Abuse in psychiatry: the cry of alarm from doctors in France

Nearly 90 caregivers denounce, in a forum that we unveil, common abuses in psychiatry, such as the use of seclusion and restraint.

While the Congress of mental health have ended, several caregivers tell how, by denouncing abuses such as isolation and restraint, they find themselves “harassed”, “placarded”, “laid off” by their management. Moreover, the debate on these practices, which have been on the increase for thirty years, was not addressed during these two days. An omission denounced by 187 signatories including 90 psychiatrists, in a forum written before the start of these meetings.

Locked rooms

For Doctor Bellahsen, the troubles began after the night of May 7 to 8, 2020. In his department, two patients who tested positive are transferred to the Covid unit, forcing the others, in contact cases, to confine themselves. But, in the evening, a psychiatrist on duty and the management decide to lock their rooms. “Instead of telling them to isolate themselves well and to respect barrier gestures, they treated them like second-class citizens, blocking the locks, according to an old prejudice of irresponsibility of the mentally ill. “

The head of the pole immediately warns the General controller of places of deprivation of liberty, an independent authority. This is not the first time that he has criticized management for “his methods”: in the Covid unit, patients are “confined”, he says, for fourteen days. This is what the supervisor, Adeline Hazan, observed on the spot, who discovers patients “locked up 24 hours a day without their clinical psychiatric condition justifying it”. Its edifying report reveals “an absolute confusion between the concepts of medical confinement and psychiatric isolation”.

The days go by in paper pajamas, in rooms without showers, TVs and no sense of time. At the same time, in another locked unit, a woman breaks her window in despair and falls two floors.

COLUMN. Isolation and restraint: “the shame of psychiatry”

The Congress on Mental Health and Psychiatry will be held on September 27 and 28 without certain major themes being addressed.

Shame in psychiatry is the inflation of physical restraints (the equivalent of the straitjackets of yesteryear) and psychiatric isolation. This shame is that of professionals who attach and lock up, for lack of anything better. This shame is that of users and their families who live in unworthy and traumatic situations. Tying up and isolating redoubles and worsens the psychological and social isolation of people already weakened by their mental disorders.

The inflation of restraints gradually grew as material, physical and human resources dwindled. The Comptroller General of places of deprivation of liberty reminds us of this in lengthy reports.

This inflation was also made possible by a de-training of professionals in psychiatry who, rather than relieving great anxieties with words and connection in addition to chemical treatments, relied on standardized and dehumanized procedures such as are currently used in hospitals.

In June 2020, the Constitutional Council asked the government to review the control of restraint and isolation requirements for the first time in order to comply with the law. Any restraint and isolation requiring the intervention of the judge of freedoms. The Minister of Health passed this bill reforming the control of isolation and restraint in the law on the financing of social security in 2020 … Which has little to do with the theme, the one that every citizen can be tied to a force bed more and more often in emergencies, nursing homes and psychiatry!

In spring 2021, for the second time, the Constitutional Council declared unconstitutional the law enacted by the government six months earlier! And for the second time, no national debate about what to tie up and lock up means in our country. In practice, it is evident that forcibly tying someone to a bed is never therapeutic. It is not and never will be a treatment, at best it is a measure to prevent physical harm to a person’s integrity. Locking someone up in a room is not a care in itself either, it is what can allow care to start when people are too ill to bear contact with themselves and with others. Lock-in can be the start of what will allow care, if the human relationship is the organizer of care. Family associations such as the psy common thread are calling for the abolition of restraint. Some countries like Iceland have already done this. Without significant political will and without an obligation of means for psychiatric hospitals to curb this deleterious phenomenon, the straps and doors will continue to tighten and close on our fellow citizens. There is an urgent need for a national debate on the issue.

The petitioners

Dr Mathieu Bellahsen, psychiatre ; Dr Georges Yoram Federmann, psychiatre ; Martine Houlier mère de patiente schizophrène ; Jean-Philippe PERNET, Infirmier ; Laurence Bloch, maman d’une jeune adulte autiste, directrice d’hôtel ; Dr Mathilde Hamonet, interne en psychiatrie ; Yves Gigou, infirmier et auteur ; Malia Klein, psychologue clinicienne ; Clément Vaissié, étudiant en médecine, ancien infirmier en psychiatrie ; Dr Anne Enot, pédopsychiatre ; Dr Patrick Chemla, psychiatre ; Association signataire : le Fil conducteur Psy d’usagers et de soignants ; Dr Valérie Houot, psychiatre ; Dr Jean Paul ; Chardon, psychiatre ; Frédéric Pierru, sociologue ; Dr Elisabeth Lisack, pédopsychiatre ; Dr Tristan Garcia Fons, pédopsychiatre ; Dr Loriane Bellahsen, psychiatre ; Dr Parviz Denis, psychiatre ; Dr Pascale Rosenberg Psychiatre ; Dr Guy Dana, Psychiatre ; Dr Martin Pavelka, pédopsychiatre ; Linda De Zitter, psychologue clinicienne ; Cécile Neffati, psychologue ; Dr Yoann Loisel, psychiatre ; Benjamin Royer, psychologue clinicien ; Dr Anne Enot, pédopsychiatre ; Céline Matthieussent, psychologue clinicienne ; Dr Franck Drogoul, psychiatre ; Dr Hervé Bokobza, psychiatre ; Dr Virginie Cruveiller, pédopsychiatre ; Clélia Gasquet, maîtresse de conférence en géographie de la santé ; Dr Christian Sueur, psychiatre addictologue ; Céline Masson, psychanalyste, professeur des universités ; Dr Martine Garrigou, psychiatre ; Thérèse Petitpierre, psychologue ; Dr Veronique Egal, psychiatre ; Annie Topalov, psychologue clinicienne ; Christian Topalov, sociologue ; Marie Pascale Chevance Bertin, psychanalyste ; Dr Olivier Labergère, psychiatre ; Frédéric Mougeot, sociologue ; Dr Olivier Boitard, psychiatre ; Dr Pierre Zanger, Psychiatre ; Dr Maud Mainfroy, psychiatre ; Dr Pierre Paresys psychiatre ;Dr Catherine Nourry psychiatre retraité ; Dr Jean-Loup Lebreton, psychiatre ; Dr Eliane Calvet, psychiatre ; Marie-Jean Sauret, professeur émérite de psychopathologie clinique ; Dr Jean-Pierre Bouleau, psychiatre ; Dr Jean-Michel Delaroche, psychiatre ; Claire Ballongue, psychologue ; Aurore Gribos, psychologue ; Baptiste Garreau, psychologue clinicien ; André Bitton, retraité, président d’une association d’(ex-)usagers de la psychiatrie ; Dr Marie Allione, psychiatre ; Didier Donstetter, psychologue clinicien psychothérapeute ; Bénédicte Louvet, interne en psychiatrie ; Jenna Madarbaccus, psychologue ; Dr Philippe Gasser, psychiatre ; Michel Bruno, psychologue clinicien ; Pr Pierre Delion, pédopsychiatre, professeur émérite ; Dr Pascal Boissel, psychiatre ; Dr Djamila Mebtouche, psychiatre ; Dr Michele Zann, psychiatre ; Dr Pedro Serra, psychiatre ; Laure Thiérion, psychologue clinicienne ; Marie-Noëlle Godet, psychologue clinicienne; Dr Anne Groussin, psychiatre ; Dr Benoit Blanchard, pédopsychiatre ; Dr Catherine Laval‌, pédopsychiatre ; Jérôme Costes, infirmier en psychiatrie ; Dr Sandrine Deloche, pédopsychiatre ; Dr Laurent Delhommeau, pédopsychiatre ; Dr Anne Kummer, psychiatre ; Adeline Antier éducatrice spécialisée, cheffe de service éducatif ; Virginie Périlhou, infirmière en psychiatrie ; Patrick Estrade, infirmier en psychiatrie ; Florence Hourquebie, Infirmière ; Dr Paul Machto, psychiatre ; Maximilien Valente, interne de psychiatrie ; Marguerite Compagnat, psychologue ; Dimitri Talbot, cadre de santé ; Dr Michel Montes, psychiatre ; Dr Geneviève Hénault, psychiatre ; Fanny Lung, sociologue directrice de la SOFOR ; Catherine Skiredj Hahn, sociologue ; Dr Chantal Potart, psychiatre ; Dr Alexandra De Seguin, psychiatre ; Olivier Esnault, infirmier de secteur psychiatrique ; Dr Catherine Lemoine, psychiatre ; Amandine Vitra, psychologue clinicienne ; Dr Pascale Moins, psychiatre ; Audrey Valade, psychologue clinicienne ; David Thomas, travailleur social ; Estelle Gioan, psychologue clinicienne ; Dr Julien Prorel, psychiatre ; Peirangelo Di Vittorio, philosophe ; Maïder Leroux, psychologue clinicienne ; Jorhann Bouvier, interne en psychiatrie ; Aurélia Khorkoff, psychomotricienne ; Simon Jaunin, psychologue clinicien ;Dr Eliane Proca, psychiatre ; Fred Racine, documentaliste ; Dr Jocelyne Lengronne, psychiatre ; Valérie Waill-Blévis, psychanalyste ;Christine Lartigue, psychologue ;Mathilde Stentelaire, éducatrice spécialisée ; Valérie Joye, psychologue ;Dr Danielle viterbo, psychiatre ; Humberto Estevez Duran, psychologue ; Danièle Silva, psychologue clinicienne ; Dr Delphine Glachant, psychiatre ; Emmanuelle Forner, psychanalyste ; Caroline Bernard, psychologue clinicienne ; Dr Philippe Bichon, psychiatre ; Dr Charles-Olivier Pons, pédopsychiatre ; Dr Christophe du Fontbaré, psychiatre ; Elsa Benetos, interne en psychiatrie ; Edwige Landault, psychologue clinicienne ; Charlotte Barcet, psychologue ; Dr Géraldine Delcambre, psychiatre ; Patrice Marteil, psychologue clinicien ; Flore Verga, psychologue ; Myriam Naval, cadre bancaire ; Dr Emmanuel Venet, psychiatre ; Dr Pierre Jarlan, pédopsychiatre ; Liliana Gonzalez, psychologue clinicienne ; Dr Fatma Farah, psychiatre ; Céline Lefebvre-Israël, psychologue clinicienne ; Dr Paola Velasquez, pédopsychiatre ; Dr Irène Kaganski, psychiatre ; Dr Pascale Beau, psychiatre ; Élise Gauthier, psychologue clinicienne ; Charlotte Clermont , psychologue ; Da’ad de Gunzbourg, psychanalyste ; Dr Nawal Souissi, psychiatre ; Amaury Marecaux, psychologue ; Anne Bourgain, psychologue ; Sabine Hamza, psychomotricienne ; Stéphane de Crépy, psychologue clinicien ; Dr Jean-Christophe Maccotta, pédopsychiatre ; Rosangela, Ribeiro dos Santos, psychologue clinicienne ; Dr Nadia Baba, psychiatre ; Dr Maud Mainfroy, psychiatre ; Monique Zerbib, psychologue clinicienne ; Dr Yves Kaufmant, psychiatre ; Dr Anne Marie Kaufmant, psychiatre ; Brigitte Bonnel, psychologue clinicienne ; Dr Sophie Slovak, pédopsychiatre ; Dr Dominique Bertin, pédopsychiatre ; Dr Morgane Derijard-Kummer, pédopsychiatre ; Dr Fethi Brétel, psychiatre ; Dr Bruno Tournaire Bacchini, psychiatre ; Dr Jean-Pierre Martin, psychiatre ; Dr Laurine Mechali Ringenbach, psychiatre ; Dr Véronique Spahr, pédopsychiatre ; Pr Alain Vanier, psychiatre, professeur émérite des universités ; Dr Jean-Christophe Maccotta, pédopsychiatre ; Dr Roger Ferreri, psychiatre ; Dr Nathalie Lambert, pédopsychiatre ; Dr Stéphane Daure, psychiatre ; Dr Audrey Vanel, psychiatre ; Nelly Derabours, infirmière de secteur psychiatrique ; Jean-Claude Chaise, psychologue et Christine Chaise, enseignante retraitée, parents de malade psychique ; Audrey Le Quilliec, infirmière ; Michel Bruno, psychologue clinicien ; Christina Vincent, psychologue clinicienne ; Maxime Martin, psychologue clinicien ; Anne Élodie Bronisz, psychologue ; Mazet Nadine, psychologue ; Marion Minari, psychologue clinicienne ; Anaïs Ravaud, psychologue clinicienne ; Florent Gabarron-Garcia, psychologue ; Dorine Bertrand, psychologue clinicienne ; Alain Gutton, praticien en hypnose ; Charlotte Clermont , psychologue ; Anne Bourgain, psychanalyste ; Amandine Bachelery, psychopedagogue ; Elizabeth Serin, psychologue clinicienne ; Françoise Sellier, psychologue ; Cécile Pinaire, psychologue clinicienne ; Rhadija Lamrani Tissot, psychanalyste ; Sylvain Bourg, éducateur spécialisé ; Françoise Attiba, psychologue ; Olivier Brisson, psychomotricien.