phenomena of congestion of units that can occasionally be observed. The question of each patient’s activity is therefore, if anything, more important today than in the past. The nature of activities is also a source of difficulty. The care and patience of staff, who tirelessly try to occupy patients by listening, talking to them and providing them with various different pastimes, is clearly worthy of high praise. However, generally speaking, there is scarcely any difference between these pastimes and those that might be offered in institutions for elderly people. Of course, certain units show obvious elements of similarity with the latter, particularly geriatric psychiatric units, which pose the question here addressed in specific terms. However, in other units the age range is very wide. In the case of young people, should one content oneself with allowing them to watch the television, play a few simple board games and do some baking? Is it not necessary to find occupations that prompt them to take greater responsibility? There are examples of institutions in which the activities are clearly more sophisticated. For example, one hospital has a cafeteria accessible to patients, managed by a “board” on which patients are members. Generally speaking, overall reflection needs to be undertaken in this regard. It would be worth conducting an overall investigation of three areas in particular: nature activities, and gardening in particular (which admittedly imposes the necessity of patients going outside as well as tools); sports which can be played (UMDs are not exempt on this point); and, finally, use of the Internet, which it is surprising to see has not given rise to any coordinated reflection, to the point that institutions offering (limited) use thereof to their patients are rare. The necessary control of such activities should not become an insurmountable obstacle to their implementation. Moreover, it would be worth introducing exchange of innovations between institutions, which would facilitate assessment with regard to the results thereof for patients using these new facilities. 5.2.2.3 – Issues concerning Units Once again, prompt reflection also needs to be called for concerning the differences that exist between the sectors of individual institutions, and all the more so between institutions. Once again the point of departure is unquestionable. Every head of department obviously has to assess the best treatment to be given to the patients they cater for. The major therapeutic differences that separate units are not therefore here in question. What is in question, on the other hand, is the respective places that should be held by necessary treatment and the fundamental rights, which are just as necessary, attached to every patient. Each person’s rights may have to be adapted to the context of their health, their safety, and that of others… However, it inconceivable that the scope of these fundamental rights should vary mechanically with each change of sector, and therefore of unit. There could thus be no better illustration of the supremely contingent character thereof. Yet, it is precisely this latter character which is inadmissible, with regard to rights that give expression to the dignity of the person. For this reason, the management of each institution, with the support of the CME and of the heads of department, needs to define the elements that are unaffected by differences between sectors and are exclusively based, and only when necessary, on the differences between patients’ disorders. This needs to apply: 62