In light of the above, the 2014 recommendations are now obsolete and replaced by those set
out below. These new recommendations will be subject to monitoring in the CGLPL's annual report
for 2020.
2. Recommendations concerning mental health institutions
2.1
General recommendations
The CGLPL's recommendations followed by a response from the Minister of Health are published in
full in Appendix 4.
2.1.1
Solitary confinement and restraint
In 2014 the CGLPL recommended improving the traceability of measures and bringing them under
the scrutiny of the Département-level Commission for Psychiatric Treatment. This recommendation
was put fully into effect in the texts: Article L.3 222-5-1 of the Public Health Code introduced by the
Act of 26 January 2016, followed by the Instruction of 29 March 2017 on the policy for reducing
solitary confinement and restraint practices within authorised psychiatric health institutions designated
by the Director-General of the Regional Health Agency for providing involuntary psychiatric
treatment, stipulates the conditions for keeping the record and organises the procedure for
monitoring practices within the institution, at regional and national level.
Moreover, in keeping with another of the CGLPL's recommendations, the Recommendations for
clinical practice, circulated on 20 March 2017 by the National Authority for Health (HAS), specify the
monitoring procedure and systematic interviews that must be held when placing someone in solitary
confinement.
This progress is in keeping with the CGLPL's guidelines. However, from the inspections
carried out in the institutions, it is clear that this progress is struggling to have a tangible impact in
practice. The CGLPL therefore recommends that communication around these measures as well as
training initiatives and oversight measures by the ARSs be stepped up.
Step up the measures bearing on communication, training and oversight of solitary confinement
and restraint in mental health institutions (see Art. L.3 222-5-1 of the Public Health Code
introduced by the Act of 26 January 2016 and instruction of 29 March 2017 on the policy for
reducing solitary confinement and restraint practices within authorised psychiatric health
institutions designated by the Director-General of the Regional Health Agency for providing
involuntary psychiatric treatment).
2.1.2 Patients' rights
The CGLPL recommended drawing up standard information leaflets on sectioning, displaying the
internal rules and organising citizen's advice centres in mental health institutions.
Efforts along these lines are in progress, on the one hand by working groups formed by the
Ministry of Health, and on the other by the national conference of public health institution medical
committee and psychiatric hospital chairs. The CGLPL is at these authorities' disposal to share its
expertise with them.
Consult the CGLPL on draft information documents intended to be given to patients committed
involuntarily.
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