Barcelona, Friday, August 18, 2017 - Always, the medical teams are on the front line when sirens signal an attack. In Barcelona yesterday, as in Paris, London, or Brussels in recent months, hospitals were immediately mobilized to deal with the influx of wounded. And as always, calls for donations of blood were quickly heard.
The (blind) trust of security specialists in madness specialists
In the second line, psychiatrists were also solicited. To respond to the distress of the victims and witnesses of the attack. But also, much more complex and more uncertain, to play a role of prevention. Thus, this morning at the microphone of RTL, the Minister of the Interior, Gerard Collomb said to work in close collaboration with the Ministry of Health to mobilize psychiatric hospitals and psychiatrists in the fight against terrorism. " protocols "In the words of the Minister of the Interior should be developed to strengthen the detection of risk profiles and" trades With the entourage of people developing " delusions around Islamic radicalization ". Gérard Collomb believes that there are two types of terrorists. " You have both planned attacks like the one that just happened in Spain and then you have people who radicalize themselves brutally with often extremely troubled psychological profiles "The former mayor of Lyon developed, including referring to the man who tried to attack the military on 9 August.
This is not the first time that security officials want to believe that psychiatry could offer a response to the terrorist threat. A few months ago, the head of the Coordination Unit of the fight against terrorism (UCLAT), Loïc Garnier said for the Obs: "Terrorism is a very complicated disease. Of those we are looking for and who we are looking for, some have religious motives. But others have mostly psychiatric problems, "he said.
As many terrorists as psychiatric profiles (or not)
While religious radicalization and the act of terrorism are inevitably important fields of reflection for psychiatrists, they stress the extreme complexity of the subject. In particular, the diversity of profiles and the evolution of terrorist acts must be taken into account. " The big mistake is to want to fix and reduce a variable terrorist phenomenon both in time - terrorism today has nothing to do with 9/11 - and in space. I saw a dozen very different configurations. It's a moving and polymorphic phenomenon A few days ago psychiatrist Daniel Zagury, an expert at the courts, noted. Similarly, regarding the role of psychiatry, he emphasized an ambivalent character: " What we have to understand is that we can not summarize a phenomenon as terrible as terrorism to psychiatry, but at the same time, we can not do without, in many cases a psychiatric analysis ". Also in the shade, Roland Coutanceau, president of the French League for Mental Health, remarked for the Cross last year: " We think we have to be crazy to kill! But in reality, you have to be megalomaniac and paranoid. But these are personality disorders rather than mental illnesses ".
However, in a "preventive" context, the vigilance of psychiatrists could actually be exercised with some of their patients who may be influenced by the news. " In the 1990s (...) people deluded a lot about the devil, against a backdrop of heavy drug take. After some killings, we observe that the level of violence increases among psychotics in the region where they took place. The terrorist climate of today, with its violence and its carnage, can also excite something, especially since the images turn over and over again. Dr Jean Furtos, Honorary Scientific Director of the National Observatory of Practices in Mental Health and Insecurity in Lyon, also observed in la Croix. In this respect, it is interesting to note that some saw in the murder perpetrated by a motorist Monday in Sept Sorts (Seine et Marne) a " imitation of terrorist acts In the words of Professor Samuel Lepastier, quoted by Libération.
The lack of resources of psychiatry: a brake on the fight against terrorism?
In addition to the complexity of the subject and the "illusory" character for many of the "de-radicalization" (according to the expression of Dr. Ludwig Fineltain in issue 22 of the Bulletin de psychiatrie, published in August 2016), to be able to play a role of "prevention" "Or" detection "increased, psychiatrists will require additional resources. " It would be necessary to invent a mass device, but in times of restrictions, one tends to focus on the heaviest cases. Ideally, the medical-psychological centers should also address these socially fragile public (...). In the past, there have been attempts at mental health clinics to accompany people who are not sick. But they too have all closed Jean Furtos was sorry a few months ago.
Thus, in the light of the many debates on the subject, it appears that Gerard Collomb's proposal should not remain without comments and questions, which leads to the hope that it is not limited to an untimely statement but on a real work of reflection.