patients (UMD). Admission to UMDs always takes place with the patient having the status of a person hospitalised by court order, henceforth referred to as “committal to psychiatric treatment at the request of a representative of the State” (ASPDRE), that is to say by decision of the prefect. Discharge is also decided upon by order of the prefect after an opinion has been issued by the medical treatment committee of the UMD, considering the patient to no longer represent a danger requiring their maintenance in a UMD. In most cases, it is decided that the patient is to return to a traditional psychiatric ward in their institution of origin; the regulations lay down a deadline of twenty days for this purpose. Yet, from inspections conducted and letters received, the Contrôleur Général has ascertained that patients remain in UMDs even when the medical treatment committee and the prefect have pronounced a decision in favour of their discharge. Apart from the fact that, due to spontaneous apprehensiveness, the institutions of origins are reluctant to readmit patients who have represented a danger for staff, it is above all the vagueness of the texts that makes it impossible to determine which authority is in a position to impose the institution that is to cater for a patient discharged from an UMD, thus leaving room for negotiations of uncertain results. During this time, the patient is obliged to remain in the UMD, sometimes for up to two and a half years. In his Opinion, the Contrôleur Général recommends that, by means of a circular, the authorities should: - on the one hand, recall that prefectoral orders bringing stays in UMDs to an end shall at the same time be followed by an order on the part of the prefect of the French department in which the institution of origin is located, readmitting the patient to the latter; these orders naturally being binding upon the institution, which is liable towards the patient and to the latter’s close relations for any failure to act. - on the other hand, elaborate a procedure enabling the regional health agency concerned (or, in case of several agencies, the central administration), to which the case is referred in due time by the management of the UMD, to take care of immediately determining, in case of doubt, the institution to which the patient is to be returned, the fundamental criterion to be followed in this respect being the patient’s capacity for rehabilitation, in particular with regard to the latter’s family relations, the prefect of the department thus established then immediately issuing the necessary order. At the date of publication of this Opinion, the Contrôleur Général had not received any response from the minister of Social Affairs. He received the latter’s response at 15th March 2013. The minister states that situations in which patients are maintained in UMDs in an unjustified manner are exceptional and that solutions have been found for the cases raised by the Contrôleur Général in his letters on the subject since 2011, thanks to measures taken by the regional health agencies (ARS) concerned. She also points out that she subscribes to the Contrôleur Général’s request to remind regional health agencies of the rules applicable to the end of stays in UMDs. However, to date, the Contrôleur Général has not been informed of the issuing of such information. The inspectors will continue to exercise special vigilance with regard to the length of stays in UMDs and all the more so insofar as all of the latter have been inspected and it is now a question of follow-up inspections of these organisations. 4. Actions taken in response to less Recommendations, Opinions and Cases taken up 70 recent