Confronted with allegations of “Fail” In the psychiatric follow-up of the perpetrator of the Paris attack, psychiatrists are moved by an accusation “hot” in a case that mixes jihadism and pathology, and denounce “a gross attack on an already mistreated profession”.

Gérald Darmanin highlighted, Monday, December 4, a “psychiatric failure” in the aftermath of the young radical Islamist who carried out the fatal knife attack near the Eiffel Tower in Paris on Saturday evening, added “The doctors were convinced several times that he was getting better”.

“The Home Secretary’s comments are beginning to move the psychiatric community. To speak of a failure of psychiatry is a pretty gross attack on our already mistreated profession.”, Bernard Granger, professor of psychiatry at Paris Cité University, told Agence France-Presse. He regrets “A hot reaction in which we are looking for those responsible”and point “The uncertainties about the measures taken are still very high”.

A person “can live out despite good treatment”

“It’s a little strong coffeeagrees Michel Triantafyllou, president of the union of public psychiatrists. Linking psychiatric disorders to the commission of terrorist attacks 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 evade their responsibilities” face the grievances of society.

“What prevailed [chez l’assaillant] : jihadist ideology or mental illness, which could also have been re-triggered or exacerbated in light of events in the Middle East? »asks Alain Mercuel, coordinator of the mobile psychiatric and precarity teams in Ile-de-France and psychiatrist at the Sainte-Anne hospital.

Discontinuing the neuroleptic may be helpful “endorsed the act because the person was capable of decompensating.”but a person “can be able to act despite well-cared-out treatment”notes Alexandre Baratta, who works in a psychiatric intensive care unit in Sarreguemines.

In his unity, “Three patients suffer from serious mental illnesses, are highly susceptible to radical Islamism, would not necessarily take action, but can be instrumentalized” because their pathology defines them “vulnerable” And “more violent”, he explains. In case of “Warning signals”the doctor can notify the sentencing judge.

“Great contempt for the government”

The attacker in Paris was listed for Islamist radicalization (FSPRT). “subject to a treatment order with strict psychiatric supervision and control by a coordinating doctor” until the end of the probation on April 26, 2023, after a new psychiatric assessment, said the anti-terrorism prosecutor Jean-François Ricard on the evening of Sunday, December 3.

At the end of October, the attacker’s mother saw her son “withdrawn into oneself”He filed a report with the police, who tried in vain to have him examined by a doctor and automatically admitted to the hospital as no problems arose, according to a source familiar with the case. The mother did not want to request compulsory hospitalization.

Interior Minister Gérald Darmanin demanded this from the authorities on Sunday “may require a restraining order for care.” for monitoring a radicalized person for psychiatric disorders in order to prevent acts of violence.

“It is very difficult to treat people under coercion, especially when the ideology is massive”emphasizes Alain Mercuel from Sainte-Anne Hospital. “The interim care order can be useful, but it is not a miracle cure.”thinks Bernard Granger, who also mentions “Implementation difficulties” (Delay, lack of staff). And “The compulsory hospitalization procedure offers guarantees. We will not return to the Letters de Cachet of the Ancien Régime.”.

Currently, at the request of the prefect in connection with a serious disturbance of public order, psychiatric care is possible without consent, “if a medical expert has given the treatment order and a mental illness requires treatment”specifies Michel David, former president of the French Federation of Psychiatry.

Several hospital players also point this out “Decline of Psychiatry”in deep crisis. “In 1999, the public hospital served one million people. Today there are between 2.3 and 2.4 million patients with fewer psychiatrists.”, remembers Jean-Pierre Salvarelli. The main organizations of hospital psychiatrists have repeatedly denounced this “advanced decay” of the sector and the “great contempt for the government”.