of the CGLPL's observations by word of mouth, had taken the initiative of anticipating the first necessary actions. Furthermore, she stated that the institution had undertaken to put an immediate stop to a certain number of practices: - patients would no longer be confined to an ordinary room; - patients hospitalised over the long term in the unit for "agitated and disruptive patients" would be assigned to a unit intended to care for patients for long periods; - detained patients would no longer be systematically placed in restraints upon their arrival from the prison, but accommodated in an assessment unit for subsequent referral to the other units in the institution depending on their medical problem; - the internal yards of hospital units would be freely accessible to patients hospitalised with their consent. She went on to point out that reminders of the regulations and training had been given in the institution, which is looking into the conditions for implementing those recommendations of the CGLPL that could not be applied with immediate effect. She issued the institution with a sixmonth deadline for complying fully with all of the CGLPL's recommendations. In a letter dated 17 November 2016, the new director of the institution maintained that the CPA had endeavoured to abide by all of the CGLPL's recommendations and committed to implementing its management plan, particularly involving the users and representatives of users' associations in this process. He requested a follow-up inspection by the CGLPL so that the latter "could see the extent to which the changes made were effective and the efforts that had been initiated." The CGLPL duly notes with satisfaction the improvements announced by the Government and by the management of the Ain psychotherapy centre. It recommends that the Government do their utmost to ensure that the recommendations issued during this visit are brought to the attention of all mental health institutions and that, during inspections and audits conducted in these institutions, any similar deviations be sought. 3. Thematic report entitled "Solitary confinement and restraint in mental health institutions" The rights of patients who are hospitalised without their consent and the psychiatric care arrangements in place for all people deprived of liberty raise crucial questions with regard to fundamental rights. Since 2011, French lawmakers have regulated the measures for enforced hospitalisation by initiating systematic scrutiny by the Liberty and custody judge; that said, some people can be subjected to additional physical constraints, such as placement in a seclusion room or in restraints for example, without these measures being inspected by the judicial authorities. The CGLPL's visits to mental health institutions have lifted the lid on such extensive use of solitary confinement and restraint that they seem to have become essential for professionals. The almost total absence of public debate on the development of these treatments is perplexing. This is why it appeared pertinent to shed light on these procedures. 42

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