MONITORING PSYCHIATRIC INSTITUTIONS disabilities are found in many other places of deprivation of liberty that were not discussed at the Symposium, including prisons, police stations, homes for the elderly or orphanages. Persons held in psychiatric institutions have a range of legal statuses, as they can be placed following either criminal or civil proceedings. In the first instance, the decision regarding placement as part of the criminal justice system is decided by a judge and the placement is involuntary. As part of the civil procedure, we find persons whose placement is involuntary (a placement also called “mandatory”, “forced” or “without consent”) and that, in some countries, is ordered by a judicial authority or subject to judicial review, as well as persons who have agreed to being placed in an institution. A shift from voluntary to involuntary placement is nonetheless common, and in practice it is not unusual for individuals who have been voluntarily placed not to be free to leave the establishment and to be subject to the same conditions and measures restricting their freedom (e.g. placement in closed units, seclusion) as persons placed against their will. These so-called “volunteers” are particularly at risk as they do not enjoy the same legal safeguards as involuntary persons as they were initially placed in the institution on a “voluntary” basis. “By definition, everyone detained in a prison, police station or an immigration detention centre is deprived of liberty. This is not the case in a health-care setting or care home, even though many patients or residents thought to be voluntary are not so in reality.” Catherine Paulet, member, SPT The terminology used to refer to people who are institutionalised in psychiatric hospitals varies enormously and includes: “persons with mental disorders”, “persons with mental health problems��, “persons with mental disabilities”, or “persons with psychosocial disabilities”. In this report, we favour the use of terms such as “persons with mental disabilities” or “persons with psychosocial disabilities” to reflect the historical paradigm shift embodied by the CRPD which, for the first time, enshrines in an international treaty the fact that 13