Key Benefits:
The National Assembly and the Senate adopted,
The President of the Republic enacts the following legislation:
The Public Health Code is amended to read:
1° Article L. 3211-2-1 is as follows:
"Art. L. 3211-2-1.-I. ― A person subjected to psychiatric care under Chapters II and III of this Title orArticle 706-135 of the Code of Criminal Procedure is said in psychiatric care without consent.
"The person is taken care of:
« 1° be in the form of a complete hospitalization in an establishment referred to in Article L. 3222-1 of this Code;
« 2° Either in any other form, which may include outpatient care, home care provided by an establishment referred to in the same article L. 3222-1 and, where applicable, home hospitalization, part-time stays or short-term full-time stays in an establishment referred to in article L. 3222-1.
“II. ― When care takes the form provided for in 2° of I, a care program is established by a host psychiatrist and cannot be modified, to take into account the evolution of the patient's health condition, as in the same conditions. The care programme defines the types of care, their periodicity and the places of their realization, in conditions determined by decree in the Council of State.
"For the establishment and modification of the care program, the host psychiatrist shall receive the patient's advice at an interview in which he or she shall give the patient the information provided for in section L. 3211-3 and the notice of the provisions of section III of this section and those of section L. 3211-11.
"III. ― No coercive measures may be implemented with respect to a patient in the form provided for in 2° of I."
2° The last paragraph of Article L. 3211-2 is as follows:
"When both medical certificates have concluded the need to maintain psychiatric care, the psychiatrist proposes in the certificate referred to in the third paragraph of this article the form of care referred to in 1° and 2° I of Article L. 3211-2-1 and, where applicable, the care program. This proposal is based on the patient's health and the expression of his or her mental disorders. » ;
3° In the second paragraph of Article L. 3211-3, the first occurrence of the reference: ", L. 3213-1" is deleted;
4° In the first paragraph of Article L. 3211-12-5, 2° of Article L. 3212-1 and the first sentence of the penultimate paragraph of Article L. 3222-1-2, after the reference: "2°", is inserted the reference: "I".
Article L. 3211-11-1 of the same code is as follows:
"Art. L. 3211-11-1.-In order to promote their healing, rehabilitation or social reintegration or if external steps are necessary, persons who are the subject of psychiatric care under chapters II and III of this title or ofArticle 706-135 of the Code of Criminal Procedure in the form of a full hospitalization may be granted short-term exit authorizations:
« 1° In the form of accompanied exits not exceeding twelve hours. Sick persons shall be accompanied by one or more staff of the host institution, by a member of their family or by the trusted person designated under section L. 1111-6 of this Code, for the duration of the release;
« 2° In the form of outputs not accompanied by a maximum duration of forty-eight hours.
"The short-term exit authorization is granted by the director of the host institution, after favourable advice from a psychiatrist of this institution.
"In the event that the measure of psychiatric care has been taken pursuant to Chapter III of this title, the Director of the host institution shall transmit to the representative of the State in the department information relating to the application for authorization, including the favourable opinion of the psychiatrist referred to in the fourth paragraph of this article, no later than 48 hours before the expected date of release. Except as written opposition by the representative of the State in the department, notified no later than twelve hours before the scheduled date, the exit may take place. The representative of the State cannot impose any additional measures.
"When the psychiatric care measure follows the request of a third party, the director of the receiving institution shall inform the latter, beforehand, of the unaccompanied exit authorization and its duration. »
Chapter II of Book II of Part III of the Code is thus amended:
1° The second paragraph of Article L. 3222-1-1 A is supplemented by the words: ", in particular in the event of a need for full hospitalization under the conditions provided for in the second paragraph of Article L. 3211-1";
2° The first paragraph of Article L. 3222-1-1 is as follows:
"People admitted to psychiatric care without consent in the form of a full hospitalization, pursuant to Chapters II and III of Title I of this book, may be taken care of and transported to a health facility referred to in Article L. 3222-1 without their consent when strictly necessary and by means appropriate to their condition. » ;
3° The last paragraph of Article L. 3222-1-2 is deleted;
4° After article L. 3222-4, an article L. 3222-4-1 is inserted as follows:
"Art. L. 3222-4-1. - Deputies and senators as well as representatives to the European Parliament elected in France are allowed to visit at any time the health facilities mentioned in Article L. 3222-1. »
Article L. 3211-12 of the same code is thus restored:
“II. ― The judge of freedoms and detention may rule only after receiving the advice of the college referred to in section L. 3211-9 of this Code when the person is subject to an orderly care measure under section L. 3213-7 of the same code or codeArticle 706-135 of the Code of Criminal Procedure as a result of an unresolved classification, a decision of criminal irresponsibility, or a judgment or judgment of a declaration of criminal irresponsibility on the basis of the first paragraph of Article 122-1 of the Criminal Code and in respect of acts punishable by at least five years' imprisonment in the event of a breach of persons or at least ten years' imprisonment in the event of a breach of property.
"The judge may not, in addition, decide the release of the measure only after having collected two expertise established by psychiatrists on the lists referred to in Article L. 3213-5-1 of this Code.
"The judge shall set the deadlines in which the advice of the college and the two expertise provided for in this II shall be produced, within a maximum limit set by decree in the Council of State. After these delays, he decides immediately. »
Article L. 3211-12-1 of the same code is as follows:
"Art. L. 3211-12-1.-I. ― The full hospitalization of a patient may not continue without the judge of freedoms and detention, pre-appeared by the director of the institution when the hospitalization has been pronounced in accordance with Chapter II of this title or by the representative of the State in the department when it has been pronounced in accordance with Chapter III of this title, Article L. 3214-3 of this Code or of theArticle 706-135 of the Code of Criminal Proceduredecided on this measure:
« 1° Before the expiry of a twelve-day period from the date of admission pursuant to Chapters II or III of this Title or to Article L. 3214-3 of the same Code. The judge of freedoms and detention is then seized within eight days of the admission;
« 2° Prior to the expiry of a twelve-day period from the decision to amend the form of patient care and to complete hospitalization pursuant, respectively, to the last paragraph of section L. 3212-4 or to the III of section L. 3213-3. The judge of freedoms and detention is then seized within eight days of the decision;
« 3° Prior to the expiration of a period of six months from the date of any judicial decision providing hospitalization pursuant toArticle 706-135 of the Code of Criminal Procedureany decision taken by the Judge of Freedoms and Detention pursuant to this I or articles L. 3211-12 or L. 3213-9-1 of this Code, when the patient has been kept in full hospitalization continuously since that decision. Any decision of the Judge of Freedoms and Detention made prior to the expiry of this period pursuant to 2° of this I or of any of the same articles L. 3211-12 or L. 3213-9-1, or any new judicial decision pronouncing hospitalization pursuant toArticle 706-135 of the Code of Criminal Procedure rescheduling this deadline. The Judge of Freedoms and Detention is then seized at least 15 days before the expiration of the six-month period provided for in this 3rd.
"However, where the Judge of Freedoms and Detention has ordered, prior to the expiry of one of the time limits referred to in 1° to 3° of this I, an expertise either pursuant to the III of this article or, on an exceptional basis, in consideration of the notice referred to in II, that period shall be extended for a period not exceeding 14 days from the date of this order. The full hospitalization of the patient is then maintained until the decision of the judge, unless the patient is terminated under Chapters II or III of this title. The order referred to in this paragraph may be made without a prior hearing.
"The judge shall set the deadlines in which the expertise mentioned in the penultimate paragraph of this I shall be produced, within a maximum limit set by decree in the Council of State. After these delays, he decides immediately.
“II. ― The referral referred to in I of this article is accompanied by the motivated advice of a psychiatrist of the reception establishment stating the need to continue full hospitalization.
"When the patient is in one of the cases referred to in Article L. 3211-12, the notice referred to in the first paragraph of this II shall be rendered by the college referred to in Article L. 3211-9.
"III. – The judge of freedoms and detention orders, if any, the release of the complete hospitalization measure.
"When ordering this release, it may, in the light of the elements of the case and by reason of decision, decide that the release takes effect within a maximum of 24 hours, so that a care program can, if any, be established pursuant to the II of Article L. 3211-2-1. Upon the establishment of this program or after the period referred to in the first sentence of this paragraph, the full hospitalization measure is terminated.
"However, when the patient is in one of the cases referred to in the II of Article L. 3211-12, the judge may only decide the release of the measure after having collected two expertises established by the psychiatrists on the lists referred to in Article L. 3213-5-1.
"IV. ― Where the judge of freedoms and detention has not ruled before the expiry of the twelve-day period provided for in 1° and 2° of I or the six-month period provided for in 3° of the same I, the release of the full hospitalization measure is acquired after each of these periods.
"If the judge of freedoms and detention is seized after the expiry of the eight-day period provided for in 1° and 2° of the I or the fifteen-day period provided for in 3° of the same I, he finds without debate that the release of the full hospitalization is acquired, unless exceptional circumstances are justified at the origin of the late referral and the debate may take place in the respect of the rights of »
Article L. 3211-12-2 of the same code is as follows:
"Art. L. 3211-12-2.-I. ― When it is seized under articles L. 3211-12 or L. 3211-12-1, the judge, after adversarial debate, publicly decides. He may decide that the debates take place or continue in the board's chamber if it is to result from their advertisement an infringement of the privacy of private life, if it arises from disorders of a nature to disturb the serenity of justice or if one of the parties so requests. It is entitled to this request when it comes from the person who is the subject of psychiatric care.
"At the hearing, a person who is the subject of psychiatric care is heard, assisted or represented by a chosen lawyer, designated under legal aid or an ex officio clerk. If, in the light of a reasoned medical opinion, medical reasons hinder, in its interest, the person's hearing, the person is represented by a lawyer under the conditions set out in this paragraph.
"The Justice of Freedoms and Detention shall rule in a courtroom assigned to the Ministry of Justice, specially fitted out on the right of the host institution or, if necessary, on the right of another health institution located in the jurisdiction of the Court of Grand Instance, in the circumstances and in the manner prescribed by a convention between the High Court and the Regional Health Agency. This room must ensure the clarity, security and sincerity of the debates as well as public access. When these conditions are not met, the judge, either on his or her own motion or at the request of one of the parties, shall rule at the seat of the High Court.
“II. - When the judge of freedoms and detention decides in the room referred to in the last paragraph of the I, the president of the High Court may, if necessary, authorize a second hearing to be held on the same day at the seat of the High Court. »
Section L. 3211-12-4 of the same code is amended as follows:
1° The second sentence of the first paragraph is supplemented by the words: ", with the exception of the last paragraph of the I";
2° The second paragraph is supplemented by a sentence as follows:
"When the order referred to in the same first paragraph was made pursuant to section L. 3211-12-1, a notice by a psychiatrist of the person admitted to psychiatric care without consent stating the need to continue full hospitalization is sent to the Court of Appeal's office no later than 48 hours before the hearing. »
Chapter II of Book II title I of Part III of the Public Health Code is amended as follows:
1° In the first sentence of the second paragraph of Article L. 3212-4, after the second occurrence of the word "care" are inserted the words: "for a period of one month";
2° Section L. 3212-7 is amended as follows:
(a) At the outset, a sub-item is added:
"At the end of the first period of psychiatric care in accordance with the second paragraph of section L. 3212-4, care may be maintained by the director of the institution for one-month periods, renewable in accordance with the terms and conditions set out in this section. » ;
(b) The beginning of the first sentence of the first paragraph is as follows: "In the last three days of each of the periods mentioned in the first paragraph, a psychiatrist... (the rest without change). » ;
(c) The second paragraph is deleted;
(d) The third paragraph is amended to read:
― in the first sentence, after the word "evaluation", the word "medical" is inserted;
― after the first sentence, is inserted a sentence as follows:
"This evaluation is renewed every year. » ;
(e) The second sentence of the last paragraph is deleted;
3° In the last paragraph of Article L. 3212-9, after the word "certificate", are inserted the words "medical or, if unable to examine the patient, a medical notice".
Within one year of the promulgation of this Act, the Government shall submit to Parliament a report on the dematerialization of the registry provided for in the Act.Article L. 3212-11 of the Public Health Codeexamining its technical feasibility and detailing the modalities of consultation and collection of the observations of the authorities responsible for the control of health facilities hosting persons in psychiatric care without consent that may be implemented as well as the legislative or regulatory adaptations it would make necessary.
Chapter III of Book II title I of Part 3 of the Public Health Code is amended to read:
1° Article L. 3213-1 is as follows:
"Art. L. 3213-1. - I. The representative of the State in the department pronounces by order, in the light of a circumstantial medical certificate not capable of emanating from a psychiatrist in the reception establishment, the admission to psychiatric care of persons whose mental disorders require care and compromise the safety of persons or seriously affect public order. Prefectural orders are motivated and accurately state the circumstances that have made admission to care necessary. They designate the establishment referred to in section L. 3222-1 that provides for the care of the sick person.
"The director of the reception facility shall promptly transmit to the representative of the State in the department and to the departmental commission of psychiatric care referred to in article L. 3222-5:
« 1° The medical certificate referred to in the second paragraph of Article L. 3211-2-2;
« 2° The medical certificate and, where appropriate, the proposal referred to in the last two paragraphs of the same article L. 3211-2-2.
“II. ― Within a period of three free days following the receipt of the medical certificate referred to in the penultimate paragraph of Article L. 3211-2, the representative of the State in the department decides on the form of care provided for in Article L. 3211-2-1, taking into account the established proposal, if any, by the psychiatrist in accordance with the last paragraph of Article L. 3211-2-2 and the public safety requirements He joins his decision, if any, the care program established by the psychiatrist.
"Waiting the decision of the representative of the State, the sick person is taken care of in the form of a complete hospitalization.
"III. ― Where the proposal established by the psychiatrist pursuant to Article L. 3211-2-2 recommends a care in a different form than full hospitalization, the representative of the State may not alter the form of care of the persons referred to in Article L. 3211-12 until after having collected the advice of the college referred to in Article L. 3211-9.
"IV. ― The interim measures, decisions, notices and medical certificates referred to in this chapter are on the register referred to in section L. 3212-11. » ;
2° Section L. 3213-3 is amended as follows:
(a) I is thus modified:
― the beginning of the first sentence is as follows: "In the month following the admission to psychiatric care decided under this chapter or resulting from the decision mentioned inArticle 706-135 of the Code of Criminal Procedure And then... (the rest without change). » ;
- in the second sentence, after the reference: "L. 3211-2-1", the words "of this code" are inserted;
(b) The second sentence of II is deleted;
(c) The last sentences of the III are deleted;
(d) Is added an IV as follows:
"IV. ― When the representative of the State decides not to follow the advice of the college referred to in Article L. 3211-9 recommending the care of a person referred to in Article L. II. 3211-12 in any other form than full hospitalization, he or she shall order an expertise under the conditions provided for in Article L. 3213-5-1.
"When the expertise confirms the recommendation of care in another form than full hospitalization, the representative of the State decides to take care in the form referred to in 2° of I of Article L. 3211-2-1, in accordance with the proposal mentioned in the first paragraph of I of this article.
"When the expertise advocates the maintenance of full hospitalization and the representative of the State maintains full hospitalization, he shall inform the director of the reception facility, who shall bring the judge of freedoms and detention before the latter shall decide on this measure at short notice under the conditions laid down in article L. 3211-12. This paragraph shall not apply where the decision of the representative of the State shall be taken within the time limits mentioned in 1° and 2° of I of Article L. 3211-12-1. » ;
3° After the word: "specified", the end of the last paragraph of Article L. 3213-4 is thus written: "in II of Article L. 3211-12. » ;
4° Section L. 3213-5 is repealed;
5° Section L. 3213-7 is amended as follows:
(a) The first paragraph is supplemented by a sentence as follows:
"However, if the person concerned is already subject to a psychiatric care measure under the same section L. 3213-1, the production of this certificate is not required to amend the basis of the current measure. » ;
(b) Two subparagraphs are added:
"If the state of the person referred to in the first paragraph permits, the person shall be informed by the judicial authorities of the opinion of the person referred to in the first paragraph and of the actions that may be taken by the representative of the State in the department. This information is transmitted by any means and appropriately to its condition.
"The notice referred to in the first paragraph indicates whether the proceedings relate to acts punishable by at least five years' imprisonment in the event of a breach of persons or at least ten years' imprisonment in the event of a breach of property. In this case, the person is also informed of the conditions under which he may be terminated the measure of psychiatric care under sections L. 3211-12, L. 3211-12-1 and L. 3213-8. » ;
6° Article L. 3213-8 is thus restored:
"Art. L. 3213-8. - I. ― If the college referred to in Article L. 3211-9 issues a notice that the measure of psychiatric care in the form of a complete hospitalization of which a person referred to in Article II of Article L. 3211-12 is no longer necessary and that the measure of care without consent may be lifted, the representative of the State in the department orders an expert opinion of the mental state of the person by two conditions-1 The latter shall decide, within a maximum period of seventy-two hours from the date of designation, on the need to maintain the measure of psychiatric care.
“II. ― When the two opinions of the psychiatrists provided for in I confirm the lack of necessity of complete hospitalization, the representative of the State orders the lifting of the measure of psychiatric care.
"When these notices differ or advocate the maintenance of the psychiatric care measure and the representative of the State maintains it, he shall inform the director of the reception facility, who shall bring the judge of freedoms and detention before the latter shall decide at short notice on this measure under the conditions laid down in article L. 3211-12. This paragraph shall not apply where the decision of the representative of the State shall be taken within the time limits mentioned in 1° and 2° of I of Article L. 3211-12-1. » ;
7° Article L. 3213-9-1 is as follows:
"Art. L. 3213-9-1. - I. ― If a psychiatrist participating in the care of the patient attests by a medical certificate that a measure of psychiatric care in the form of a complete hospitalization is no longer necessary and that the measure of care without consent may be lifted or that the patient may be taken care of in the form mentioned in the 2nd of the I of Article L. 3211-2-1, the director of the reception institution refers to the certificate of the medical
“II. ― When the representative of the State decides not to follow the opinion of the psychiatrist involved in the care of the patient, he shall promptly inform the director of the host institution, who shall immediately request the examination of the patient by a second psychiatrist. It renders, within a maximum period of seventy-two hours from the decision of the representative of the State, an opinion on the need for full hospitalization.
"III. ― Where the opinion of the second psychiatrist provided for in II of this article confirms the lack of necessity of complete hospitalization, the representative of the State orders the lifting of the care without consent or decides to take care in the form mentioned in 2° of Article L. 3211-2-1, in accordance with the proposal contained in the medical certificate referred to in I of this article.
"When the opinion of the second psychiatrist provided for in II calls for the maintenance of full hospitalization and the representative of the State maintains full hospitalization, he shall inform the director of the host institution, who shall take the judge of freedoms and detention so that the latter may decide at short notice on this measure under the conditions laid down in article L. 3211-12. This paragraph shall not apply where the decision of the representative of the State shall be taken within the time limits mentioned in 1° and 2° of I of Article L. 3211-12-1. »
Section L. 3222-3 of the same code is repealed.
Chapter IV of Book II title I of Part 3 of the Public Health Code is amended to read:
1° Article L. 3214-1 is as follows:
"Art. L. 3214-1.-I. ― Persons with mental disorders are subject to psychiatric care with their consent. When persons held in free psychiatric care require full-time hospitalization, it is carried out in a health facility referred to in Article L. 3222-1 within a specially appointed hospital unit.
“II. ― When their mental disorders make their consent impossible, persons detained may be subjected to psychiatric care without consent pursuant to section L. 3214-3. Persons detained in psychiatric care without consent shall be taken care only in the form referred to in 1° of II of Article L. 3211-2-1. Their hospitalization is carried out in a health facility referred to in Article L. 3222-1 within a specially designed hospital unit or, on the basis of a medical certificate, within a suitable unit.
"III. ― Where their interest warrants, detained minor persons may be hospitalized in a suitable service in an establishment referred to in section L. 3222-1 outside the units provided for in I and II of this section. » ;
2° Section L. 3214-2 is amended as follows:
(a) In the first paragraph, the references: "and L. 3211-12 to L. 3211-12-4" are replaced by the references: ", L. 3211-12 to L. 3211-12-4 and L. 3211-12-6";
(b) The second paragraph is deleted;
(c) The second sentence of the last paragraph is supplemented by the words: ", unless the detained person is hospitalized within a hospital unit specially designed by consenting to his care".
I. ― At 6° of Article L. 3215-2 of the Public Health Code, the reference: "L. 3213-5" is replaced by the reference: "L. 3213-9-1".
II. ― Section L. 3844-1 of the same code is amended as follows:
1° At 4°, after the reference: "2°", is inserted the reference: "of I" and, after the first occurrence of the reference: "L. 3222-1", are inserted the words: "of this code";
2° The 7° is thus modified:
(a) At the beginning, the references: "In the last paragraph of articles L. 3211-2-1 and L. 3211-9, at 2° and at the penultimate paragraph II of article L. 3211-12, at the last paragraph of I and IV" are replaced by the references: "In the second sentence of the first paragraph of article L. 3211-2-1, at the last paragraph of article L. 3211-12,
(b) The references: "in the first sentence of the second paragraph of I and the second paragraph of Article L. 3213-1, at 2° and, twice, in the last paragraph of Article L. 3213-8", are deleted;
3° At 9°, the last two occurrences of the words: "at the first sentence of the word" are replaced by the word "at";
4° In the b of 11°, the word "third" is replaced by the word "second";
5° The 13th is thus written:
« 13° Article L. 3214-1 is as follows:
"Art. L. 3214-1. I. ― Persons with mental disorders are subject to psychiatric care with their consent. When persons held in free psychiatric care require full-time hospitalization, it is carried out in a health facility within a suitable structure.
"II. ― When their mental disorders make their consent impossible, detainees may be subjected to psychiatric care without consent pursuant to section L. 3214-3. Persons detained in psychiatric care without consent shall be taken care only in the form referred to in 1° of II of Article L. 3211-2-1. Their hospitalization is carried out in a health facility within a suitable structure or, on the basis of a medical certificate, within a suitable unit.
"III. ― Where their interest justifies it, detained minor persons may be hospitalized in a suitable service in a health facility outside the units provided for in I and II of this section.”
III. ― Section L. 3844-2 of the same code is amended as follows:
1° The 1st is repealed;
2° At the beginning of the 5th, the reference: "At the end of the second paragraph of Article L. 3222-3", is deleted.
I. ― I and IV of Article L. 3211-12-1 of the Public Health Code, in their writing resulting from section 5 of this Act, as well as sections 6 and 7 of the Act come into force as of September 1, 2014.
II. ― The 1st and 2nd of I and IV of the same section L. 3211-12-1, in their drafting pursuant to section 5 of this Act, are applicable to decisions of admission to psychiatric care without consent and to decisions of readmission to full hospital effective 1 September 2014.
The 3° of the I of the same article L. 3211-12-1, in its writing resulting from the same article 5, is applicable to judicial decisions pronouncing hospitalization in application of theArticle 706-135 of the Code of Criminal Procedure and decisions taken by the judge of freedoms and detention pursuant to I ofarticle L. 3211-12-1 or articles L. 3211-12 or L. 3213-9-1 the Public Health Code effective March 15, 2014. For all decisions made between 1 and 15 March 2014, the Judge of Freedoms and Detention shall be seized at least eight days before the expiration of the six-month period provided for at the same 3rd.
III. This section is applicable in New Caledonia and French Polynesia.
This law will be enforced as a law of the State.
Done in Paris, September 27, 2013.
François Hollande
By the President of the Republic:
The Prime Minister,
Jean-Marc Ayrault
The guard of the seals,
Minister of Justice,
Christiane Taubira
Minister of Social Affairs
and Health,
Marisol Touraine
The Minister of the Interior,
Manuel Valls
