Download Judgment: English
Country: France
Year: 2008
Court: The European Court of Human Rights
Health Topics: Mental health, Prisons
Human Rights: Freedom from torture and cruel, inhuman or degrading treatment, Right to life

The applicant was a French national and a sister to a detainee, who also was a French national and committed suicide on 20 July 2000 in his cell in Bois-d’Arcy Prison where he was placed in pre-trial detention. In April 2000, the applicant’s brother was placed under investigation and detained pending trial for the armed assault of his former partner and their 13-year-old daughter; occasioning total unfitness for work for more than eight days; and for criminal damage and theft.

On 2 July 2000, the detainee attempted to commit suicide by cutting his arm with a razor. The psychiatric emergency team diagnosed an acute delirious episode and prescribed him anti-psychotic neuroleptic medication. On that occasion, the detainee mentioned that he had a history of psychiatric problems and that he had previously been admitted to a psychiatric institution and given neuroleptic treatment. From 3 July on wards, the detainee was monitored by the regional medical and psychological service based in the prison and was placed in a cell on his own under a special supervision of more frequent patrols. The detainee continued to be prescribed the anti-psychotic medication, was being handed several days’ supplies twice a week. There was no supervision by the prison medical staff as to whether he actually took the medication.

On 5 July 2000, the detainee was penalized to serve 45 days in a punishment cell for assaulting a warder. The penalty was ordered by the disciplinary board that had by then described that the detainee appeared “very disturbed” during the inquiry.  In a letter he wrote to the applicant on 6 July 2000, the detainee said that he was “at the limit” and compared his cell to a tomb; portrayed himself as crucified. On 12 July the detainee’s lawyer requested that her client be examined to ascertain whether his mental state was compatible with his detention in a punishment cell. [Paragraphs 7&8]
On 20 July 2000, the detainee committed suicide. An expert medical report subsequently revealed that at the time of his death, the detainee had not taken his neuroleptic medication for at least two to three days.

A judicial investigation opened thereafter ordered an expert psychiatric report which concluded that the detainee had been suffering from acute psychotic disorders and that his suicide had been the consequence not of a depressive syndrome but of an acting-out process linked to such disorders, especially if he hadn’t taken his medication properly.

In January 2005 the Versailles Court of Appeal upheld the investigating judge’s ruling that there was no case to answer, finding that the medical staff had not been negligent in failing to supervise that the detainee was taking the medication; that the investigation and the additional inquiries had found no evidence of potential negligence on the part of the prison staff either; and that neither the imposition of a disciplinary sanction nor the fact of not checking that the medication was being taken had constituted a manifestly deliberate breach of a duty of care. [Para. 12]

On 3 February 2005, the applicant lodged her claim to the European Court of Human Rights (ECHR). The applicant claimed that the French authorities violated Articles 2 (the right to life) and 3 (prohibition of inhuman or degrading treatment) of the European Convention on Human Rights in their failure to take the necessary measures that could protect her brother’s life and by placing him in a punishment cell for 45 days which had been excessive in view of his mental health status.

The ECHR held that from 2 July 2000 onward, the authorities had known that the detainee was suffering from psychotic disorders that could make him cause acts of self-harm. The ECHR considered that the risk had been real and that the detainee had required careful monitoring in case of any accident. The ECHR noted that there had not been any discussion of whether the detainee should be admitted to a psychiatric institution despite his first suicide attempt. Given the fact that the detainee was known to have been suffering from serious mental disturbances that had posed a suicide risk, the authorities were expected to take special measures in light of the state’s obligation to take preventive operational measures to protect an individual whose life was at risk.

The ECHR also noted that the authorities should at the very least have provided him with medical treatment corresponding to the seriousness of his condition. The ECHR seriously doubted the advisability of letting a prisoner administer his daily medication when he is known to be suffering from psychotic disorders; the ECHR concluded that this lack of supervision had contributed to his death though what had made him commit suicide was not known.
The ECHR noted that by the time the disciplinary board passed the punishment (three days after the detainee attempted to commit suicide), the detainee’s mental state had not been considered although he had made incoherent statements during the inquiry into the incident and had been described as “very disturbed” at the time.

The ECHR observed that detainment in the punishment cell isolated prisoners by depriving them of visits and all activities, and thus, was likely to aggravate any existing risk of suicide. The ECHR reiterated that the vulnerability of mentally ill people called for special protection; a solitary confinement in a punishment cell for a long time of a prisoner suffering from mental disorder would inevitably harm his mental state, especially when he actually attempted a suicide previously. The authorities, therefore, breached their obligation to protect the detainee’s right to life under Article 2 of the Convention.

The ECHR recognized the difficulties the prison authorities faced and the need for punishing assaults on warders. However, the penalty imposed on the detainee was the maximum penalty for the most serious category of offenses and there was no consideration of his mental state or of the fact that that it was his first such incident. The ECHR observed that the penalty was severe and might well have threatened the detainee’s physical and moral resistance.

The ECHR reiterated that prisoners known to be suffering from serious mental disturbance and to pose a suicide risk required special measures that would protect them in their condition and ensure compatibility with the requirements of humane treatment. The ECHR held that the penalty imposed on the detainee was not compatible with the standard of treatment required for a mentally ill person and constituted inhuman and degrading treatment and punishment, a violation of Article 3 of the Convention.

(The contents of this summary were taken from the judgement of the case as issued in the press release by the Registrar of the ECHR on the date of the Chamber Judgment, 16 October, 2008)