practice for all that. And yet, their implementation would not require new means – simply instructions, monitoring or training. In this respect, the introduction of a right to collective expression for prisoners under the Prison Act dated 24 November 2009, for which an implementing regulation has been adopted, can only develop in step with a cultural change. The supervisory measures that have been taken are not enough to bring about a new means of expression – even though this is unquestionably worthwhile in terms of social regulation and rehabilitation. Likewise, it is regrettable that the information documents (welcome booklets, internal regulations, information concerning hospitalisation, etc.) handed out to prisoners and their families are not sufficiently available or understandable, because they have not been updated, translated or distributed. On these and other comparable points, the CGLPL can only ask that the administration take any measures where there are no objections in principle or financial obstacles. 1.3 The recommendations concerning mental health institutions The CGLPL's general recommendations concerning mental health institutions bear on the general treatment conditions of patients hospitalised without consent – including prisoners, on the right to information for patients and the exercise of rights of defence, on the right to maintain family ties, on access to activities and, above all, on the use of solitary confinement or restraint measures. The details and supervision of these recommendations can be found in Appendix 4. The organisation of the hospital system in public institutions, which operate independently and benefit from the distribution of powers within the central administration of the Ministry of Health, is such that the supervision of the CGLPL's recommendations by this administration is difficult. As previously explained, only those recommendations falling within the remit of the General Directorate for Healthcare Services were subject to supervision submitted to the CGLPL. It is therefore particularly regrettable that this authority does not have any information about the action taken following a significant proportion of its observations. The CGLPL therefore asks the Ministry of Health to change its practices in this regard. Within the few responses it received, the CGLPL does not observe any disagreements in principle on the contents of the recommendations. It is particularly satisfied to note that the Ministry is intending, in 2017, to add the application of several of these recommendations to the agenda for the two working groups set up to implement the Act of 26 January 2016 on modernising the French health service: one on the use of solitary confinement and restraint, and the other on local mental health projects. The CGLPL will assist the Government any way it can in improving the treatment of people hospitalised without consent. Of the general recommendations submitted for the Government's attention, the CGLPL would like to stress one in particular: the treatment of prisoners. For when the latter are hospitalised without consent in a mental health institution, they are often placed in a seclusion room, or in restraints in some cases, regardless of their clinical condition and sometimes for the entire duration of their stay. Such practice, which entails using solitary confinement not for medical reasons but for security reasons, is in violation of the Act of 26 January 2016. It violates the rights of patients, particularly the right to be able to access all treatments and activities on offer at the institution in which they are hospitalised. It stems from an excessive interpretation of the security obligations of health institutions and subjects prisoners to conditions that restrict their rights much more heavily than is the case in prison. Instructions must therefore be given so that the reception of prisoners 53

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