2024-01-10 09:52:04
A bill tabled at the end of December by Les Républicains (LR) deputies wants to ensure that the control of isolation and restraint measures by the judge of freedoms and detention does not disrupt the organization des care and safety protocols in units pour sick difficult.
Since 2022, the control of isolation and restraint measures by the judge of freedoms and detention (JLD) has sometimes made the operation of Units for Difficult Patients (UMD) and Specially Designed Hospital Units (USHA) difficult. This is what around fifteen parliamentarians underline in a bill tabled at the end of December. Its single article would establish two provisions:
– ” Implementation [du contrôle du JLD] is done without prejudice to intensive care protocols and special safety measures” in UMD and within USHA.
– “The internal regulations of these units are enforceable against patients, including concerning the organization of isolation measures in connection with the operation of the unit to ensure the safety of patients and agents. » This regulation would be presented annually to the Departmental Commission for Psychiatric Care, the Public Prosecutor and the Judge of Liberties and Detention.
Controls that undermine support?
Units for difficult patients (UMD) constitute services specialized in the support and care of patients suffering from severe psychiatric disorders and presenting a danger to themselves and/or to others and who cannot or can no longer be maintained in traditional psychiatric units, recall the deputies in the explanatory memorandum.
They specify: “If the mission of the UMDs is confirmed within the organization of the health system, it is today seriously undermined in its organization and functioning” due to the regulations relating to the control of measures restricting freedom. (…) The internal organization of these units, the needs linked to the support of patients, with a particular profile, are hampered by an identical application of the regulations to this unit compared to all other hospital structures, and this without discernment regarding the nature of the care provided. »
So, “ referrals and systematic presentations at 24 hours/48 hours/72 hours and 7 renewable days provided for by article L. 3222-5-1 of the public health code are also opposed to it, leading to serious problems in support support. » The result would then go against existing support and missions. If a ministerial instruction specifies that the implementation of the 2022 reform should be done “without prejudice to intensive care protocols and special safety measures ”, the hierarchy of standards renders it ineffective.
• Proposed law relating to the organization of units for difficult patients within the framework of systems for controlling isolation and restraint by the judge, see the National Assembly website.
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