Shootings in the middle of Paris. Shortly before noon on December 23, a man in his sixties opened fire in the rue d’Enghien, a shopping district in the 10th arrondissement, particularly frequented by the Kurdish community. In a few minutes, he killed two men and a woman and managed to injure three other people around the Ahmet-Kaya cultural center, before being stopped by customers of a hairdressing salon, also frequented by Kurds. In front of the investigators, the shooter will not delay justifying his act by his “pathological hatred of foreigners” and his desire “to murder migrants”. Former SNCF employee, William M. is already known to the courts for three separate cases, including an indictment a year ago for acts of racist violence – in 2021, the retiree went to a camp occupied by migrants in the 12th arrondissement, and had damaged six tents and injured two men with a sword.
But while his police custody had already begun for several hours, on December 23, a doctor finally asked that it be interrupted on the day of the 24th. After having examined the main suspect, the specialist declared that “the the state of health of the person concerned was not compatible with [cette] measure”. It was in a structure little known to the general public that William M. was then transferred: in the 14th arrondissement, the psychiatric infirmary of the police headquarters (or I3P) was responsible for welcoming him, in order to determine whether his mental state allowed the interrogation to continue. “That’s our job: we welcome psychopaths, people in the throes of delirium, people who have committed illegal acts, ‘crackers’ or homeless people picked up by the police. Then we take care of knowing whether or not they are eligible for police custody”, summarizes Tom *, a nurse for almost 10 years in this very special service.
Created in 1872, the infirmary of the Paris police headquarters benefits from a unique operation in France. Elsewhere in the territory, if a person combines “an imminent danger to the safety of people” and “manifest mental disorders”, it is up to the mayors to take the orders which will then allow them to be sent to a hospital. public, as provided for in Public health code. But in Paris and its three airports, patients will be taken to the I3P, following a report sent by a police commissioner and a prior medical opinion carried out in the medical and surgical emergencies of the Hotel -Dieu – or a behavioral examination carried out in the medico-judicial emergency room (UMJ) – concluding that there is an incompatibility with a police custody measure. People arrested for “disturbing public order and undermining the safety of people” then land in this 16-bed infirmary, while waiting to speak with a certifying doctor who will have to rule on their case. This specialist will be responsible in particular for writing “the detailed certificate which must allow the prefect to possibly take a decision to admit psychiatric care without consent”, specifies the police headquarters to L’Express.
“We even have a few regulars”
Each year, the I3P welcomes around 1,900 people within its walls, received day and night by a medical team present seven days a week. Among these many patients, some are more famous than others – the violence of their acts , their unexpected political demands or the eccentricity of their offenses have sometimes marked the spirits. In 2019, caregivers thus saw Essia B., a forty-year-old suspected of having caused the death of ten people in the fire of a Parisian building, a man accused of having beheaded his mother, and another having climbed the Eiffel Tower with his bare hands before hanging on it for more than six hours. In 2017, the Russian artist Piotr Pavlenski also spent a few hours in the infirmary, after trying to set fire to a branch of the Banque de France, in the center of the capital.
Julien*, nurse at I3P
“It scrolls, and we see everything”, comments Julien *. Landed in the service only two years ago, this nurse has already seen his share of patients with more or less serious pathologies, ranging from mild anxiety attacks to profound psychiatric disorders. He assures us to welcome “without distinction” the “crackers in a state of lack”, sometimes violent, and people found in the midst of a crisis in the street, train stations or airports, like this Korean “completely schizophrenic” arrested at the got out of his plane a few weeks ago, convinced that the Japanese government wanted to poison him. “People who say they want to kill Emmanuel Macron, for example, I have ten a month. But I have twice as many homeless people driven mad by the street, who in reality have nothing to do there”, says- he. “We even have a few regulars,” adds Tom, who regularly receives the same woman from Marseille and suffering from infantile psychosis, who “regularly freaks out in Paris”.
“We see immediately if something is wrong”
But unlike a traditional psychiatric service, the two nurses are not there to “cure” these men and women, nor even to understand where their possible problems come from. The residents of the I3P only stay in the infirmary for a maximum of 24 or 48 hours – the time that a certifying doctor examines them and decides to send them back to police custody, find them a place in a psychiatric hospital or release them. in nature. “To find out whether or not they are compatible with police custody, these few hours are more than enough,” says Julien.
In the meantime, the healthcare team attends to the needs of the patients, prescribes medication if necessary and, above all, observes. “Most of the time, we see right away if something is wrong, and we manage to quickly diagnose the disorder”. In 2019, a report by the Comptroller General of Prisons and Places of Deprivation of Liberty (CGLPL) indicated that a “high proportion of patients were not hospitalized after their visit to the I3P”: they were 45.77% in 2016, 43.64% in 2017, and 40.31 % in 2018. “For those, the question arises of the usefulness of the presence of a certifying doctor beyond the current duration [8h-13h] in order to shorten the length of stay at the IPPP and thus in particular to avoid spending the night there”, notes the report.
“Generally, it goes very well. The patient arrives handcuffed, framed. Very few jump at our throats, contrary to what one might imagine”, explains Julien. But sometimes it happens that there is an “error in judgment”. Understand: an apparently calm patient, who will finally have to be “mastered” a few minutes later. “It can be very violent, you have insults, blows. These are patients in crisis, often on treatment stoppage: they are delirious in the street, scream in public spaces, jostle people, then come to your house” .
Psychologically, the carer sometimes needs to take a step back, so as not to let himself be haunted by the stories of patients who have particularly marked him. “A woman we took in had killed her son, then realized what she had done once she was placed under treatment… I let you imagine. Another had killed her psychologist, and thought she was stuck in the matrix, in a fictional world. Sometimes it’s hard”. Over time, the nurse has also developed some habits outside of work: when he takes the metro, for example, he no longer waits for the train on the edge of the platform. “We received so many ‘pushers’ that now I’m being careful”.
Staff on strike
Infiltrated for 15 months within the I3P for the needs of a book, the journalist Valentin Gendrot also testifies to the “casting errors” which regularly pass the door of the infirmary – these people arrested by the police, without whether they have a psychiatric disorder. “I saw autistic patients for example, or people who worked in specialized establishments for the disabled. They should not have been there”, recalls the author of The I3P undercover: the inside story of the police psychiatric ward (Albin Michel, 2022). “Especially since the caregivers manage the emergency, and sometimes face unexpected situations. It can be quite stressful”. While he was in charge of a transfer from the I3P to the psychiatric hospital during his infiltration, the journalist thus attended the runaway, live, of his patient. “You find yourself running after a tied up person, who has just received medication and whom you lose in the middle of Paris. You worry about him… It’s intense”.
Despite this dense daily life, none of the caregivers interviewed indicated that they were afraid for their life within the I3P. “We can count on extremely well-trained supervisors, which is not necessarily the case in other psychiatric services”, wishes to specify Julien. Lately, however, the nurse and his colleagues have had to get used to a reduction in staff. “Between retirements and recruitment difficulties, the teams have gone from 8-10 colleagues to 6, in the best of cases. We are at the minimum level of security”, denounces Frédéric Guillo, secretary general of the CGT Prefecture from police. A fortnight ago, he recalls that his colleagues were forced to put themselves “to seven” on the same patient to succeed in controlling him.
“On paper, we are 10 agents short. But when you are in contact with madness every day, you cannot afford to be understaffed,” he breathes. Tired by their working conditions and worried about the future of the service, which hierarchically depends on the Paris police headquarters – a status denounced by the report of the general controller of prisons and places of deprivation of liberty of 2019 -, part I3P staff decided to go on strike on December 13th. In order to make their service more attractive, they are calling in particular for the recruitment of missing staff, and asking to benefit retroactively from the measures put in place by the Ségur de la santé in 2020, for which they were not eligible.
*Names have been changed.