Paris, April 5, 2016

Thousands of men and women with psychosocial disabilities in French prisons are at risk of suicide or harming themselves because of the neglect of their physical and mental health, Human Rights Watch said in a report released today.

The 69-page report, “Double Punishment: Inadequate Conditions for Prisoners with Psychosocial Disabilities in France,” documents the lack of adequate mental health care and appropriate conditions for prisoners with psychosocial disabilities. The situation is exacerbated by overcrowding, stigma, and isolation, Human Rights Watch found. A shortage of mental health professionals in many prisons means that appointments are infrequent and often brief and limited to prescribing medication. The lack of adequate conditions and care also results in difficult working conditions for prison staff.

“It’s shameful for a country like France to keep people with mental health conditions locked up for months or years in prisons without adequate access to mental health care,” said Izza Leghtas, Western Europe researcher at Human Rights Watch. “The lack of adequate mental health treatment effectively amounts to additional punishment for prisoners who need this care.”

Human Rights Watch interviewed 50 prisoners, prison staff, and medical professionals in eight prisons, as well as government officials and others.

When their condition deteriorates, prisoners with psychosocial disabilities are in some cases transferred to psychiatric hospitals against their will and isolated in conditions that can constitute cruel, inhuman, or degrading treatment under international law, Human Rights Watch found.

“I prefer 1,000 times to be in a cell than in an isolated room in the hospital, my arms and feet tied down as if I were an animal,” said Sarah (pseudonym), a prisoner who has previously been sent to psychiatric hospitals.

Return to the prison environment – without adequate support or appropriate accommodations – can lead to a recurrence of mental health conditions and re-hospitalization, sometimes ensnaring prisoners in an endless cycle of hospitalization, discharge, deterioration, and re-hospitalization. Such a cycle is both harmful to the patient’s health and disruptive and costly to the prison and the hospital involved.

Suicide rates in French prisons are higher than in the general population – seven times as high, according to a study of suicides from 2006 to 2009 by the National institute for demographic studies. But prisoners with psychosocial disabilities are more likely to harm themselves or commit suicide than other prisoners. According to the French government, there were 113 suicides in French prisons in 2015.

Sarah, who had scars from self-inflicted wounds on her arms, said people she had met in prison later committed suicide, “So of course I thought, if she can’t cope, will I be able to?” she said.

The last comprehensive study of mental health in French prisons was published in 2004. It found that almost a quarter of inmates had psychosis – which can include depression, bipolar disorder, or schizophrenia – much higher than the 0.9 percent among the general population. A frequent explanation is that judges and juries have viewed people with psychosocial disabilities as more dangerous than others and handed down longer sentences.

A 2014 law seeking to rectify that tendency provides that sentences should be reduced by one-third for defendants whose state of mind during a crime was compromised by a mental health condition.

“I prefer 1,000 times to be in a cell than in an isolated room in the hospital, my arms and feet tied down as if I were an animal,” said Sarah (pseudonym), a prisoner who has previously been sent to psychiatric hospitals.

Return to the prison environment – without adequate support or appropriate accommodations – can lead to a recurrence of mental health conditions and re-hospitalization, sometimes ensnaring prisoners in an endless cycle of hospitalization, discharge, deterioration, and re-hospitalization. Such a cycle is both harmful to the patient’s health and disruptive and costly to the prison and the hospital involved.

Suicide rates in French prisons are higher than in the general population – seven times as high, according to a study of suicides from 2006 to 2009 by the National institute for demographic studies. But prisoners with psychosocial disabilities are more likely to harm themselves or commit suicide than other prisoners. According to the French government, there were 113 suicides in French prisons in 2015.

Sarah, who had scars from self-inflicted wounds on her arms, said people she had met in prison later committed suicide, “So of course I thought, if she can’t cope, will I be able to?” she said.

The last comprehensive study of mental health in French prisons was published in 2004. It found that almost a quarter of inmates had psychosis – which can include depression, bipolar disorder, or schizophrenia – much higher than the 0.9 percent among the general population. A frequent explanation is that judges and juries have viewed people with psychosocial disabilities as more dangerous than others and handed down longer sentences.

A 2014 law seeking to rectify that tendency provides that sentences should be reduced by one-third for defendants whose state of mind during a crime was compromised by a mental health condition.