The mirror image of asylums and prisons: A study of institutionalization trends in France (1850–2010)
| Author | Bernard E Harcourt,Sacha Raoult |
| Published date | 01 April 2017 |
| DOI | 10.1177/1462474516660696 |
| Date | 01 April 2017 |
| Subject Matter | Articles |
Article
Punishment & Society
2017, Vol. 19(2) 155–179
! The Author(s) 2016
The mirror image
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of asylums and prisons:
DOI: 10.1177/1462474516660696
journals.sagepub.com/home/pun
A study of
institutionalization
trends in France
(1850–2010)
Sacha Raoult
Aix-Marseille Universite, France
Bernard E Harcourt
Columbia University, USA
Abstract
This article analyzes trends in prison rates and mental hospital rates in France since the
earliest available statistics. It shows that, on almost two centuries of data and amidst an
agitated political history, every asylum trend in France is ‘‘countered’’ by an inverse
prison trend, and vice-versa. Both trends are like a mirror image of each other.
We reflect on the possible explanations for this intriguing fact and show that the
most obvious ones (a population transfer or a building transfer) are not able to account
for most of the relationship. After these explanations have been dismissed, we are left
with an enigma with wide theoretical and practical implications. How is it that when
prisons fall, asylums rise and when prison rise, asylums fall? We suggest possible
research avenues drawing on the 1960s and 1970s critical literature on ‘‘total institu-
tions’’ and offer implications for current theories of the ‘‘punitive turn’’ and current
quantitative studies of prison rates.
Keywords
discipline, mental illness, prison, social control, theories of punishment, total institutions
Corresponding author:
Sacha Raoult, Aix Marseille Univ, LDPSC EA4690, LAMES UMR 7305, F-13000, Marseille, France.
Email: sacha.raoult@univ-amu.fr
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Punishment & Society 19(2)
Introduction
During the Vichy re´gime in France, a dramatic number of asylum patients died in
what has come to be known as ‘‘l’he´catombe des fous,’’ the hecatomb of the insane.
Famine and malnutrition, misdiagnosed by the medical professionals, and the
delayed response of the Vichy government, took the lives of about 45,000 mental
hospital patients (Von Bueltzingsloewen, 2009). In tandem with a sharp
drop in new asylum admissions, explained at the time by lowered ‘‘alcoholism’’
admittances, the extremely high mortality of patients produced a sharp drop
in mental hospitalization rates—sliding almost by half from a high of 278 per
100,000 in 1940 to 164 per 100,000 by 1946. The rapidity of the decline was unpar-
alleled in the history of asylums in France.
During the very same period, the French prison population rose in an unprece-
dented fashion, with three distinct waves of prisoners: a first wave of traitors and
spies who aided the German enemy from the beginning of the war in 1939 to the
armistice of September 1940; a second wave from the beginning of the occupation
to the Libe´ration in June 1944—the largest contribution to the inflation—composed
of political prisoners, re´sistants, and communists, sentenced severely in newly cre-
ated ‘‘special’’ courts, as well as prisoners convicted by German courts but detained
in French prisons; and finally, a third wave composed of wartime collaborators
with the Germans. By the end of the war, prison rates had more than quadrupled
from about 40 per 100,000 in 1937 to 170 per 100,000 in 1944.
The direct causes of the dramatic drop in asylum patients and steep rise in the
prison population seem completely unrelated, although naturally, they were all tied
to the war and the occupation of France; but while they appear disconnected, the
symmetry between the trends, as reflected in Figure 1, is eerie, to say the least.
The Vichy re´gime was not the only time period where a quantifiable inverse
relationship between asylum and prison populations happened in France. In fact,
this relation is even starker over the longue dure´e of existing, reliable statistics.
Figure 2 extends the time series from the earliest date of reliable statistics, the
year 1851, to the present. Figure 3 compares the five-year average change for
each of the time series over the same period, with the exception of the world
wars where the data are noisier because of the more dramatic shifts and lags.
One could only describe the relationship as ‘‘mirror image’’: when prison populations
rise, asylum populations fall; when prison populations fall, asylum populations rise. . .
This is not the first time that an inverse relationship between asylums and prisons
has been identified. In fact, the French situation is entirely consistent with recent
research on the United States and also tracks the trends in other European countries.
In the United States, over the entire period of available population statistics, asylum,
and prison rates have trended in opposite directions, producing a virtual mirror
image of each other, as reflected in Figure 4 (Harcourt, 2006a, 2011a).
A similar inverted relationship can be seen among a number of European coun-
tries over the past several decades, where prison population rates have been trend-
ing upwards, as evidenced in Figure 5, while mental hospitalization rates have been
trending downwards, as evidenced in Figure 6 (Harcourt, 2011c).
Raoult and Harcourt
157
Figure 1. Rates of asylum and prison populations in France (1936–1955).
In all those countries, a contemporary shift ‘‘from the asylum to the prison’’ has
been observed: a conjugation of mental hospital deinstitutionalization and growth
of imprisonment. Those two phenomena suggest at least a conjectural relationship
between the two institutions, something to investigate further. But the French case
is something else entirely: a much lengthier and more intriguing pattern to study
the interaction between the two institutions. In France, we find, over 150 years of
data, several movements from the prison to the asylum and from the asylum to the
prison. This ‘‘mirror image’’ implies a more robust relationship between the two
‘‘total institutions’’ than previous research suggested.
The French empirical data are especially rich because of a combination of two
characteristics of France that are difficult to find in other countries. First, France
158
Punishment & Society 19(2)
Figure 2. Rates of asylum and prison populations in France (1851–2009).
Figure 3. Five-year average percentage change for asylum and prison populations in France
(1850–2010).
Raoult and Harcourt
159
Figure 4. Rates of asylum and prison populations in the United States (1934–2001) (source:
Harcourt, 2011c).
Figure 5. Rate of prison population in Belgium, France, UK, Switzerland, and Italy (1987–
2006) (source: Harcourt, 2011c).
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Punishment & Society 19(2)
Figure 6. Rate of psychiatric beds in Belgium, France, UK, Switzerland, and Italy (1970–2000)
(source: Harcourt, 2011c).
has a long history of state statistics that have been gathered since the early 19th
century (on this history, see Desrosie`res, 2008). Second, French has had an agitated
political history over the studied period, including several regime changes and wars
(Caron, 1981; Sirinelli, 1995).
The first part of this paper establishes the empirical data and the second part
discusses their possible implications. These findings admittedly raise more questions
and challenges than they answer. There is no simple explanation for the continuity of
confinement, nor for the offsetting effect of these trends. In this paper, we discuss the
three main types of explanations: demographic, material, and cultural.
We conclude that our findings pose a challenge to some contemporary dominant
theories of punishment: the idea of a recent ‘‘culture of control’’ in Anglo-Saxon
countries (Garland, 2001) or of the role of different styles of capitalism on pun-
ishment practices in the West (Lacey, 2008). We suggest that the failure to include
asylums in the study of contemporary penal practices may prove to be one of the
most important shortcomings of the research community since the high tide of
reflection on the asylum in the 1960s and 1970s (following most notably
Goffman, 2007 and Foucault, 1961).
The historical data
France presents a rich case study for the mirror image relationship and off-setting
effect of asylum and prison populations for two important reasons: first, because
Raoult and Harcourt
161
institutionalization statistics for prisons and mental hospitals have been recorded
since the beginning of the 19th century, so the time series is far more extensive than
in the United States;1 and second, because French history has been replete with
political shifts, wars, and economic crises during the past two centuries, which have
had important repercussions on institutionalization rates. Despite all that, the
empirical evidence clearly establishes that practically every trend in prison rates
has been the mirror image of the trend in the context of asylum rates.
In its post-revolutionary period, France established a distinct dichotomy between
‘‘penal’’ detention and ‘‘medico-administrative’’ detention. The Napoleonic criminal
code of 1810, in its article 64, stated that ‘‘there is no crime’’ when the suspect was
‘‘de´ment’’ (mad) during the facts; while the 1838 law, creating the modern ‘‘asiles,’’
justified institutionalization on the condition of mental alienation, not on a particu-
lar deed. While the dichotomy was clear in legal texts, in penal practice,...
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