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Moulia-Pelat E, Pons R, Nabhan-Abou N. L’article 122-1 et après ? Devenir des patients reconnus irresponsables sur le plan pénal, entre 2015 et 2019, dans l’Ouest de la France. ANNALES MEDICO-PSYCHOLOGIQUES 2022. [DOI: 10.1016/j.amp.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fovet T, Thibaut F, Parsons A, Salize HJ, Thomas P, Lancelevée C. Mental health and the criminal justice system in France: A narrative review. FORENSIC SCIENCE INTERNATIONAL. MIND AND LAW 2020; 1:100028. [PMID: 35996435 PMCID: PMC9387428 DOI: 10.1016/j.fsiml.2020.100028] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/29/2020] [Accepted: 07/31/2020] [Indexed: 06/01/2023]
Abstract
The treatment of people diagnosed with mental disorders who committed crimes differ greatly in countries around the world because of the long histories of criminal justice and psychiatry specific to each country. As a result, it is often difficult to grasp the specificities of each system. The main objective of this paper is to provide a narrative review of the interactions between the French mental health and judicial systems. Subsequently, we will discuss how the concept of forensic psychiatry does not yet exist in France and how it can be applied.
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Affiliation(s)
- Thomas Fovet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000, Lille, France
| | - Florence Thibaut
- University of Paris, University Hospital Cochin, AP-HP, INSERM U1266, Institute of Psychiatry and Neurosciences, Paris, France
| | - Anne Parsons
- Department of History, UNC Greensboro, Greensboro, NC, United States
| | - Hans-Joachim Salize
- Central Institute of Mental Health, Medical Faculty Mannheim / Heidelberg University, Mannheim, Germany
| | - Pierre Thomas
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000, Lille, France
| | - Camille Lancelevée
- Fédération de Recherches en Psychiatrie et Santé Mentale des Hauts-de-France (F2RSM Psy), Saint-André-Lez-Lille, France
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Houcinat M, Arcani R, Jouve E, Poinso F, Piercecchi MD, Guivarch J. Views of Medical Examiners and Psychiatrists on the Compatibility of the Mental State with Detention in Police Custody in Marseille University Hospital. J Forensic Sci 2020; 65:1669-1675. [PMID: 33104307 DOI: 10.1111/1556-4029.14484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/17/2020] [Accepted: 05/21/2020] [Indexed: 11/29/2022]
Abstract
Police custody is detention in response to a suspicion of crime. A person in custody has the right to be examined by a physician, who is responsible for determining whether the person's medical condition allows him/her to continue to be held in detention. However, there is no consensus on the definition of compatibility of the mental state with custody. Our objective was to determine the relevant criteria for compatibility and incompatibility of the mental state with detention in police custody according to medical examiners and psychiatrists. A descriptive study using a semi-structured questionnaire was conducted from November 2016 to May 2017 with medical examiners and psychiatrists who examined detainees in police custody in Marseille. We recruited 17 medical examiners and 43 psychiatrists. We identified three sets of criteria used to determine a mental state compatible with custody: care, pathology/disorder, and the context of police custody. The primary determinant of incompatibility was a need for immediate hospitalization, followed by a high suicide risk, psychiatric dangerousness, delusional symptomatology, an inability to understand questions, and an inability for the detainee to defend him-/herself. The psychiatrists and medical examiners differed significantly in their views of suicide risk, delusional symptomatology, and psychiatric diagnosis. Our work has permitted identification of the main determinants of incompatibility of the mental state with custody according to psychiatrists and medical examiners in Marseille. It offers preliminary results to reach a consensus and provide an inventory for physicians to use regarding police custody.
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Affiliation(s)
- Mouna Houcinat
- Department of Psychiatry, Assistance Publique Hôpitaux de Marseille (AP-HM), La Conception University Hospital, 147 Boulevard Baille, Marseille, 13005, France
| | - Robin Arcani
- Department of Internal Medicine and Therapeutics, Assistance Publique Hôpitaux de Marseille (AP-HM), Timone University Hospital, 264 Rue St Pierre, Marseille, 13005, France.,INSERM, INRA, C2VN, Aix Marseille University, Marseille, 13005, France
| | - Elisabeth Jouve
- Department of Medical Evaluation and Public Health, Assistance Publique Hôpitaux de Marseille (AP-HM), La Conception University Hospital, 147 Boulevard Baille, Marseille, 13005, France
| | - François Poinso
- Faculty of Medicine of Marseille, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille, 13385, France.,Department of Child Psychiatry, Assistance Publique Hôpitaux de Marseille (AP-HM), Sainte Marguerite University Hospital, 270 Boulevard de Sainte-Marguerite, Marseille, 13009, France
| | - Marie-Dominique Piercecchi
- Department of Forensic Sciences and Health Rights, Assistance Publique Hôpitaux de Marseille (AP-HM), Timone University Hospital, 264 Rue St Pierre, Marseille, 13005, France.,CNRS, EFS, ADES, Aix Marseille University, 51 Boulevard Pierre Dramard, Marseille, 13015, France
| | - Jokthan Guivarch
- Faculty of Medicine of Marseille, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille, 13385, France.,Department of Child Psychiatry, Assistance Publique Hôpitaux de Marseille (AP-HM), Sainte Marguerite University Hospital, 270 Boulevard de Sainte-Marguerite, Marseille, 13009, France.,ISC-EPRED, EA 1228, Institute for Criminal Sciences, 43 place Charles de Gaulle, Poitiers, 86073, France
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Guivarch J, Piercecchi-Marti MD, Poinso F. Folie à deux and homicide: Literature review and study of a complex clinical case. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2018; 61:30-39. [PMID: 30454559 DOI: 10.1016/j.ijlp.2018.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 05/11/2018] [Accepted: 10/03/2018] [Indexed: 06/09/2023]
Abstract
UNLABELLED Folie à deux is a psychiatric illness involved in homicides. OBJECTIVE To study the mechanisms leading to homicide and determine homicide risk factors in folie à deux patients through a literature review and the study of a complex clinical case. MATERIALS AND METHODS We included articles available on PubMed, ScienceDirect or Cairn that address the forensic implications of folie à deux. Then, we analyzed the criminal psychiatric assessments of two murderers (husband and wife) of a child in a case of folie à deux. RESULTS Seventeen articles were included. In the cases examined, homicides were committed with great violence, usually against a victim in the family circle, and were sometimes followed by suicide. The main risk factor for homicide was the combination of mystical and persecutory delusions. The homicides occurred in response to destabilization of the delusional dyads. Concerning the clinical case, we described the circumstances surrounding the killing and analyzed the four expert reports that permit us to infer the occurrence of induced psychosis, which is a form of folie à deux. DISCUSSION Psychiatrists must attain a better knowledge of folie à deux to allow early identification of risk situations and to improve their assessments.
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Affiliation(s)
- J Guivarch
- Service de pédopsychiatrie, CHU Sainte Marguerite, 270 boulevard de Sainte Marguerite, 13274 Marseille Cedex 9, France; Faculté de medecine de Marseille, Aix-Marseille Université, France; Institut des Sciences Criminelles, Poitiers, France.
| | - M D Piercecchi-Marti
- Faculté de medecine de Marseille, Aix-Marseille Université, France; Service de Médecine Légale et Droit de la Santé, CHU Timone, 13385 Marseille Cedex 5, France; Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France.
| | - F Poinso
- Service de pédopsychiatrie, CHU Sainte Marguerite, 270 boulevard de Sainte Marguerite, 13274 Marseille Cedex 9, France; Faculté de medecine de Marseille, Aix-Marseille Université, France.
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Irresponsabilité et responsabilité pénales : faut-il réformer l’article 122-1 du Code pénal français ? ANNALES MEDICO-PSYCHOLOGIQUES 2018. [DOI: 10.1016/j.amp.2018.02.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Guivarch J, Piercecchi-Marti MD, Glezer D, Murdymootoo V, Chabannes JM, Poinso F. Is the French criminal psychiatric assessment in crisis? INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2017; 51:33-41. [PMID: 28242031 DOI: 10.1016/j.ijlp.2017.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 11/01/2016] [Accepted: 01/18/2017] [Indexed: 06/06/2023]
Abstract
The criminal psychiatric assessment in France seems to be facing growing criticism related to disagreements between experts and, on the other hand, a lack of interest of psychiatrists for the assessment. We start by explaining the current framework of the criminal psychiatric assessment in France, which differs from the assessment used in English-speaking countries, where Roman law applies. Then, we will describe the disagreements through a literature review and two clinical vignettes. Finally, we will try to understand the causes of discrepancies between experts and the reasons for a supposed lack of interest of the psychiatrists for the expertise. For this, we conducted a survey among the psychiatric experts. We individually questioned experts on the discrepancies and on their awareness of the expertise. We found that 75% of the experts we surveyed had already faced the divergent opinion of a colleague. In addition, the experts were divided on their conclusions related to the fictional scenario we gave them for an a priori assessment (a person with schizophrenia who was accused of murder), particularly in the specific contexts that we submitted to them. The main cause of disagreement between experts was the various schools of thought that influence the psychiatric experts in the forensic discussion and, therefore, the conclusions of a case. Moreover, the experts believed that the decrease in the number of psychiatric experts could be attributed to the adverse financial situation of the assessment, the considerable workload required, and the extensive responsibility that falls on the expert. Calling on a team of forensic experts to perform assessments seems to be the first solution to this crisis. Furthermore, if the experts were better compensated for the assessments, more people would want to undertake this work.
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Affiliation(s)
- J Guivarch
- Service de Pédopsychiatrie, CHU Sainte Marguerite, 270 Boulevard de Sainte Marguerite, 13274 Marseille Cedex 9, France; Institut des Sciences Criminelles, Poitiers, France.
| | - M-D Piercecchi-Marti
- Service de Médecine Légale et Droit de la Santé, CHU Timone, 13385 Marseille Cedex 5, France; CNRS, EFS, ADES UMR 7268, Aix Marseille Université, 13916 Marseille, France
| | - D Glezer
- CRIR AVS PACA, CHU Sainte Marguerite, 270 Boulevard Sainte Marguerite, 13274 Marseille Cedex 9, France
| | - V Murdymootoo
- Service de Pédopsychiatrie, CHU Sainte Marguerite, 270 Boulevard de Sainte Marguerite, 13274 Marseille Cedex 9, France
| | - J-M Chabannes
- Service de Psychiatrie Adulte, CHU Conception, 147 Boulevard Baille, 13385 Marseille Cedex 5, France
| | - F Poinso
- Service de Pédopsychiatrie, CHU Sainte Marguerite, 270 Boulevard de Sainte Marguerite, 13274 Marseille Cedex 9, France
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Guivarch J, Piercecchi-Marti MD, Glezer D, Chabannes JM. [Differences in psychiatric expertise of responsibility for schizophrenic persons accused of murder: Study with experts of the Court of Appeal of Aix-en-Provence]. Encephale 2015; 42:296-303. [PMID: 26471517 DOI: 10.1016/j.encep.2015.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 01/09/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION In France, forensic psychiatric assessment plays a central role in the relationship between psychiatry and justice. The psychiatric expert is commissioned to determine whether or not the accused has a mental disorder and to specify whether or not it affected discernment at the time of offense. Nowadays, psychiatric expertise is coming under more and more criticism, particularly regarding divergences between experts. OBJECTIVES Our objectives were to find points of divergence between experts, try to understand causes and suggest ways to try to reduce them. METHODS For this we conducted a study, between July 2012 and January 2013, with psychiatric experts of the Court of Appeal of Aix-en-Provence through semi-structured interviews. We focused on a limited context: psychiatric expertise of responsibility for schizophrenic persons accused of murder. We questioned the experts about the issue of criminal liability of a person with schizophrenia in general but also in clinical situations we thought particularly involved in disagreements. RESULTS We recruited a population of 17 psychiatrists, mostly males of average age of 58 years, working mostly in the department of adult psychiatry of a hospital. We highlighted the differences between the experts, first with regards to the issue of liability in general. Experts divided seemed to keep in majority (52.9 %) the alternative between abolition and alteration of discernment when faced with a schizophrenic person accused of murder. The differences were even more pronounced in specific contexts. Thus, the fact that the person had suffered from delirium at the time of the offense led half of the experts (47.1 %) to conclude a systematic abolition of discernment, while the other half made such a conclusion when the delirium was directly linked to the facts. Discontinuation of neuroleptic treatment, drug abuse or existence of premeditation changed the conclusions of the experts in half the cases, more in the sense of an increased accountability in the cases of drug abuse or premeditation, and in the direction of a reduction of liability in case of cessation of treatment. The denial of facts by the accused caused fewer disagreements between experts. Among experts, 76.5 % had already observed differences, which, according to them, were based primarily on schools of thought, or personal views (64.7 %), which could distort clinical evaluation and especially forensic interpretation of the relationship between pathology and facts. The experts thought it was possible and desirable to reduce differences and proposed different solutions for this, especially the return to dual expertise and colleges of experts. DISCUSSION Our results were consistent with those in the literature. Based on proposals from experts and data from the literature, we identified five perspectives likely to reduce differences: first it would be useful to put in place a better specific training in forensic psychiatry and expertise, not only theoretical but also in terms of practical training through tutoring. We would identify a jurisprudence in forensic psychiatric assessment and identify consensual points. It would be good to allow experts to acquire sufficient experience not just through tutorials but also by statutory changes. Moments of exchange between experts - including a return to dual expertise and the organization of work meeting - could also reduce differences. Finally, we propose legislative changes: not only to rewrite the paragraph 2 of Article 122-1 of the French Penal Code, but also to give priority to the expertise of responsibility on the expertise of dangerousness. CONCLUSION We showed that there were differences between the experts mainly concerned with the forensic interpretation, and that they seemed linked to schools of thought or to personal views of each expert. To reduce the differences, we discussed five perspectives.
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Affiliation(s)
- J Guivarch
- Service de pédopsychiatrie, CHU Sainte-Marguerite, 270, boulevard de Sainte-Marguerite, 13274 Marseille cedex 9, France.
| | - M-D Piercecchi-Marti
- Service de médecine légale et droit de la santé, CHU Timone, 13385 Marseille cedex 5, France; CNRS, EFS, ADES UMR 7268, Aix-Marseille université, 13916 Marseille, France
| | - D Glezer
- CRIR AVS PACA, CHU Sainte-Marguerite, 270, boulevard de Sainte-Marguerite, 13274 Marseille cedex 9, France
| | - J-M Chabannes
- Service de psychiatrie, CHU La Conception, secteur 13G04, 147, boulevard Baille, 13385 Marseille cedex 5, France
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