public health institution, and an opinion of 6th February 2014, published in the Journal Officiel on 25th February 2014. It is to be recalled that the Act of 25th February 2008 leads to secure medical jurisprudence centre placement (rétention de sûreté) of persons condemned to prison sentences of fifteen or more years for very serious crimes, when it is established that they are especially dangerous after having served their sentence. However, there is another category of persons who may be taken there: persons sentenced by an Assize Court to fifteen or more years of imprisonment for crimes of the same nature as those mentioned above, who have been subject to the court supervision (article 723-29 of the Code of Criminal Procedure), prolonged by secure surveillance, and who have disregarded obligations of the latter (article 723-37). Since the Act of 2008, supplemented on this point by the Act of 10th March 2010, five persons have been taken to the premises of the socio-medical-jurisprudence centre (CSMJS) of Fresnes as a result of this course of events, the first of whom arrived on 23rd December 2011. This limited number obviously does not stand in the way of questioning the course of events that led them to be taken there. All five of the persons placed since 2011 were taken there for breaches of the obligations imposed upon them, in accordance with the procedures provided for under article 723-37, and for disregard of psychiatric treatment obligations in particular. Apart from the legal questions posed by this new measure (cf. paragraph 9 of the Opinion of 6th February 2014), the Contrôleur Général had already begun to question the applicable rules. Indeed, the intentions of the Act of February 2008 are clear: secure detention (rétention de sûreté) takes the form of placement in a secure medical jurisprudence centre in which the person is provided with “medical, social and psychological care intended to enable the measure to be brought to an end”. In other words, far from being an end in itself and, therefore, entailing permanent deprivation of liberty, placement in a secure medical jurisprudence centre is an instrument of change intended to put an end to the “dangerous” character of the person. However, an initial group of problems was identified by the CGLPL with regard to the definition of the applicable rules. The latter cannot constitute a prison regime (the centre is not a prison) although security measures are, of course, required. Yet, members of prison staff who are present (in an occasional manner, moreover, since there are no permanent inmates) are in practice led to treat the two different sets of rules as being equivalent. A second group of difficulties was mentioned, which changes the nature and implications of placement in a secure medical jurisprudence centre insofar as the care provided is far from corresponding to the designated objectives of the Act. In the first place, inmates are, as a rule, kept in a state of inactivity: nothing is organised to provide them with any occupation. For example, at the time of inspection there existed no educational projects, professional activities or outdoor activities whatsoever. Only a sports hall and an IT room (with “screened” Internet access) were used. Furthermore, due to the small number of inmates it had not so far been possible to put any medical projects of therapeutic care in place, which are for the most part based upon group therapies. In practice, the persons placed in detention since 2011 did not therefore have the benefit of any mental health care of their own, nor of that implemented for the inmates of Fresnes prison. They were entitled to regular consultations with a psychiatrist (in principle once a week) and nurse visits (once a week), which does not constitute a real treatment programme. 21

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