been placed in seclusion for fifteen days “for having had sexual relations with a female patient, and in order to prevent him from meeting her again”. Placement in seclusion for therapeutic reasons was never mentioned by the medical staff that the inspectors met in this institution. Yet, placement in isolation rooms leads to the application of a particularly strict regime: the room is bare and is simply furnished with a securely fixed bed, on which a fireproof mattress is placed, with a cover and sometimes a sheet. In most cases, patients are allowed nothing else other than a pillow. They are not allowed access to the toilet or to a sink, in an adjoining room, without authorisation. In the vast majority of cases, visits are prohibited. Treatment of this kind is not subject to any control since it is officially “treatment carried out for the good of the patient”. Moreover, at the time of their inspections of metal health institutions, the inspectors ascertained that, in most cases, hospitalised prisoners are systematically placed in seclusion rooms, this situation not being dictated by therapeutic reasons. It was clearly asserted to the inspectors that these are security measures imposed in order to prevent escape. It was also revealed that this measure is sometimes required by the prefectural authorities. 1.1.2 Within Interregional Secure Hospital Units (UHSI) The situation within specially equipped hospital units (UHSA) cannot be exa mined here, the Contrôleur général only having inspected one of the two institutions currently open. UHSIs exclusively accommodate persons in custody. Under the terms of article D.395 of the code of criminal procedure, “prisoners admitted to hospital are considered as continuing to serve their sentences or, in the case of unconvicted prisoners, as being on remand. Prison regulations remain applicable to them insofar as possible”. Therefore, after their return to prison, prisoners undergoing somatic treatment and care (UHSI) may be subject to disciplinary proceedings for all of the faults listed under articles R.57.7. 1 to R.57.7.3 of the code of criminal procedure. According to the staff interviewed by the inspectors, hospitalised prisoners are rarely subject to disciplinary proceedings on their return to the prison environment, it being understood that no sanctions are pronounced, and a fortiori applied, during periods of hospitalisation. Other practices exist, apart from these seldom implemented statutory procedures. The inspectors were thus informed that, within one UHSI a prisoner had apparently been handcuffed to their bed on the initiative of prison staff; contrary to current regulations, this handcuffing had lasted for about thirty minutes without being reported to the interregional department of prison services (DISP). In order to take the phenomena of agitation and refusal to obey on the part of patients within UHSIs into account, protocols (in some cases not signed or dated) have sometimes been elaborated. In one UHSI inspected, a document of this kind exclusively concerns cases of physical restraint that do not fall within the scope of medical treatment but which constitute, according the very terms used within the text, “corrective treatment”; oddly enough, actions of this kind are prescribed by doctors but responsibility thereof falls to the prisons administration. In another unit, the rules and regulations lay down the conduct to be followed in case of incidents committed by hospitalised prisoners: “In cases of serious breaches of the teaching hospital’s (CHU) rules and regulations committed by prisoners, the managing director of the teaching hospital may in particular have them removed from the hospital as a disciplinary 104

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