JEAN-JACQUES GAUTIER NPM SYMPOSIUM 2016 various forms of restraint (physical and chemical). This reality calls for action, especially as existing international standards tend to limit, and even prohibit - in the case of the CRPD Committee - the use of such practices. The CPT standards on psychiatry only provide for the use of seclusion and restraint in exceptional circumstances, as a last resort, for the shortest time possible, and under the constant supervision of qualified medical staff. The CPT specifies that the use of such practices should never be applied as a punishment and that each instance of seclusion or restraint should follow a procedure that enable the use of these practices to be recorded and properly traced.13 In May 2016, the French NPM published a report on seclusion and restraint in France, following visits conducted in more than 100 healthcare establishments over the last few years.14 This report highlights the fact that no scientific study confirms the therapeutic effectiveness of restraint and seclusion and reveals a huge disparity in the use of these practices in France, a disparity also observed by NPMs in other countries: • variations in the use of seclusion and restraint depending on the establishment (use sometimes widespread and completely commonplace or practically absent), even within the same establishment where significant differences were sometimes found from one unit to the next; • a variety of reasons given to justify the measure: “risk” posed by the individual, therapeutic purpose, but also often “disciplinary” reasons; • variation in the duration of the measures, from a few hours to several months. The Paraguayan NPM has observed non-violent practices in crisis situations in certain institutions, such as the “hug” method (abrazo) or restraint using sheets. 13 14 24 CPT Standards, §§ 47-50. General Controller of Places of Deprivation of Liberty (CGLPL), Isolement et contention dans les établissements de santé mentale, éditions Dalloz, Paris, 2016: http://www.cglpl.fr/2016/isolement-et-contention-dans-les-etablissements-desante-mentale/.