According to a national study conducted by the Regional Federation of Mental Health and Psychiatry Research of Hauts-de-France (F2RSM), a large majority of those detained present, on release from prison, a psychiatric or substance-related disorder. Data that confirms the necessary mobilization of all actors to improve the mental health of detainees, at the time of the development of the new interministerial roadmap “Health of persons placed in the hands of justice” 2023 – 2027 , specifies the Ministry of Health and Prevention.
This report presents the results of the national study on mental health in the outgoing prison population (SPCS) which set itself the objective of evaluating the mental health and the course of care of people leaving prison in France. It comprises three parts which concern respectively: the male prison population leaving prison; the female prison population leaving prison establishments in Hauts-de-France; and the mental health system in prisons in certain overseas territories. The SPCS study was funded by the DGS (Direction Générale de la Santé) and SpF (Santé Publique France). It was supported by the F2RSM Psy (Regional Federation for Research in Mental Health and Psychiatry) and coordinated by Professor Pierre Thomas. The study was led by Thomas Fovet and Camille Lancelevée, assisted by Oumaïma El Qaoubii and Élodie Floury for the Overseas section. The methodology was designed by Marielle Wathelet. The study was made possible by the participation of around a hundred investigators, mental health professionals working in prisons, responsible for collecting the data.
The work of the 2019-2022 roadmap relating to the health of persons placed in the hands of justice has highlighted the need to improve knowledge of the state of health, particularly mental, of prisoners.
Indeed, the previous nationwide study[1]conducted in 2004, was mainly interested in the mental health of people on entering prison as well as during their incarceration and highlighted an over-representation of psychiatric disorders, with varying severity, among people in prison compared to the general population.
- Main results of the study
The results, which therefore relate to the particular moment before release, confirm the finding of degraded mental health for a majority of detainees.
Two-thirds of men detained in remand centers and three-quarters of women released from prison present, on release from prison, a psychiatric or substance-related disorder:
- Half of those surveyed have a substance-related disorder,
- A third of men (and half of women) are affected by mood disorders (including depression),
- A third of men (and half of women) are affected by anxiety disorders,
- 10% of men (and a sixth of women) are affected by a psychotic syndrome,
- A quarter of men (and half of women) are prone to insomnia.
The study also makes it possible to characterize the severity of these mental disorders at discharge: 32.3% of men (and 58.8% of women) are considered moderately to seriously ill for men, while the risk of suicide is estimated at 27.8% for men (and 59.5% for women) with a high risk estimated at 8.2 and 19.1% respectively.
With regard to the care pathway, the majority of participants were able to benefit from at least one consultation by a general practitioner annually, plus one by a mental health professional (respectively 89.6% and 96.2%) . More than a third were followed by a medico-social institution specializing in addiction (CSAPA, CAARUD). In the days preceding discharge, 22% of male respondents and 33.6% of female respondents reported having a scheduled appointment with a mental health professional, and 14% of male respondents and 27.5% of female respondents with a mental health professional. addictology.
It should be noted that the proportion of people treated with opiate substitution medication is equivalent at entry and during detention.
Another striking finding is the prevalence of childhood trauma. 98.2% of men and 99.2% of women had been exposed to at least one childhood trauma (neglect or abuse).
With regard to their prison career, 31.9% of men and 46.6% of women did not have access to sports activities. Similarly, 41.8% of men and 46.6% of women did not have access to visiting rooms. With regard to socio-cultural activities, 68.4% of men and 48.9 women were unable to benefit from them. As for vocational training, its access remains limited, 76.5% of men and 65.6% of women not having had access to it.
[1] Rouillon F., Duburcq A., Fagnani F., Falissard B., Epidemiological study on the mental health of people detained in prison, DGS study, 2004.