Soins psychiatriques en détention : quelles spécificités ?

Abstract

Although epidemiological studies of the mental health of prisoners are limited, the literature is unanimous about the higher-than-average number of psychological disorders in the prison population, estimated in France to be 71,678 persons on June 1, 2022. While the psychiatric practice in prisons is perceived to be distinctive, are there objectively identifiable differences in terms of semiology and/or practice? What are its specificities? The literature underlines the epidemiological singularities regarding the distribution of psychological disorders in detention, but also the existence of particular clinical forms. Four approaches lend themselves to discussion, taking into account the problematic nature of each one: treating classical pathologies in an unusual setting, creating the dynamics of treating patients who have little or no access to treatment outside the prison, confronting penitentiary injunctions and reactionary situations, and finally taking into consideration the function of the psychiatrist, which cannot be limited to the question of pathology.