for going outside, they lamented not being able to continue to listen to the music and having to wait for the next timeslot in order to be able to go back to the party. A visit to one institution in the Paris suburbs illustrates the possibility of adapting the restrictions placed upon autonomy and liberty on a daily basis. Every morning, a team meeting thus reviewed the situation of all patients, in particular with regard to restrictions placed upon liberty. The latter are discussed according to the patient’s level of mental imbalance, the risk of running away and their understanding of the need to be hospitalised for treatment. In the first place, the CGLPL emphasises the absolute necessity of allowing patients to have access to the open air, which units located on the upper floors do not always enable. In the second place, it considers that personalisation of the restrictions placed upon liberty of movement, by means of assessment meetings, constitutes good practice, which should be brought into general use in psychiatric hospital units as a whole. Moreover, the possibility of access to the exterior has a direct impact upon the possibility of smoking. Smoking is, of course, prohibited within the units. A visit to one unit, located within a general hospital, enabled the inspectors to ascertain that the situation on the upper floors neither enabled patients committed without consent to go out into the open air, which constitutes a fundamental health problem, nor to have access to any smoking area. Their only possibility of smoking a cigarette was on the landing of a fire escape, at regulated times and in the presence of a member of staff. Some closed units have secure internal patios enabling patients to go out to smoke either at defined times or as they wish. In a number of institutions inspected, there was a right to smoke on fenced balconies set aside for smoking or in a fenced courtyard. This courtyard, enclosed by a coloured fencing, according to remarks reported to inspectors, is difficult to accept by patients given the "cage" aspect that it produces, but on the other hand, it offers all patients the possibility of going outside when they wish. Moreover it has been observed that except in exceptional cases, isolation rooms do not have any neighbouring courtyard and depending on the institution, persons are taken outside to smoke or have their treatment increased or are authorised to smoke in the isolation room. In some cases nicotine substitution treatment is offered. Generally the CGPL finds difficulties in applying the Act of 10th January 1991 relating to the fight against alcoholism and tobacco addiction known as the "Evin Act", in closed units. Autonomy in money management Whereas autonomy in managing property is not always possible and the presence of a guardian or custodian has been ordered, the fact remains that patients should not lose all sense of money during their stay in psychiatric care. Autonomy, which should include management of property that they have, requires that they hold sums of money which are essential for purchasing products that are necessary for their daily well-being. The majority of institutions provide this opportunity either directly or via a patients’ association but inspections have found that there are exceptions, the reasons being the risk of theft. Normally patients are able to withdraw money when on accompanied visits or for organised activities set up by the association of which they are a member. The frequency of these withdrawals and the sum allotted to them depend not only on their resources and their needs but also on their ability to manage this money based on their type of illness. However it has been found that carers sometimes encounter problems in receiving sums which are necessary to meet the basic needs of protected adults from guardians and custodians. 139