Finding the moral heart of treatment: Mental health care in a French prison

The psychiatric report as moral tool: A case study in a French district court

“…An initial article presented the results of research looking at prison psychiatry (Fernandez and L ez e, 2011) and here we shall now look at forensic psychiatry. In order to complete this research about the way in which this social filter functions, we combined and intersected several techniques of inquiry (observing legal proceedings, analysing reports and conducting individual interviews) in the context of a collective study funded by the "Mission de recherche Droit et Justice" [Law and Justice Research Programme of the French Minist ere de la Justice [Ministry or Department of Justice] (Fernandez et al, 2011). The results of this research were then developed and discussed within the European research programme entitled "Towards a critical moral anthropology" (Advanced Grant European Research Council, 2010e2013) comparing the moral economies implemented in legal, penal and medical institutions of social control.…”

“…As the policy initiated in the 1960s of removing psychiatric care from the hospital context continues to run its course, the deficit of means allocated to public psychiatry can be seen in both the shortage of court appointed forensic psychiatrists (700 for the whole of France) and the shortage of hospital beds in prisons (Fernandez and L ez e, 2011).…”

“…We define this notion as the art of managing or treating populations through moral sentiments and as a way of understanding the unequal distribution of attention and human worth in contemporary societies (Fassin and Rechtman, 2009;Fernandez and L ez e, 2011).…”

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

“…Both in France (Le Bianic, 2011) and in the United Kingdom (Rose, 1998), authors underline the broadening of psychiatrists' role as experts for defining and assessing dangerousness. In the French case, Fernandez and Lézé (2011) also emphasize that prison psychiatrists insist on their humanitarian role in alleviating suffering, which some interpret as instituting compassion as "a moral disguise and an ethical counterpoint" to security-driven policies (Fassin, 2013). Lorna Rhodes' ethnography (2004) of mental health practices in Supermax prison in the United States has delved into the complex interplay between mental health care and custodial requirements, which places rationality as a major criterion for differentiating the two.…”

“…Some are hospital patients, others are mentally disordered offenders, whether convicted and sentenced or not. In these situations of "fluid boundaries between care, surveillance and punishment" (Fernandez and Lézé, 2011), the signification attributed to confinement remains ambiguous.…”