Lancement d’une recherche – action visant l’implémentation de la HCR20 à la maison d’arrêt d’Amiens

Abstract

In France, an average of 40% of convicted prisoners are repeat offenders. To prevent disruptions in care that may lead to new offenses, the regional medico-psychological department (SMPR) of the Amiens prison first introduced short-term post-incarceration support (6 months) in 2021. The multidisciplinary team now intends to facilitate the transition to a desistance process for incarcerated men who are undergoing treatment in prison and to, provide support when they are released. The strategy consists of three main components: training, organization, and expanding the range of care. The team has already started training for three tools: HCR20 V3, SAPROF, and CAPP-IRS. The first pertains to the assessment and management of the risk of interpersonal violent relapse, the second focuses on identifying protective factors related to violence, and the third addresses psychopathy, a significant risk factor for violence. In terms of organization, care at the SMPR has been restructured to incorporate the assessment of the level of risk of relapse during detention and its reassessment during post-carceral follow-up. The aim now is to strategically address any identified dynamic risk factors, taking protective factors into account. The expansion of the care provided, begun in 2022, led to the opening of a therapeutic and integration cohabitation unit (TICU) in October 2023, serving as a “gateway” facility accommodating 5 men who have been released from custody supported by the SMPR in post-carceral care, also for a duration of 6 months. The primary objective of this observational, prospective, and single-center study is to measure the effectiveness of intra-carceral and post-carceral support – restructured around risk assessment and management tools – for individuals exiting the Amiens prison after achieving desistance at the end of the follow-up and for a period of 5 years. This effectiveness could be reflected in a reduction in psychopathic traits and in the level of risk of recidivism for those supported in post-carceral care, from the time of incarceration to the end of care. These mental health care professionals also wish to document the implementation of the three tools in their service and assess their predictive validity within their sample. The study also serves to evaluate the effectiveness of the experimental TICU program. The early identification of risk factors should improve the specificity and prioritization of risk prevention actions as part of routine care. Demonstrating the effectiveness of this extended treatment program, tailored to the needs of the outgoing incarcerated population, could lead to the replication of this specialized psychiatric approach in other penal facilities. The project is part of a common effort to break down barriers between the various sectors involved in the care of individuals who are released from prison. Collaborative multidisciplinary teamwork, both within the department and with mainstream psychiatric care facilities, lies at the core of the results of this research. Could it be possible to revitalize the individual and collective commitment of those working with patients who may present a risk of violence?