BEAUVAIS, SAINTE-GAUBURGE, FRAGNY, L'HÔPITAL-LE-GRAND (REC.)
the children, would make it possible to discuss practices and combine
know-how and the values shared regarding education in a closed
environment.
Providing education in a “restricted” environment is far from
straightforward. It deserves careful and ongoing reflection, such as
the pragmatic development of a “doctrine” that could initiate the
necessary initial and ongoing training that was described above.
4/ Finally, there are considerable variations in closed educational
centres in terms of the somatic and psychiatric care of minors, their
psychological care, and their health education. The presence of a
nurse is very unequal. Somatic care is often provided by a general
practitioner who specially comes to the institution or to whom the
minors are taken, without any agreement defining the respective
rights and obligations of the physician and the institution. While
one or two psychologists often offer consultations, connections are
much harder to establish with psychiatrists, and agreements between
the closed educational centres and a specialised medical centre are
rare, even when the institution’s population is clearly in need of such
services.
While it is true that children in these centres generally do not have
major difficulties from the somatic point of view, the same is not
true in terms of mental wellness. Here again, a formalisation of
outside expertise in the form of agreements with doctors, nurses and
healthcare facilities is desirable. The central administration should
be able to develop such “model” agreements that would allow for
the standardisation of practices. Regional health agencies, under the
aegis of the Minister of Health, should facilitate the signing of such
agreements, with their application being checked by the local steering
committee (the meetings of which are, in the cases mentioned,
random).
These recommendations should be considered in the updating of
the specifications currently being prepared by the Ministry of Justice
and Liberties. The Contrôleur général has noted that these updates
were preceded by active consultation with the directors of the closed
educational centres.
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