Access to computers and the Internet remains especially difficult and rare in psychiatric
institutions. In the best case scenario, the patients have the right to keep their computer with a
release of liability against theft - note that very few of these rooms are equipped with cupboards
that can be locked by the patient. In the worst case scenario, computers are forbidden, without any
justification related to the treatment. During its visits, no therapeutic activity organised around
computers was observed by the CGLPL. Similarly, the institutions do not generally have access to
the Internet or an internal network open to the patients.
It appears that the need for safety, and especially the fear of absconding, is sometimes
considered much more important than the need for healthcare. Therefore, the freedom of
movement is abnormally restricted. Outings of patients admitted for psychiatric healthcare on the
request of a third party (ASPDT) within the premises of the institutions are sometimes only
permitted if accompanied by caretakers, for security reasons, even if the psychiatrists believe that
the patient’s condition does not justify it; this practice is contrary to the provisions of the Public
Health Code. Outings of patients admitted for psychiatric healthcare on the request of a State
representative (ASPDRE) outside the institution are sometimes subjected by the government
agency to conditions that go beyond the medical prescriptions (progressive conditions: first,
accompaniment by two caretakers, then by one caretaker before authorising an accompaniment by
a family member).
It is also necessary to allow patients the possibility of being by themselves if they wish. In
this respect, access to the rooms is often difficult: sometimes, the patients do not have the right to
remain in their room during certain times “to present themselves for activities”, even though there
are no or very few activities. Due to this, they remain in the living room, drowsy or even asleep.
These restrictions are violations of the fundamental rights as they do not result from a
requirement connected to the state of health of the patient and are not the subject of a medical
decision. Such a decision must be explicit, proportional, personalised and justified by the
requirements of healthcare. The absence of any recourse against this only makes for a stronger case
in favour of a strict assessment of the patient’s needs.
This does not imply advocating the definition of a standard institution, but
reflecting on this question is a prerequisite to question whether we wish to
progress in respecting the fundamental rights of persons deprived of liberty
in psychiatric institutions.
In 2015, the attention of the inspectors was especially drawn to the application of the new
provisions of the Public Health Code. In fact, when these provisions were modified by the Law
dated 5 July 2011, and then by the Law dated 27 September 2013, the legislator consolidated the
rights and guarantees given to persons placed under psychiatric treatment without consent, in
particular revising the terms of informing the patients and the intervention of the liberty and
custody judge (JLD). The new provisions, integrated in Articles L 3211-1 et seq. of the Public
Health Code, are fully applicable with effect from 1 September 2014.
1.1
Notifying the patient of the measure of hospitalisation without consent
and informing the patient about his rights are done in principle, but this
poorly controlled and often too formal act does not appear to fulfil its
objective
Article L. 3211-3 of the Public Health Code states that when a person is affected by mental
disorders and is subjected to psychiatric healthcare without consent, any restriction upon the
exercise of their individual liberties shall be adapted, necessary and proportioned to their mental
state and to the implementation of the required treatment. In all circumstances, the dignity of the
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