Involuntary hospitalizations remain a blind spot in the protection of fundamental rights. In a report published this Thursday, the Inspector General of Places of Deprivation of Liberty highlights persistent abuses: arbitrary deprivations of liberty, misuse of isolation and restraints, and sometimes ineffective judicial oversight. In 2022, nearly 76,000 people were hospitalized against their will, out of the 286,000 admitted to psychiatric care. This reality is all the more concerning given that mental health has been designated a major national priority for 2025.
A system under tension that exposes patients
According to Dominique Simonnot, these violations of rights are not solely due to legal loopholes but are part of a broader crisis: lack of resources, territorial inequalities, and deteriorating access to care. While judges now oversee all involuntary hospitalizations, and since 2022, isolation and restraint measures, these safeguards remain insufficient. Judges cannot assess the medical necessity of the decisions, the vulnerability of patients limits their ability to defend themselves, and the decisions rendered sometimes encounter obstacles to their implementation in healthcare facilities.
The report also highlights areas completely lacking a legal basis: constraints applied in emergency rooms, the isolation or restraint of minors, and the operation of psychiatric intensive care units. From one institution to another, even from one department to another, practices vary considerably, revealing a system without clear guidelines.
For an ambitious policy to reduce constraints
In light of these findings, the Inspector General is calling on the State to undertake structural reform. Among her 27 recommendations are: strengthening patient recourse, improving training for judges, lawyers, and healthcare professionals, strictly regulating emergency practices, creating a genuine legal framework for minors, and, above all, establishing binding indicators to reduce the use of isolation and restraint. The idea would be to make a portion of the funding for these facilities contingent on a reduction in these practices, which the WHO considers a violation of human rights.
While numerous accounts from patients and families denounce a psychiatric system that is too often violent due to a lack of resources, the report reiterates a fundamental truth: the justice system alone cannot correct the shortcomings of a system that still relies too heavily on coercion due to a lack of sufficient alternatives. An ambitious, structured, and adequately funded national policy now appears essential.
