Ixchel Delaporte likes to look behind the scenes. After his work The Grapes of Miserye, released in 2018, in which she denounced the working conditions of the wine workforce in the shadow of the great châteaux, the journalist and documentarian publishes this Thursday Listen to the walls talking (Ed. Iconoclast) and lifts a corner of the veil on the psychiatric hospital.
For eight months, Ixchel Delaporte lived in Cadillac, in Gironde. Its inhabitants live alongside the hospital’s approximately 2,000 patients. psychiatric. The journalist returns, to 20 minutes, on this immersion “in this little microcosm, where we barter and where we bring kebabs or cokes from outside so that things are smoother” and his book, “an attempt to bring down the walls of the psychiatric hospital so that people are less afraid.”
Why were you interested in psychiatry?
We often confront mental illness through news stories. At that moment, we find ourselves with people who act out, who are violent, and we are hit suddenly, but without understanding. Romain Dupuy [le jeune schizophrène qui a tué deux soignantes à Pau en 2004] is an extreme example. And often after very brutal acts of violence, when we rewind the thread, we realize that there was an area of psychiatric illness which was not sufficiently taken into account.
This raises the question that these patients are in complete invisibility most of the time and are subject to immense media exposure when a tragedy occurs. There is no middle ground between these two extremes and this reinforces a feeling of distance from these people. This book is an attempt to break down the walls of the psychiatric hospital so that people are less afraid. We must not act as if these patients do not exist, but give them a face. We don’t hear them tell their own stories.
And you wanted to give them a voice with this book. Was it difficult to communicate with them?
They are fragile people, and many of them have problems communicating with others. I didn’t force those who didn’t want to talk to me, I let them come to me, sitting on a park bench. Of course I didn’t meet everyone, but I had friendships with some of the patients, with the return of speaking honestly about myself.
We meet each other, but not a sick person. We discover that we have lots of things to say to each other, and mental illness is no longer at the forefront. For example, when I speak with Sylvie, who is schizophrenic and suffers from Diogenes syndrome, I talk about poetry, her daughter or her cancer. We really talk to each other. By diving into this little microcosm, where we barter and bring kebabs or cokes from outside to make things smoother, I remember that these are human beings who exist through the eyes of others. The units operate very rigidly, so the users’ house, which offers coffee, Internet access and books, is taken over. It is also a meeting place for lovers who are not in the same units.
Everyone is a little on edge, and this contributes to situations degenerating into small or large humiliations, confinements and abusive use of restraint. »
Was access to caregivers ultimately more difficult in your experience?
I thank the management for having the courage to let me move freely, even if there was a unit that I was not able to enter because I was told that things were going very badly. The lack of time and staff also explains why exchanges were reduced with caregivers. There was the desire of some of them to confide in me their feelings anonymously, which shows the complexity of saying what is wrong, without finding themselves in difficulty within the institution or vis-à-vis -vis his colleagues.
And, I also think that some psychiatrists are very bothered by us seeing what is happening inside the units, particularly regarding the consideration of patients or the way in which we take care of them.
Is the very medicalized approach to the detriment of listening to patients?
Patients ask for listening and trust and this does not fit into the protocols. Medicalization is obviously necessary because medications make it possible to regulate the disease, so that patients are less violent, depressed or suicidal. But we are talking about pure humanity in psychiatry and the exchanges around their personal history and their experiences are part of a possible improvement in their health. I observed a certain lack of humanity and discussion. Everyone is a little on edge, and this contributes to situations degenerating into small or large humiliations, confinements and abusive use of restraint. For example, if there are too few caregivers to control an aggressive or agitated patient, it is easier to place him in an isolation room.
Do all psychiatric hospitals use these most restrictive measures in the same way?
Some hospitals use these methods as little as possible, but this requires a lot of administrative will. It should be noted that in certain situations, they are necessary. In the book, a patient says that restraint was, for her, a lifesaver. It allowed him to reconstitute himself, to feel his bodily envelope because, during attacks of schizophrenia, people have the sensation of being shattered into a thousand pieces. But some patients experience it badly, and it is not always the most appropriate response. Some caregivers also feel mistreated when administering them.
How to describe life in Cadillac where patients from the psychiatric hospital sometimes wander around during the day or live in apartments?
It’s a mix of genres and the people of Cadillac have no choice, the hospital has been there for 400 years. It can happen that a patient talks to himself, verbally attacks a passerby or throws his belongings, but it is not like that all the time. This bothers some residents but others, like the bookseller Christophe, have decided to fraternize. It’s a clear and radical choice, which probably takes away some of its customers.
I noticed that a lot of housing in Cadillac is unsanitary and that this is a very practical windfall for landlords, since these are guaranteed rents, paid by the patients’ guardians. There is no funding for therapeutic apartments, even though the objective is to get patients out of the overwhelmed hospital as quickly as possible. Once housed in Cadillac, city nurses bring patients their medications. The opportunity to identify possible disruptions in care in advance or to defuse crisis situations. Without them, I don’t know what Cadillac would be like.