The General Controller of places of deprivation of liberty, Dominique Simonnot, denounces “a significant number of serious malfunctions affecting the dignity of patients and their fundamental rights” within the public mental health establishment (EPSM) of Vendée, at the Georges Mazurelle hospital center in La Roche-sur-Yon, in a report published Thursday, October 26.
Six controllers visited the establishment from June 27 to July 6, 2022. It has 822 lots, including 341 for full-time hospitalizations, divided into twelve units, including four admissions, three units for children and one for adolescents. . They warn of “serious and widespread violations of the fundamental rights of hospitalized persons”.
According to them, “Patient privacy is not respected” in the geriatric psychiatric units which have 100 beds in total, since patients cannot lock the door of their room or of their sanitary space containing the toilets and the shower, even in double rooms. Many patients complain of intrusion and “expressed a feeling of insecurity”. The guardian of one patient even filed a complaint against another in April 2022.
Furthermore, the Supervisor recalls that “patients in free care must be able to move freely” and “restrictions imposed on hospitalized patients without their consent must be justified”while the doors of 5 out of 12 units are closed and even patients in free care have to wait for a caregiver to open them.
The same goes for the duration of isolation and restraint measures, which are often too long and not always decided by psychiatrists. In 2021, the average duration of isolation measures was “remarkably high”, underlines the report, namely 157 hours (more than six and a half days) in adolescents, 209 hours in a seclusion room and 433 hours in other rooms. Restraint durations vary between 74 and 220 hours, but one patient remained restrained for 600 hours, or 25 days. The use of these measures must therefore “to be reduced”recommends the Comptroller.
“Isolation and restraint measures can only be exceptional and motivated by the sole need to ‘prevent immediate or imminent harm to the patient or others'”also recalls Dominique Simonnot, while his controllers found that some of these measures were prescribed “if necessary”, for example, if the patient is aggressive, urinates on the floor or insults the nursing staff. She also insists that these measures cannot target patients in free care.
On site, the inspectors also noted “very serious human resources difficulties“, since 18 posts for psychiatrists and 40 for nurses are vacant and the doctors are “insufficiently” present in the units and often see patients during interviews “whose duration may be less than five minutes”.
Furthermore, “a large number of caregivers complain that they are not sufficiently trained to provide information to patients” in care without consent. These patients are rarely aware of their rights and do not know that they can appeal against the decision of the liberty and detention judge who ordered their hospitalization. Judge that they do not always meet or whose decisions they learn months later. “There must be an end to arbitrary hospitalizations”concludes the Comptroller.
In a letter addressed to the psychiatric hospital on Thursday, the Minister of Health, François Braun, explains that “the management of the establishment is committed to the development of an immediate action plan that the report called“. The services of the regional health agency also moved to the establishment on September 8, 2022.
François Braun points in particular to the fact that “the establishment’s human resources are experiencing demographic tensions”with a lack of psychiatrists. “A reorganization of medical functions is underway”, he assures. He goes on to assure that “measures relating to the protection of the physical privacy of patients have been taken”. Finally, according to François Braun, “other measures relating to the rights of people hospitalized without their consent have been taken”.