Section 6 “Fundamental Rights put to the test by Mental Health” Numerous studies and reports show that the current period appears to be marked by a return to viewing patients essentially in terms of the danger that they may present. Yet, since the 19th century at least, criminal law and psychiatry have formed a sometimes infernal couple, successively or simultaneously sharing the management of dangerousness. Sometimes the balance has tipped in favour of treatment and sometimes on the side of repression. But never as today in a new combination, which could be described as fearsome, of treatment and constraint, of treatment and confinement. Although the 1970s witnessed the progressive disappearance of exclusive reliance on asylums, promoted by the anti-authoritarian social movements of the time (Basaglia, Guattari and anti-psychiatry), one can only note that today the psychiatric and criminal approaches are often combined in order to deal with dangerousness. Sexual offenders, recidivist of all kinds, convicted prisoners – sometimes serving long sentences – in spite of the existence of mental disorders, to each category its type of confinement. New institutions have been created, ever more specialised but evermore closed (young offenders’ institutions, specially-equipped hospitalisation units, secure socio-medicaljurisprudence centres etc.). In this context, and beyond their possible dangerousness (a notion whose definition is not without posing difficulties245), persons deprived of liberty suffering from mental disorders often find themselves placed in a very special situation. Apart from the ideological context, major institutions stress the worrying rise of psychiatric pathologies: thus the WHO notes that, amongst the ten pathologies giving most cause for concern at the dawn of the 21st century, five are mental in nature246. Places of deprivation of liberty are no exception to this reality. Indeed, at the time of their inspections of closed institutions, not only in prisons but also in detention centres for illegal immigrants (CRA), young offenders’ institutions (CEF) and police custody facilities, the members of the Contrôle Général were struck by the number of persons deprived of liberty appearing to be suffering from psychic disorders. This empirical observation is confirmed by the arguments brought up by the staff of these institutions, all of whom mention an increase in mental disorders among the persons for whom they are responsible. Behavioural disorders, delirious assertions, hallucinations, aggravated assault, commission of suicidal acts etc. mental illness is manifested in a wide range of different symptoms. The reasons leading to the presence and maintenance of these persons in institutions which are a priori little-suited to their condition and the way in which healthcare could be provided for them in the latter did not always appear to be pertinent. The case of persons who are doubly weakened, by 245 Cf. Annual Report of the Contrôle Général for 2011, p. 63 et seq. 246 Depression, schizophrenia, bipolar disorder, addictions and obsessive behavioural disorders. 159

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