The Droit Pluriel association, in partnership with the Île-de-France Ethical Reflection Space and the GHU Paris Psychiatry & Neurosciences, carried out research called EDGAR which proposes to understand the judicialization of psychiatric work by taking as an axis of reflection the procedure for notification of rights made to people hospitalized without their consent.
For around fifteen years, hospital psychiatry has been engaged in a process of increasing judicialization, particularly visible since the law of July 5, 2011 on hospitalizations without consent. This law introduced a double imperative: guarantee better legal information for hospitalized people and establish systematic control by the Judge of Liberties and Detention (JLD). If these developments aim to strengthen the rights of patients, they raise many concrete issues for healthcare teams, legal professionals, and the people concerned themselves.
In this context, the Droit Pluriel association, in partnership with the Île-de-France Ethical Reflection Space and the GHU Paris Psychiatry & Neurosciences, conducted qualitative research aimed at better understanding the impact of this judicialization on work in psychiatry. Taking as a starting point the procedure for notifying rights to people hospitalized without their consent, the research is based on interviews and focus groups to combine the experiences, difficulties and expectations expressed by those directly concerned. The challenge of this work is to explain the practical and ethical tensions as well as the expectations expressed by the different people (care professionals – health service users – legal professionals), involved around this procedure and, more broadly, around access to the right(s) in psychiatric hospitals.
The study focuses on the difficulties encountered by health professionals in carrying out this procedure and then attempts to explain the structuring axes of the criticism formulated by all the actors around this procedure and, more generally, on the subject of the recognition of rights in psychiatric units.
The report opens with the various recommendations made by the participants during the research. In particular, one of these axes is linked to the desire to see legal offices deployed within the units. This measure appears to present several advantages: by changing the place occupied by the law in health establishments; by offering hospitalized people a regular or even permanent access point capable of supporting them in asserting their rights; or again, by authorizing forms of professional intermediation between the world of care and the world of law.
This research gave rise to the creation of several additional resources:
- A video of crossed views (below), which illustrates the main lessons of the research. It illustrates, through the words of the people concerned, the results of the survey and offers a synthetic and accessible journey of the experiences and issues identified.
- Three videos of testimonials from former patients, who recount their experiences of forced hospitalization and their encounter with the law. These stories reflect, in a sensitive and direct manner, the concrete effects of these systems on individual journeys.
- A booklet to better guarantee the effectiveness of the notification of rights during hospitalization without consent. Based on research verbatims, it highlights the difficulties encountered in the implementation of the notification of rights and suggests avenues for reflection and improvement based on the cross-knowledge produced by research.
These productions are aimed at all people affected by mental health. They constitute tools for awareness-raising, training and reflection, allowing us to better understand the issues linked to access to the right to hospital, to fuel debates on current practices and to encourage concrete initiatives to guarantee better support.
“Dealing with rights in psychiatry”, Final report of the EDGAR research Guaranteeing the effectiveness of the notification of rights in hospitalizations in psychiatric care without consent, Jean Bienaimer, Anne-Sarah Kertudo, Aurélien Troisoeufs, Paul-Loup Weil-Dubuc
EDGAR Research Summary
