be less involved in UHSA’s functioning.

  25. The law (Loi dite HPST, du 21 juillet 2009 portant réforme de l'hôpital et relative aux patients, à la santé et aux territoires) launched a massive reorganization of hospital governance. In French public psychiatry, the reform put an end to the “secteur psychiatrique” as organizing principle of the mental health system. This set of complementary mental health services provided for each territory was the core organizational principle of mental health services since the 60s.

  26. Article R3222-1 du Code de Santé Publique créé par le décret n° 2011-847 du 18 juillet 2011 relatif aux droits et à la protection des personnes faisant l'objet de soins psychiatriques et aux modalités de leur prise en charge–art. 6.

  27. Until the creation of UHSAs, the only way for prisoners to be hospitalized was under the status of involuntary commitment, in regular hospitals. According to the date available, in 2010 and 2011, 51 and 53 % of Le Vinatier’s UHSA’s admission were voluntary (UHSA 2012). Data for Villejuif’s UHSA were not available yet.

  28. Le Vinatier UHSA has a mean duration of stay between 46 and 72 days, close to the 66 days mean duration of stay of the general hospital.

  29. Circulaire interministérielle DGOS/R4/PMJ2/2011/105 du 18 mars 2011 relative à l'ouverture et au fonctionnement des unités hospitalières spécialement aménagées (UHSA).

References

  • Alezrah, Charles and Bobillo, Jean-Marc 2004 Portes ouvertes ou fermées en hospitalisation temps plein?. L’information psychiatrique 80(7):571–578.

    Google Scholar 

  • Barrès, Michel, and Danièle, Fuchs 1990 Les unités pour malades difficiles. Rapport au ministre de la Solidarité, de la Santé et de la Protection sociale. Document de travail.

  • Bergman-Levy, Tal, Avi Bleich, Moshe Kotler and Yuval Melamed 2010 Security and psychiatry: the British experience and implications for forensic psychiatry services in Israel. Israel Medical Association Journal 12(10):587-91.

    Google Scholar 

  • Bodin, Romuald 2012 Les métamorphoses du contrôle social. Paris: La Dispute.

    Google Scholar 

  • Bouagga, Yasmine 2013 Ils ont fait le choix d’être ici, ils assument. Morale punitive et sens de la responsabilité dans les unités de haute sécurité aux Etats-Unis. In Economies morales contemporaines. Didier Fassin and Jean-Sébastien Eideliman, eds. Paris: La Découverte.

    Google Scholar 

  • Brodwin, Paul 2013 Everyday Ethics: Voices from the Front Line of Community Psychiatry. Berkeley, CA: University of California Press.

    Google Scholar 

  • Burgelin, Jean-François 2005 Santé, justice et dangerosités : pour une meilleure prévention de la récidive. Rapport de la Commission santé-justice, Ministère de la justice, juillet.

  • Busfield, Joan 1986 Managing Madness: Changing Ideas and Practice. London: Hutchinson.

    Google Scholar 

  • Carrier, Nicolas 2010 Anglophone Sociologies of the Punitive Turn: Critical Shyness, Totalizing and Reductive Perspectives. Penal Field. New International Journal of Criminology 7.

  • Cartuyvels, Yves, with Brice Champetier and Anne Wyvekens 2010 Soigner ou punir ?-Un regard critique sur la défense sociale en Belgique. Bruxelles: Publications des Facultés Universitaires Saint-Louis.

    Google Scholar 

  • Castandet, Philippe 1991 Le pavillon fermé est-il anachronique? In L’information psychiatrique 67(5).

  • Castel, Robert 1977 L’ordre psychiatrique. L’âge d’or de l’aliénisme. Paris: Ed. de Minuit.

    Google Scholar 

  • Castel, Robert 1983 De la dangerosité au risque. Actes de la recherche en sciences sociales 47:119-127.

    Article  Google Scholar 

  • Chabannes, Jean-Marc 2004 Les unités d’hospitalisations spécialement aménagées (UHSA), ou le résultat d’un divorce malheureux. l’Information Psychiatrique 80(4):291-4.

    Google Scholar 

  • Coldefy, Magali, ed. 2007 La prise en charge de la santé mentale : recueil d’études statistiques. Paris: La Documentation française.

    Google Scholar 

  • Colin, Henri 1912 Le quartier de sûreté de Villejuif. Annales médico-psychologiques 2:370-391.

    Google Scholar 

  • Colin, Marcel, and Jacques Hochman 1963 Diagnostic et traitement de l’état dangereux. In Etudes de criminologie clinique. Marcel Colin, ed. Paris: Masson.

    Google Scholar 

  • Conrad, Peter 1992 Medicalization and Social Control. Annual Review of Sociology 18:209-32.

    Article  Google Scholar 

  • Davidson, Larry 2012 Use of coercion in recovery-oriented care: Staying vigilant. Psychiatric Services 63(8):834.

    Article  Google Scholar 

  • De Beaurepaire, Christiane, with Michel Bénézech and Christian Kottler 2004 Les dangerosités : de la criminologie à la psychopathologie, entre justice et psychiatrie. John Libbey Eurotext.

  • Desia, Anne, and G.ustave Robbe 1998 Aspects Techniques des Soins pour des Patients Psychotiques Dangereux dans L’unité pour Malades Difficiles Henri Colin. Forensic: revue de psychiatrie légale 18:19–20.

    Google Scholar 

  • Dormoy, Odile, ed 1995 Soigner et/ou punir. Questionnement sur l’évolution, le sens et les perspectives de la psychiatrie en prison. Paris: L’Harmattan.

    Google Scholar 

  • Dubret, Gérard 2008 UHSA : Un Formidable Effort Dans La Mauvaise Direction. L’information Psychiatrique 84:543–50.

    Article  Google Scholar 

  • Esposito, Eric, and James, Thomas 2000 Etude des situations de violence dans un service de psychiatrie adulte. Revue Française de Psychiatrie et de Psychologie Médicale IV(43).

  • Eyraud, Benoit 2008 Prise en charge thérapeutique et protection des intérêts civils: des institutions aux enjeux imbriqués. In Psychiatries dans l’histoire. Jacques Arveiller, ed. Presses universitaires de Caen.

  • Eyraud, Benoît, and Livia, Velpry 2011 Ce que l’histoire de la psychiatrie nous dit de la psychanalyse et de l’utilitarisme. Revue du MAUSS 37.

  • Eyraud, Benoît and Delphine, Moreau 2013 Formes et régulations de l’enfermement psychiatrique: de la création de l’asile aux nouvelles unités sécurisées, l’exemple de l’hôpital du Vinatier. Cultures et conflits 90(été).

  • Fassin, Didier, and Jean-Sébastien Eideliman, eds 2013 Economies morales contemporaines. Paris: La Découverte.

    Google Scholar 

  • Fatome, Thomas, with Michel Vernerey, Françoise Lalande, Martine Valdes, Boulouque and Blandine, Froment 2001 L’organisation des soins aux détenus. Rapport d’évaluation, IGAS/ISGJ.

  • Fau-Vincenti, Véronique 2011 Le Concept “d’aliéné difficile” à la source des UMD. Santé Mentale 154(Janvier).

  • Fenell, Philipp 1996 Treatment Without Consent: Law, Psychiatry and the and the Treatment of Mentally Disordered People Since 1845. London: Routledge.

    Book  Google Scholar 

  • Fernandez, Fabrice, and Samuel Lézé 2011 Finding the moral heart of carceral treatment. Mental health care in a French prison. Social science and Medicine 72(9):1563-1569.

    Article  Google Scholar 

  • Foucault, Michel 1981 L’évolution de la notion d’”individu dangereux” dans la psychiatrie légale. Déviance et société 5(5-4):403-422.

    Article  Google Scholar 

  • Garland, David 2001 The culture of control. Crime and social ordre in contemporary society. University of Chicago Press.

    Google Scholar 

  • Garraud, Jean-Paul 2006 Réponses à la dangerosité. Rapport de la mission parlementaire sur la dangerosité et la prise en charge des individus dangereux.

  • Gauchet, Marcel, and Gladys Swain, 1980 La pratique de l’esprit humain. Paris: Gallimard.

    Google Scholar 

  • Gaussarès, Christian, and André Poirel 1991 Etude du flupentixol et du décanoate de flupentixol chez des malades psychotiques hospitalisés en unité pour malades difficiles. Nervure 4(1):24-28.

    Google Scholar 

  • Goffman, Erving 1961 Asylums: Essays on the Social Situation of Mental Patients and Other Inmates. Anchor Books.

  • Goldstein, Jan 1987 Console and Classify: The French Psychiatric Profession in the Nineteenth Century. Cambridge : Cambridge University Press.

    Google Scholar 

  • Gonin, Daniel 1991 La santé incarcérée: médecine et conditions de vie en détention. L’Archipel.

  • Goujon, Philippe and Charles Gautier 2006 Les délinquants dangereux atteints de troubles psychiatriques : comment concilier la protection de la société et une meilleure prise en charge médicale? Les rapports du Sénat, juin.

  • Guignard, Laurence 2005 L’irresponsabilité pénale dans la première moitié du XIXe siècle, entre classicisme et défense sociale. Champ pénal/Penal field, XXXIVe Congrès français de criminologie, Responsabilité/Irresponsabilité Pénale, http://champpenal.revues.org/368, accessed July 17, 2005.

  • Guignard, Laurence, with Hervé Guillemain and Stéphane Tison, eds. 2013 Expériences de la folie. Criminels, soldats, patients en psychiatrie (XIXe-XXe siècles). Rennes: PUR.

  • Harcourt, Bernard 2006 From the Asylum to the Prison: Rethinking the Incarceration Revolution. Texas Law Review 84(7):1751-1786.

    Google Scholar 

  • Haute Autorité de Santé 1998 L’audit clinique appliqué à l’utilisation des chambres d’isolement en psychiatrie. Paris: HAS.

    Google Scholar 

  • Haute Autorité de Santé 2010 Dangerosité psychiatrique: étude et évaluation des facteurs de risque de violence hétéro-agressive chez les personnes ayant des troubles schizophréniques ou des troubles de l’humeur. Paris: HAS.

    Google Scholar 

  • Hejtmanek, Katie 2010 Caring through retraint: violence, intimacy and identity in mental health practice. Culture, Medicine and Psychiatry 34: 668-674.

    Article  Google Scholar 

  • Henckes, Nicolas 2011 Reforming psychiatric institutions in the mid-twentieth century: a framework for analysis. History of Psychiatry 22(2): 164-181.

    Article  Google Scholar 

  • Hyest, Jean-Jacques, with Guy-Pierre Cabanel 2000 Prisons: une humiliation pour la République. Paris, Sénat, décembre.

  • Kleinman, Arthur 1988 The illness narratives. Suffering, Healing and the Human Condition. Basic Books.

    Google Scholar 

  • Kottler, Christian, and Christiane de Beaurepaire, eds 2005 Dangerosité et psychiatrie. Perspectives psy 44(3):176–177.

  • Kottler, Christian 1997 UMD et thérapeutique. Revue Française de Psychiatrie et de Psychologie Médicale (6).

  • Kottler, Christian, with Jean Gouyon, Gabriel Robbe and Jean-Luc Senninger 1998 Unités pour malades difficiles. Encyclopédie Médico-Chirurgicale 37-952-A-10.

  • Labouret, Olivier 2012 Le nouvel ordre psychiatrique. Toulouse: Erès.

    Book  Google Scholar 

  • Lachaux, Bernard 2011 Les unités de malades difficiles: d’une histoire sécuritaire à un projet de soins intensifs en psychiatrie. In La psychiatrie à l’épreuve de la justice: contribution au débat. Granger Bernard, ed. Twice Daily.

  • Lamb, H. Richard, and Linda E. Weinberger 1998 Persons With Severe Mental Illness in Jails and Prisons: A Review. Psychiatric Services.

  • Lamothe, Pierre 1997 Psychiatrie en milieu pénitentiaire. Revue Française Des Affaires Sociales 51:151–160.

    Google Scholar 

  • Lamothe, Pierre, with Becache Eve and Meunier Hubert 2011 L’UHSA: un symbole et une avancée majeure. Gestions Hospitalières (506).

  • Le Bianic, Thomas 2011 Certified expertise and professional responsibility in organizations: the case of mental health practice in French Prisons. Sociological Review 59(4): 803-827.

    Article  Google Scholar 

  • Le Bihan, Patrick, with David Esfandi, Claude Pagès, Sylvie Thébault and Jean-Benoît Naudet 2009 Les Unités de Soins Intensifs Psychiatriques (USIP): expériences françaises et internationales. Médecine et Droit :138–145.

  • Lendemeijer, B., and L. Shortridge-Baggett 1997 The use of seclusion in psychiatry: A literature review. Scholarly Inquiry for Nursing Practice 11(4): 299–320.

    Google Scholar 

  • Litzler, A. 2013 Soigner et surveiller en UHSA, Archives de politique criminelle, n° 35.

  • Lombard, Catherine, with Claire Sellier, Marie-José Dodon, Florence Jason 2008 La prise en charge des patients susceptibles d’être dangereux. DRASS Rhône-Alpes.

  • Lopez Alain, with Ramiro Riera, Simon Babre, Joëlle Bourquard, Françoise Thomas and Gérard Laurand 2006 La prise en charge des patients susceptibles d’être dangereux. Paris: IDA/IGSJ/IGAS.

  • Lovell, Anne. M. 1996 Coercion and social control: A Framework for research on aggressive strategies in community mental health. In Coercion and Aggressive Treatment: A New Frontier in Mental Health Law. Deborah Dennis, John Monahan, eds. New York: Plenum Publishing.

    Google Scholar 

  • Luhrmann, Tanya 2000 Of two minds: the growing disorder in American psychiatry. New York: Knopf.

    Google Scholar 

  • Massé, Gérard 1992 Bilan et perspectives de la politique de santé mentale en France. Rapport pour le Ministère de la santé.

  • Mermaz, Louis, and Jacques Floch 2000 La France face à ses prisons: Rapport. Assemblée nationale.

  • Moon, Graham 2000 Risk and Protection: the Discourse of Confinement in Contemporary Mental Health Policy. Health Place 6(3): 239-250.

    Article  Google Scholar 

  • Moreau, Delphine and Caroline Protais 2009 L’expertise psychiatrique entre l’évaluation de la responsabilité et de la dangerosité, entre le médical et le judiciaire: Commentaire du texte de Samuel Lézé. Champ pénal/Penal field [En ligne] http://champpenal.revues.org/7120.

  • Mucchielli, Laurent, ed. 2007 La frénésie sécuritaire. Retour à l’ordre et nouveau contrôle social. Paris :La Découverte.

    Google Scholar 

  • Pactet, Florentin and Henri Colin 1902 Les aliénés dans les prisons: aliénés méconnus & condamnés. Encyclopédie scientifique des aide-mémoire. Paris: Masson.

    Google Scholar 

  • Piel, Eric and Jean-Luc Roelandt 2001 De la psychiatrie vers la santé mentale. Paris: Ministère de la santé.

    Google Scholar 

  • Pradier, Pierre 1999 La gestion de la santé dans les établissements du programme 13000: évaluation et perspectives. Paris: Ministère de la Justice.

    Google Scholar 

  • Protais, Caroline 2014 Psychiatric care or social defense? The origins of a controversy over the responsibility of the mentally ill in French forensic psychiatry. International Journal of Law and Psychiatry. 37. pp. 17-24.

    Article  Google Scholar 

  • Renneville, Marc 2003 Crime et folie: Deux siècles d’enquêtes médicales et judiciaires. Paris: Fayard.

    Google Scholar 

  • Rhodes, Lorna 2004 Total confinement. Madness and reason in maximum security prison. Berkely, CA: University of California Press.

    Google Scholar 

  • Rose, Nikolas 1998 Governing risky individuals: The role of psychiatry in new regimes of control. Psychiatry, Psychology and Law 5(2). 177-195.

    Article  Google Scholar 

  • Rouillon, Frédéric, with Anne Duburcq, Francis Fagnani and Bruno Falissard 2004 Etude épidémiologique sur la santé mentale des personnes détenues en prison. Paris : Ministère de la santé, de la jeunesse et des sports.

    Google Scholar 

  • Sautereau, Marie, with Herminie Leca, Aurélie Vittoz, Frédéric Meunier and Pierre Lamothe 2009 Les évolutions législatives françaises: un pas de plus vers la confusion justice psychiatrie. À propos de la loi du 25 février 2008 relative à la rétention sûreté et à la déclaration d’irresponsabilité pénale pour cause de trouble mental. Erudit 9(1).

  • Scull, Andrew 1985 Deinstitutionalization and public policy. Social Science and Medicine 20(5). 545-552.

    Article  Google Scholar 

  • Senon, Jean-Louis, with Cyril Manzanera, Mikael Humeau and Louise Gotzamanis 2006 Les malades mentaux sont-ils plus violents que les citoyens ordinaires? L’Information Psychiatrique 82(8). 645–652.

    Article  Google Scholar 

  • Simon, Jonathan 2007 Governing through Crime: How the War on Crime Transformed American Democracy and Created a Culture of Fear. New York: Oxford University Press.

    Google Scholar 

  • Thevenon, Colette, with Evry Archer, Jean-Jacques Revillion, and Louise Turi 2000 Malades mentaux dangereux, états des lieux et perspectives. Revue Française de Psychiatrie et de Psychologie Médicale(35).

  • Tursz, Anne 2006 Violence et santé. Rapport préparatoire au plan. Paris: La Documentation Française.

    Google Scholar 

  • Vacheret, Marion and Denis Lafortune 2011 Prisons et santé mentale, les oubliés du système. Déviance et société 35(4).

  • Velpry, Livia In press Moderniser l’enfermement en psychiatrie. Sociétés contemporaines.

  • Velpry Livia, Benoît Eyraud et al. 2014 Réguler les pratiques contraignantes de soin en santé mentale: recompositions et enjeux, in Cécile Hanon et Jean-Charles Pascal (dir.). Consentement et contrainte en psychiatrie. Paris: Collection Polémiques, Ed Doin.

  • Wacquant, Loic 2009 Punishing the poor: the neoliberal government of insecurity. Duke University Press.

    Book  Google Scholar 

  • Wolff, Nancy 2002 Risk, Response, and Mental Health Policy: Learning from the Experience of the United Kingdom. Journal of Health Politics, Policy and Law 27(5). pp. 801-32.

    Article  Google Scholar 

  • Zambrowski, François 1986 Moderniser et diversifier les modes de prise en charge de la psychiatrie française. Rapport de mission.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Livia Velpry.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Velpry, L., Eyraud, B. Confinement and Psychiatric Care: A Comparison Between High-Security Units for Prisoners and for Difficult Patients in France. Cult Med Psychiatry 38, 550–577 (2014). https://doi.org/10.1007/s11013-014-9400-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11013-014-9400-0

Keywords

Navigation