La réforme de la loi du 27 juin 1990 relative aux soins psychiatriques, considérée comme inévitable et essentielle par certains, remet considérablement en question nos habitudes de travail et introduit le concept de loi sécuritaire et de judiciarisation des prises en charge. Du fait de délais très courts entre sa publication le 06 juillet 2011 au Journal Officiel et sa mise en application dès le 01 août 2011, cette loi nécessite une adaptation en urgence de nos pratiques. Cet article synthétique se veut un outil pratique d’aide à la compréhension et la mise en place de cette nouvelle loi dans les services sectorisés de psychiatrie, à travers notamment deux arbres décisionnels résumant ses différents aspects. Nous aborderons préalablement et rapidement les différents points non modifiés par cette loi, ainsi que les nouveaux aspects qu’elle introduit.

It was widely agreed that the June 27, 1990 law needed to be changed. The new mental health legislation provides new procedures, which challenge our work habits and balance the rights of individual patient with the need to ensure public safety. In view of the very short time between the publication of the law in the Bulletin Officiel (July 6, 2011) and its application (August 1, 2011), the changes in legislation have led to concrete modifications of our practices.

The scope of this article is to provide a practical tool, which will help to better understand the new measures in the law and to provide an accessible guide of use in relation to mental health care decisions. For the purpose of involuntary admissions, we provide two flow-charts outlining the changes in the legislation in its various aspects. We propose to summarize the points, which are not modified by this legislation, and we further develop the several new aspects of the law. Notably, procedures involving compulsory detention including the care and observation period of 72hours, medical certificates, care in an emergency situation, the panel of caregivers, systematic review of each decision to detain by the Juge de la Détention et des Libertés (JLD), the particular case of patients under a criminal procedure or subjects who were hospitalized in units for dangerous patients, planned discharges, and disagreements between psychiatrists and the civil servant responsible.

The aim of this article is not to criticize the law. It simply sets out the new measures for the compulsory admission of patients in hospital and defines the new procedures for continued detention or discharge. Due to its recent implementation, we don’t have any feedback concerning long-term implications of this reform of mental health legislation, and it is premature to fully appreciate its advantages or disadvantages.