Toulouse: the reframing of the health authorities after the runaways from psychiatry
Runaways from psychiatric institutions have been in the headlines for 15 days. The first of the series could have led to a tragedy since a schizophrenic baptized “the cannibal of the Pyrenees” – after a murder and cannibalistic acts in 2013 – attacked a retiree in the middle of the city. He had fled from CHS Marchant. The ARS banged their fist on the table, son “dialogue on psychiatry with representatives of health democracy and mental health authorities” in Haute-Garonne on February 3 gave birth to several measures.
Marchant’s patients under close surveillance
In the wake of the first two escapes, the Regional Health Agency had requested “a detailed report” then carried out “an inspection mission” at the Marchant hospital (CHS). Without waiting for the results of the investigations, several measures are taken, in particular with regard to securing access:
– Closure of the gate on the exit side and reduction of the opening hours of the gate on the entrance side. Objective: to better control the entrances and exits of the establishment.
– Establishment of an outpost of the admissions office, for the control of proof of patient discharges.
– Reinforcement via an external security company (4 agents 24 hours a day, 7 days a week).
Furthermore, the clinical state of criminally irresponsible patients after offenses “will be reassessed” to Walking with “special vigilance for risky clinical situations”. Understand: the most dangerous patients will all be under close surveillance. The number of health managers was increased from 2 to 3 last weekend. Management was reinforced on Saturday morning. A security audit “supported by external experts and law enforcement” is planned at the G. Marchant Hospital Center and will aim to examine the strengths and weaknesses in terms of security on this site of nearly 44 hectares.
The Toulouse University Hospital psychiatry will review its emergency exits and will install fences and video surveillance
A “assessment of patient care and clinical status” is also practiced at the Toulouse University Hospital. This measure is added “to an adaptation of the operation of the emergency exits so that they are no longer controlled by the Fire System”. In the medium term, a reorganization is appropriate “to create a safe outdoor space” and “thus allowing external security” (video protection and fences). An inspection is currently underway.
Reminder of the methods of care in psychiatry
In the framework of “exchanges organized with representatives of health democracy and mental health authorities in Haute-Garonne” the ARS recalls the mechanisms that govern the admission of a person to psychiatric care without consent or situations of criminal irresponsibility due to mental disorder: “consent to care is the general principle”, “largely in the minority, care without consent must remain the exception…” During these exchanges, the ARS confirmed ” its willingness to listen to different points of view and to act transparently ». At this stage, none of the site managers have been removed from office…
Place of hospitalization and specificities
Open area: Freedom to come and go, alone or accompanied, according to medical instructions, within the hospital center or in town.
Closed area in framework opening: Support in a closed area with specific authorization in the unit.
Closed area: Exit from the room authorized, in a closed area.
Isolation room: Strict isolation with no exit from the room.