Gérald Darmanin had pointed this out A “psychiatric failure”. Almost a month after Armand Rajabpour-Miyandoab’s attack in Paris on December 2, which left one dead and two injured near the Eiffel Tower, the excitement has subsided and the controversy has ebbed. But in the ranks of psychiatrists, the Interior Minister’s direct attack on the psychiatric care of the radicalized young man has not been forgotten. Implicitly, it is the question of coercion and the “locking up of the crazy” that the Interior Minister has once again brought into the public debate. And he’s not the first, doctors remind us.

Most news stories about people undergoing psychiatric treatment receive extensive commentary. The five-fold murder of Meaux (Seine-et-Marne), committed on December 25th by a 33-year-old man who was already in hospital, was no exception. The mayor of the city, Jean-François Copé (Les Républicains, LR), condemned the “ inadequate “Collaboration between medical services, social and legal services” and a “Taboo around psychiatric topics”.

Faced with this political challenge, psychiatrists made the same observation, contradicting the prevailing discourse: never before have there been so many forced hospitalizations, i.e. decisions about the treatment of patients with psychiatric illnesses without consent.

At other times we spoke of internment, forced or voluntary confinement, or even compulsory or compulsory hospitalization. Since two laws – passed in 2011 and 2013 – established the regulation, which is still in force, this care carried out without the patient’s consent, an exception in medicine, can intervene at the request of the prefect in the event of a disturbance of public order , at the request of a third party or in the case of “imminent danger”, when it is impossible to find a loved one. In any case, a certain number of psychiatric certificates must certify a psychological condition that justifies the impossibility of consent and the need for care.

These two laws also allow professionals to provide this care without consent on an outpatient basis and no longer just during hospital stays “Nursing programs”.

“Significant increase” in France

According to the latest official figures, this trend is beyond doubt. “There has been a significant increase in the use of this care between 2012 and 2021.”we can read in a note from the Institute for Research and Documentation in Health Economics (Irdes) from June 2022, in which a “inflection” since 2015.

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