Forensic Psychiatry in Switzerland: At risk of security and positivist instrumentalization

The article presents a critical analysis of the development of forensic psychiatry, based on a description of the recent evolution of the Swiss penal code and its implications for penal institutions. We hence describe the increased power of the system of penal measures which leads to an increase in deprivations of liberty of indefinite duration for offenders suffering from mental disorder. Whether criminally responsible or not (being subject to the same measures in the same places of detention), it is the assessment of their dangerousness that becomes the central element to psychiatric expertise and consequently determines their criminal course. The patient is thus reduced to a sum of risk factors to be controlled and supervised. The lack of appropriate structures and the ambiguity of the notion of forensic therapy contribute to longer deprivation of liberty and a resulting violation of inmates’ fundamental rights Forensic psychiatric practice, as expert or therapist, is thus subject to an increasing pressure for practitioners to fit into this security perspective, in defiance of the cardinal principles which founded this medical discipline.