Switzerland: walling up madness

How does Switzerland handle mentally disordered offenders?

Many individuals who have committed offences and suffer from mental health illness are held under the ordinary prison regime. Others are detained in psychiatric facilities, sometimes for indeterminate lengths of time. These persons have different legal statuses, may be placed in several different settings, and receive various levels of care. What is the fate of mentally disordered offenders in Switzerland?

Prison Insider and the French National Union for Family and Friends of People Suffering Mental illness and/or Psychological Disability (Unafam) examined the experience of offenders with mental health problems in eight European countries. Here is an overview of the situation in Switzerland.

Nearly 60% of people subject to in-patient treatment are placed in prison.

Offenders are rarely admitted to general psychiatric hospitals.


Care-related hospitalisation: compulsory admission for treatment. Order whereby a person can be involuntarily committed to hospital.

CNPT: the Swiss National Commission for the Prevention of Torture (Commission nationale de prévention de la torture).

In-patient treatment measure: a sentence of mandatory mental health treatment within a specialist facility, psychiatric hospital, or prison.

Indefinite incarceration: sentencing option for individuals who are suffering from severe mental ill-health and where an in-patientl treatment measure is not believed to have a reasonable chance of success, or when, due to “particular characteristics of the offender, the circumstances of the crime committed and his or her past behaviour, it is reasonable to assume recidivism likely to occur”. Indefinite incarceration measures are usually served in prison.

Lifelong incarceration: sentencing option for offenders deemed chronically untreatable. The conditions required for such a sentence to be revoked are difficult to achieve.

Out-patient treatment measure: therapeutic measures for individuals with severe mental illness or addictions. Required alongside a prison sentence, and as such, usually delivered in prison.

SMPP (Prison Medical and Psychiatric Services, Services de médecine et de psychiatrie pénitentiaire): specialist forensic units within psychiatric hospitals. Managed by the Department of Health.

UHPP (Prison Psychiatric Unit): specialist clinical wing within Curabilis prison for prisoners with mental illnesses requiring specific treatment.

UPK: Basel University Psychiatric Clinic Psychiatric facility.