It is a striking dive into an unknown environment, or almost. An often fantasized environment, too. In A dangerous man (Ed. Goutte D’or), which has just been published, the journalist and novelist Alexandre Kauffmann takes us into the daily life of the “UMDs”, the units for difficult patients.
This is where those who are no longer needed by traditional psychiatric services are welcomed and cared for. Sick people who escape any traditional treatment, but also criminals deemed criminally irresponsible or those whose mental health has deteriorated in prison. Interview.
Your investigation begins with an immersion within the UMD of Albi, a department in which 38 of the 40 patients committed a homicide or an attempt. How did you feel when you entered this unit?
Before entering, there is necessarily apprehension. I was immediately given a small box that sets off an alarm if it is horizontal for more than 15 seconds. This is to raise the alarm in the event of an attack. In reality, once inside, you forget your fears relatively quickly. Most patients are bored, and there is more of a desire to interact. One of them straight away asked me if I worked at Daily Planet, Superman’s Diary. Another always wanted to play Scrabble with me and systematically beat me. What we perceive above all is vulnerability. There was a man who engaged in cannibalism. It’s dizzying, but we don’t think of that when we see him smoking his cigarette in Charentaises.
In your work, you are particularly interested in a man, Bosco Gonda *…
Originally, I planned to tell the story of a man who spent almost forty years in these units. When he talked to me about it, I almost had the impression of hearing a tourist guide: here, we eat better, there, the rooms are more comfortable… And then, he told me about this man, Bosco Gonda. He described him as an extreme case, the most dangerous patient in France. That intrigued me. I said to myself, “If he talks to me like that, what must it be…”
What did you discover?
His track record is indeed very impressive. This man was first imprisoned in connection with a kidnapping case. In detention, shortly after his arrival, he beat his fellow inmate and then, a few months later, killed another inmate. Experts estimated that his discernment was abolished during his act and Bosco Gonda was sent to UMD. He spent four years there, his condition seemed to have improved, so he returned to a traditional service. But during a leave, he killed and dismembered his sister, then shot police officers who tried to arrest him. He was placed back in UMD. His last act dates back around ten years, he violently attacked a nurse during Christmas dinner.
However, you say that Bosco Gonda does not correspond to the image you had of him…
I quickly realized that there was a profound gap between his journey, his actions, and the way in which people spoke to me about them. People described me as an intelligent, kind, very funny man. “An exemplary son,” I was told. Several people assured me that his actions did not correspond to the man they knew. I ended up meeting him. I actually had a sensitive man in front of me. If I didn’t know his past, I would never have been able to imagine it.
Isn’t his place in prison rather than in a psychiatric hospital?
We always have a fantasy about simulating madness. We sometimes hear “he killed people but he escaped prison”. This implies that he did well. But you should know that everyone who came from prison was only waiting for one thing: to return there. Prison is still less supervised, prisoners have the right to cook for themselves and to have their own cigarettes. In UMD, surveillance is extremely tight, it is not at all a hideout or a sinecure. Especially since in prison, inmates know roughly when they will get out, not in UMD. Usually they spend a year there, but sometimes it lasts for years or even decades. The one who told me about Bosco Gonda, for example, was sentenced to twenty years for murder, but he spent more than forty years in UMD. And this is not a unique case.
Your book establishes the observation of a sort of perpetuity which does not speak its name…
Of course, there are patients who will never leave UMD because their pathology does not progress or their behavior does not allow them to be transferred. But a patient who has committed a crime, no matter how shocking, can have a positive outcome of his illness and hope to be released one day. What we must keep in mind is that these are not delinquents but sick people, they suffer from their pathology. Moreover, those who are recognized as irresponsible receive the disabled adult allowance.
However, the difficulty remains in assessing the dangerousness. In the case of Bosco Gonda, for example, he committed a crime while on leave…
To leave UMD, Bosco Gonda first received a favorable opinion from the medical monitoring commission, made up of four people including three psychiatrists from outside the unit. Then two experts, always from outside the establishment, gave an opinion. The final decision on its transfer to a more traditional unit comes back ultimately to the prefect. But it was often repeated to me during my investigation: psychiatry is not an exact science. Experts do not claim to discover a scientific truth, they engage in forensic reasoning. Cases of recurrence are extremely rare. It is the exception within the exception. Of the 17,000 people declared criminally irresponsible each year, there are less than fifty murders.
Today, the question arises of giving Bosco Gonda a third chance. During your investigation, you discovered that he is no longer in UMD but in a traditional psychiatric department. He is already on leave and could be released shortly…
This is a very difficult question: on the one hand, there is a terrible history, on the other, there is this impossibility of being locked up for life. His behavior has been impeccable for over ten years. His ex-partner told me that she had often tested him, that she sometimes pushed him to the limit to see his reactions. She’s never seen him lose his temper. It is proof that evolution is possible with good support. Today, doctors believe that a release would be beneficial. This does not mean that it will be released into the wild. For example, it is possible to implement care without consent on an outpatient basis. It is the obligation to undergo treatments and consultations while being outside the hospital.
The question of criminal irresponsibility is eminently political. We remember the controversy after Kobili Traoré, who killed Sarah Halimi, was declared not criminally responsible…
Of course. Today, security concerns dominate. In the Romain Dupuy affair [qui a tué une infirmière et une aide-soignante à l’hôpital psychiatrique de Pau en 2004], the prefect blocked his transfer to a traditional psychiatric service for five years. He didn’t want to risk seeing him come out. However, he had a favorable opinion from the commission and the two experts. He stayed at UMD for eighteen years. He was also one of Bosco Gonda’s best friends.
* Bosca Gonda is a pseudonym, to guarantee anonymity.