once an hour. Finally, it needs to be recalled that these intrusions can be very problematic with regard to the privacy that patients should be able to maintain: in one establishment inspected, there were two cameras filming the interior of a seclusion room, one of which was installed in the part corresponding to the toilet. The third means of security does not call for any observations: portable devices for the “protection of isolated workers” issued to staff (PTI), which make it possible to set off alarms in case of agitation or other serious incidents. Most institutions issue as many of these apparatuses as there are persons involved in the treatment service. These apparatuses, which are regularly checked (often every day), are also often backed up by alarm detectors in facilities (by “key activation”) or push-button alarm switches in certain areas, such as consultation rooms. Several levels of alarm are also often distinguished, thus “level 1” alarms are dealt with by the treatment unit alone, while “level 2” alarms involve reinforcements from other units 168. 2.5.2.3 Means of Organisation of Security The first means of organisation of security is obviously the training of health workers. All institutions put training initiatives in place concerning the conduct to be adopted when confronted with violent situations: “nurses faced with agitation and violence in psychiatric wards” etc. The most common of these appears to be what is referred to as the “Oméga” training programme, which is of Canadian origin (Institut Philippe-Pinel of Montreal). The second is provided by the passing on of information between the various teams that relay each other in the units. Either working hours are organised so that those of “incoming” teams overlap those of “outgoing” teams, and common meetings allow them to update each other on patients’ behaviour and any significant incidents; or there is no provision for overlapping of hours, but the passing on of information is organised (for example a morning nurse stays on for the beginning of the afternoon etc.). The third is constituted by the capacity, which, unfortunately, is shared to unequal degrees by different establishments 169, to conduct analyses of and reflection about violence (as well as undesirable events as a whole) in order to find solutions thereto. There are various different forms of working groups in charge of studying reported incidents, sometimes in specific meetings on the subject of violence, as well as ethics committees. Thus in 2009, in one institution, such a group addressed the question of the conduct of searches upon clothing (rarely used) and the possession of drugs by a patient, amongst other issues. In another hospital, a “violence group” analysed an assault upon one patient by another and put forward solutions for the improvement of surveillance by nurses, checks upon patients’ personal cupboards and cooperation between units, in order to keep the protagonists apart. The fourth consists of the creation of dedicated security teams within institutions. In general these teams are either composed of administrative officials assigned to these tasks, or of employees of outside companies (often specialised in fire prevention and safety), or both of these at the same time. For example, in one specialised hospital the security department 168 There are also many false alarms, due to portable devices being set off inopportunely. In one institution inspected, the establishment of an ethics committee had been decided upon in principle, but the institution’s medical committee had not yet appointed the members thereof. 169 72