3. Thematic report: the fundamental rights of children in mental health institutions During the CGLPL's inspections of mental health institutions, it became clear that the notion of voluntary care is particularly delicate when it comes to children committed for psychiatry treatment, since this may be fully imposed by a third party without them being afforded the safeguards recognised in the context of involuntary care. Every year, nearly 400 children are hospitalised by decision of a public authority, State representative or judicial authority. In reality, however, in the institutions they visited, the inspectors above all came across children who had been sectioned at their parents' request, but were considered to be voluntary patients. The figures differ from report to report and should be interpreted carefully. Those that the Technical Agency for Information on Hospital Care (ATIH) communicated to inspectors report, for 2015, 18,257 children committed for full-time hospital care, including 197 committed on decision of the State representative, 239 following a provisional placement order given by the juvenile court judge as well as 42 under Article D388 of the Code of criminal procedure (children detained and admitted on decision of the prefect) and 5 under Article 706-135 of the Code of criminal procedure (following a decision of criminal irresponsibility). The situation concerning children has particularly caught the CGLPL's attention not only owing to their ambiguous status, but also because the role of legal guardians appears to be very uncertain - across all types of admission. This uncertainty is even more pronounced for children entrusted to the child welfare services, of whom there are many within units. The hospital authorities themselves do not always seem to be versed in the rules governing parental responsibility and do not sufficiently grasp the impact of placement on admission procedures, on the role of parents in provision plans and on the rights of children. Sectioning procedures, in the strict sense of the term, which are more tightly regulated by law, are typically subject to protocols, but the question of child patients is barely addressed; there is hardly any reference to assistance for child patients in exercising their rights, and things are scarcely better in practice. The inspectors have found that the authorities themselves – the State representative and liberty and custody judge in particular – struggle to guarantee the rights of children and their legal guardians properly. Because hospitalised children are particularly vulnerable, the CGLPL wished to examine the way in which their and their parents' rights are coordinated in relations with the hospital and the authorities, at the time they are committed and throughout their care delivery. The recommendations made by the CGLPL in this thematic report are based upon the inspections conducted in some thirty hospitals receiving children and careful scrutiny of the texts scattered and sometimes contradictory - which govern the matter. This report delves into the broad principles governing parental responsibility in detail. It lays down the general framework for mental health care through the organisation of the health service and the role of young patients in this system. It also probes the question of the forms in which children can be committed, whether as a so-called voluntary or involuntary patient, as well as the diverse aspects to do with respect for the rights of children and their legal guardians - particularly through case studies observed during missions, which were above all opportunities for further thought. 39

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