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II. Organization of Mental Healthcare in French Prisons
Until 1986, mental health care in French prisons was under the authority of the Prison
Administration, which is part of the Ministry of Justice. 23 In an attempt to improve
prisoners’ access to health care, it was then transferred to the Ministry of Health. Physical
health care was placed under the authority of the Ministry of Health in 1994. 24 Medical staff
working in prisons are now systemically independent from the prison authorities and are
affiliated with a hospital. They provide both physical and mental health care and include
general practitioners, psychiatrists, psychologists, nurses, dentists and other specialists.
All prisons in France have a medical unit that provides physical and mental health care,
but their size and resources vary greatly from one facility to another.
Out of the 188 prisons in France only 26 have Regional Medico Psychological Services
(SMPRs), providing mental health care including consultations with psychiatrists and
psychologists.
These 26 SMPRs have a total of 380 beds so prisoners can stay overnight. However, SMPRs
provide treatment during the day. Medical staff are not present during the evening or night
and prisoners who occupy the beds are guarded by prison guards. Prisons without an
SMPR have Outpatient Consultation and Treatment Units (Unités de consultations et de
soins ambulatoires - UCSAs) where psychiatrists working in the hospital to which the
facility is affiliated provide consultations on certain days of the week. The full-time
position of a psychiatrist, for instance, can be shared by several professionals.
Under French law, psychiatric treatment in prison requires the patient’s consent. 25
However, under general mental health laws, prisoners, like other members of the
population, may be involuntarily admitted to a psychiatric hospital upon a decision by the
prefect of a département - in their case the département where the prison is located.
23 Decree no. 86/602 of March 14, 1986 on the fight against mental illness and the organization of psychiatric sectors.
24 Law no. 94-43 of January 18, 1994, concerning public health and social protection. The law also provides for the affiliation
of prisoners to the general system of social security.
25 Article L3214-1 I of the Code of Public Health.
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