Bodily Hygiene It appears important to promote the restoration of a person’s positive image by daily bodily rituals. In some units, aesthetic care activities are organised by nursing auxiliaries. Respect for personal autonomy should also lead to adaptation of the hours of access to showers to the patient’s state. In numerous institutions visited, patients are not authorised to take showers in the afternoon and evening. Although restrictions may legitimately be imposed in order to enable proper organisation of the department – in particular, at the time of distribution of meals –, it is not proper to refuse a patient a shower for the sole reason that “their access is no longer authorised after 11 a.m.”. Furthermore, the inspectors ascertained that baths are underused in the units and that patients who ask to have a bath are rarely heard. The CGLPL recommends that hours of access to showers should be extended and adapted to the patients’ state. Certain public mental health institutions have a hairdressing salon and/or get a local hairdresser to come in return for payment. However, in one of the latter institutions it was pointed out that the haircuts offered – clippers for all men and bobs for all women – protected “neither personal dignity, nor self-esteem”; the staff therefore preferred escorted outings to a hairdresser in the town. However, visits to hairdressers are only possible when the hospital is not too far from a town centre; in certain cases, hairdressers do not come to the institution and outings to the town are rare, due to the location of the institution and its staff requirements. The CGLPL considers that pleasure and well-being are important elements with regard to learning to become autonomous or recovering one’s autonomy. Any initiative that makes it possible to promote these elements should therefore be encouraged. Showing Respect for Persons Although the inspectors ascertained that hospital teams are very receptive to the question of human dignity, the fact remains that psychiatric hospitals, like any closed institution, are not exempt from various different forms of abuse of power. One example of a measure violating dignity was brought to light at the time of a visit to a UMD: the inspectors ascertained that patients only had a spoon with which to eat the whole of their meals, obliging them in most cases to use their hands. In another institution of the same type, serious violations of dignity were observed, such as the obligation placed upon patients to undress in the corridors before going to bed. These measures, which are generally justified by reasons of protection of the person (prevention of suicide in particular), as well as security with regard to possible attacks, cannot legitimise the harm thus inflicted on patients’ self-esteem. Furthermore, it is sometimes normal practice to address patients using the familiar “tu” form, reinforcing feelings of being treated like a child and loss of autonomy. The CGLPL regularly receives letters from patients reporting that they feel belittled or threatened – with being placed in seclusion rooms in particular – if they do not show themselves to be sufficiently “docile” towards medical staff. Respect for the dignity of persons hospitalised without their consent means taking patients’ feelings of humiliation into consideration, beyond the objective reality of the situation. The CGLPL recalls that personal dignity is intimately linked to the notion of respect. It recommends that the formal “vous” form should be used for clearer relations between medical staff and patients and with a view to their readjustment to life in society. 134