Treatment of Prisoners with Mental Illness

Renolde v France [2008] ECHR 5608/05 (16 October 2008)

On 16 October 2008, the European Court of Human Rights held that the suicide of a mentally ill prisoner in France was attributable to the authorities’ failure to provide adequate medical care. This failure was a breach of the deceased’s right to life and right to be free from inhuman or degrading treatment.


Joselito Renolde was arrested for assault on 12 April 2000 and remanded in prison. On 2 July  2000, he attempted suicide. He was treated by a Rapid Crisis Intervention Team after he  reported hearing voices, who reported:

Patient who made an SA [suicide attempt] by cutting his forearm with a razor. This act took place in the context of a hallucinatory delusional state observed since yesterday by the prison duty staff. On being interviewed, the patient displays incoherent, dissociative speech, a listening attitude, mentions verbal hallucinations, [illegible], persecutory delusional statements ... The patient mentions his psychiatric history, says that he has already been admitted to hospital and has already taken Tercian ... Conclusion: acute delirious episode.

The Crisis Team prescribed antipsychotic medication, and Mr Renolde was referred to the  Regional Medical and Psychological Service (‘SMPR’). He was placed in a cell under special  supervision, and seen by the SMPR ten times in the next eighteen days. He was also given his  medication every few days by the SMPR.

On 4 July, Mr Renolde threatened a trainee warder and threw a chair in her direction. An  investigation into the incident found that Mr Renolde was a ‘very disturbed prisoner who had  already wanted to go to the SMPR at 7.50 am, received by the SMPR in the afternoon’. As to the  action to be taken, the report stated: ‘Very disturbed prisoner, being monitored by the SMPR, will  need to go before the disciplinary board.’

Mr Renolde faced a disciplinary board hearing on 5 July, and was penalised with 45 days in the  punishment cell, where he was detained for 23 hours a day without any television or other  activities. This was the maximum penalty allowed.

On 12 July, Mr Renolde’s lawyer and family requested a review of his punishment, on the basis of his psychological illness. On 20 July 2000, while this request was being processed by the authorities, Mr Renolde hanged himself.

Mr Renolde’s sister made application to the European Court of Human Rights, alleging breaches of arts 2 (right to life) and 3 (protection from torture or ill-treatment) of the European Convention of Human Rights.


Right to life

The Court reiterated that the right to life requires the State not only to refrain from the intentional and unlawful taking of life, but also to take appropriate steps to safeguard the lives of those within its jurisdiction. The Court then determined whether, given the circumstances of the case, the State did all that could have been required of it to prevent Mr Renolde’s life from being avoidably put at risk.

The Court acknowledged that the State’s obligation must be interpreted in a way which does not impose an impossible or disproportionate burden on the authorities, bearing in mind ‘the difficulties involved in policing modern societies, the unpredictability of human conduct and the operational choices which must be made in terms of priorities and resources.’

However, the Court concluded that the authorities knew that Mr Renolde was suffering from psychotic disorders capable of causing him to commit acts of self-harm. The Court suggested that the authorities, faced with a prisoner known to be suffering from serious mental disturbance and to pose a suicide risk, should ‘take special measures geared to his condition to ensure its compatibility with continued detention’. In this respect, the Court stated that, ‘in the case of mentally ill persons, regard must be had to their particular vulnerability’. The Court considered that, by failing to consider admitting Mr Renolde to a psychiatric institution and failing to supervise him taking his medication, the State had failed to satisfy its positive obligation to take preventive operational measures to protect an individual whose life is at risk.

Lastly, the Court has had regard to the fact that, three days after his suicide attempt, the applicant was ‘given the most severe disciplinary penalty, namely forty-five days’ detention in a punishment cell’. The Court observed that ‘placement in a punishment cell isolates prisoners by depriving them of visits and all activities, and that this is likely to aggravate any existing risk of suicide’. The Court reiterated that:

the vulnerability of mentally ill persons calls for special protection. This applies all the more where a prisoner suffering from severe disturbance is placed, as in the instant case, in solitary confinement or a punishment cell for a prolonged period, which will inevitably have an impact on his mental state, and where he has actually attempted to commit suicide shortly beforehand.

Inhuman or degrading treatment

The Court reiterated that ill-treatment must attain a minimum level of severity if it is to fall within the scope of art 3:

The assessment of this minimum level is, in the nature of things, relative; it depends on all the circumstances of the case, such as the duration of the treatment, its physical and mental effects and, in some cases, the sex, age and state of health of the victim.

In the context of detained persons, the Court emphasised the right of all prisoners to conditions of detention ‘which are compatible with human dignity, so as to ensure that the manner and method of execution of the measures imposed do not subject them to distress or hardship of an intensity exceeding the unavoidable level of suffering inherent in detention’.

The Court further observed that measures to protect against ill-treatment must, in the case of mentally ill persons, ‘take into consideration their vulnerability and their inability, in some cases, to complain coherently or at all about how they are being affected by any particular treatment’.

The Court concluded that Mr Renolde’s severe penalty may well have threatened his physical and moral resistance, particularly given his mental illness, and considered that such a penalty is not compatible with the standard of treatment required in respect of a mentally ill person and constitutes inhuman and degrading treatment and punishment. Relevance to the Victorian Charter It should be noted that arts 2 and 3 of the Convention are substantially similar to ss 9 and 10 of the Victorian Charter.

The Renolde case continues to develop a long line of international human rights jurisprudence which imposes positive obligations on States to protect the lives of citizens (see eg LCB v United Kingdom, 9 June 1998, § 36, Reports 1998 III; Tanribilir v Turkey [2000] ECHR 21422/93; Keenan v United Kingdom, [2001] ECHR 27229/95; Ataman v Turkey [2006] ECHR 46252/99). The onus on States is to do all that could have been required of them to prevent a citizen’s life from being avoidably put at risk, so long as this does not impose an impossible or disproportionate burden.

This obligation is now imposed on the State of Victoria, and compels public authorities to do all that could have been required of them to prevent a person’s life from being put at risk – even if that risk is self-imposed. The Renolde case, and the line of authorities which it joins, compels public authorities to take these steps to protect lives.

Additionally, the Renolde case reiterates that punishments, including imprisonment and other forms of detention, must be compatible with human dignity. This requires that the manner and method of execution of the measures do not subject the detainee to distress or hardship of an intensity exceeding the unavoidable level of suffering inherent in detention. This case, and previous international jurisprudence, states that detainees’ health and well-being has to be adequately secured, given the practical demands of imprisonment.

James Farrell is a Taxation lawyer at Corrs Chambers Westgarth and a Team Leader at the PILCH Homeless Persons’ Legal Clinic