2.4 Actions taken in response to the Opinion of 17th January 2013 concerning unjustified stays in Units for Difficult Psychiatric Patients The Contrôleur général des lieux de privation de liberté published and Opinion in the Journal Officiel of 5th February 2013 concerning unjustified stays in Units for Difficult Psychiatric Patients (UMD). Persons who “present a danger for other persons of such a nature that the necessary treatment, surveillance and security measures can only be implemented in a specific unit” may be committed to specialised psychiatric facilities known as units for difficult psychiatric patients (UMD). Committal to a UMD is made by decision of a representative of the State, i.e. by decision of the prefect. Discharge is also decided upon by prefectural order, after an opinion has been issued by the medical treatment committee of the UMD, considering the patient to no longer represent a danger requiring their maintenance in a UMD.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, the CGLPL 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 origin 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 a UMD, thus leaving room for negotiations of uncertain results. In the meantime, the patient is obliged to remain in the UMD. The Contrôleur Général recommended that the authorities take appropriate measures by means of a circular: - on the one hand, recalling that prefectural 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, defining a procedure enabling the regional health agency concerned (or the central administration in case of several different agencies), to which this point is duly referred in good time by the management of the UMD, to fulfil the task of immediately determining, in case of doubt, the institution to which the patient is to return, the essential criterion to be followed in this regard being the capacity for rehabilitation of the patient, in particular with regard to their family ties, the prefect of the department which has thus been determined then immediately issuing the required order. This Opinion, which was passed on to the Minister of Health and Social Affairs on 17 January 2013, has not received any response, either on 5th February 2013, its date of publication, or in the course of the year 2014. th Independently of the fact that article L.3222-3 of the Public Health Code (CSP), on which the creation of UMDs was based, has been abrogated by the Act of 27th September 2013 16, the 16 Act no. 2013-869 of 27th September 2013 for the amendment of certain provisions arising from Act no. 2011-803 of 5 July 2011 concerning the rights and protection of persons subject to psychiatric treatment and the practical details of their care and treatment (Journal Officiel, 29th September). th 29