The Right to the Maintenance of Relations outside of the Institution The maintenance of relations outside of the institution makes up for patients’ isolation by enabling them to keep in touch with family, friends and even more broadly speaking, - by means of the Internet-, with current trends and social changes. It is appropriate, and even more so with regard to relations with the outside than in other domains, to reconcile the requirements of the framework of constraint with that of maintenance of autonomy and preparation for discharge. Yet, the inspectors ascertained great differences in the application of rights with regard to communication with the exterior in the institutions visited, with regard to both telephone calls and visits, as well as Internet access and outings. There were disparities between different centres, as well as between units within the same department, leading to a lack of equality between patients without any apparent justification, of a medical order in particular. Visits and Telephone Calls Psychiatrists are justified in recalling that the possibility of telephoning and family visits are medical decisions linked to the patient’s state of health. However, the right to maintenance of family ties is a fundamental right with regard to which any restrictions have to be appropriate, necessary and proportionate. Such is not the case when persons committed for psychiatric treatment without their consent are systematically deprived of their telephone and visiting rights for an observation period that, depending on the institution, may vary from a few hours to several days. In one institution visited, the head of department justified the prohibition of communication with the outside (visits, letters and telephone), for fifteen days following the patient’s arrival, on the grounds that they had to “find themselves alone with themselves”. No remedy exists against decisions to prohibit visits made by psychiatrists, and the testimonies of hospitalised persons and their close relations reveal great distress and incomprehension in the face of prohibition to communicate: “I just wanted to tell my friend to cancel an important meeting that I had the next day”; “I had my wife hospitalised in the night of 15th September and it was impossible for me to see her before 13th October, without being able to obtain any explanation”. The CGLPL considers that general and absolute prohibition of visits and telephone access imposed upon all patients, whatever their pathology, violates article 8 of the European Convention on Human Rights and article L. 3211-3 of the Public Health Code. Restrictions of this kind can only be individual and justified and should, if necessary, be explained to the patient and close relations concerned. Visits constitute the occasion for moments of intimacy, both for patients and for their close relations, and it appears essential, when children are present in particular, that these moments should be protected in suitable areas. In order to make up for the unsuitability of the premises used to cater for families, certain departments encourage visits in the hospital cafeteria or grounds; these practices should be encouraged. It would be appropriate to protect the confidentiality of meetings inside departments and to allow freedom of movement with visitors outside. In this spirit, certain institutions have made special provision for the availability of children’s games in the gardens, as ascertained in one institution in Picardy. The specific operation of UMDs shows more or less restrictive rules, which reduce patients’ autonomy and constrain their close relations. In one UMD in the South of France, visits may be made formal in a special and restrictive manner: families have to apply for visits in writing, and the doctor’s response depends upon the patient’s clinical state. The doctor completes a form entitled “Visiting Application Response”, specially provided for this purpose, and sends it 135