L’objectif était de documenter le vécu de l’audience par le juge des libertés et de la détention des patients hospitalisés sans consentement et de déterminer leur compréhension des tenants et des aboutissants de son intervention. L’enquête a été menée auprès de patients hospitalisés en admission en soins psychiatriques à la demande d’un tiers (ASPDT) ou sur décision du représentant de l’État (ASPDRE). Seuls 13 % d’entre eux étaient en mesure de citer le lieu de l’audience et 21 % le titre exact du juge. La moitié des participants ont contesté la mesure d’hospitalisation lors de l’audience, et plus de la moitié ont bénéficié du conseil d’un avocat. La majorité des participants estiment que le juge s’est montré à l’écoute, bienveillant et clair mais remettent en cause son impartialité et son indépendance vis-à-vis des décisions médicales. Plus de la moitié des patients se déclarent en désaccord avec sa décision mais seul un cinquième envisage de faire appel. Le maintien de l’hospitalisation a suscité un sentiment d’injustice pour plus d’un tiers des intéressés, de la résignation et de l’indifférence pour environ un quart d’entre eux. Les trois quarts de l’échantillon portent un regard favorable sur le contrôle judiciaire de l’hospitalisation. Un sentiment de protection est plus fréquent chez les personnes qui ont un niveau d’études supérieur au baccalauréat et qui souffrent d’un trouble de l’humeur. De même, un sentiment d’accusation est plus fréquent en cas d’hospitalisation en ASPDRE. Le sentiment que « tout était joué d’avance » est plus fréquent chez les patients les plus jeunes. Cette étude montre que le vécu et la compréhension de l’audience sont marqués par des sentiments et des réactions contrastés.

To assess involuntary admitted patients’ experience and understanding of their hearing with the judge ruling on civil detention cases according to the Act of July 5th 2011.

The evaluation was conducted through face-to-face interviews, from a semi-structured questionnaire, with 48 involuntary admitted patients under psychiatric care admission on a third party request (ASPDT) or on state representative decision (ASPDRE) (participation rate=96%).

Few participants knew the name of the hearing place (13%) and the judge's exact title (21%). About 58% of them had benefited from lawyer services. During the hearing, half of the patients contested the need for hospitalization. The judge was perceived as clear (79%), listening (69%) and benevolent (58%), but only 46% of patients believed that he/she was impartial and 35% that he/she was independent from medical decisions. More than half of the patients disagreed with the judge's decision (56%). However, only 19% of them planned to appeal. Three out of four were in favour of a judicial review of involuntary hospitalization. A feeling of protection was more common in people with a higher educational level (65% versus 35%, Chi² (1)=3.9, P=0.05) and who suffered from mood disorders (75% versus 46%, Chi² (1)=3.8, P=0.05). A feeling of being accused was more frequent in persons with hospitalization under psychiatric care admission on state representative decision (ASPDRE) than on a third party request (ASPDT) (37% vs 10%, Chi² (1)=4.9, P=0.03). Persons under guardianship were also more likely to report such feelings (32% versus 10%, Chi² (1)=3.4, P=0.06). The feeling that “everything was preordained” was more common in younger patients (m=36.4 years [SD=13.9] vs m=46.2 years [SD=17.8], t-test [46]=2.01, P=0.04), as well as among those who used the advice of a lawyer, with an association at a trend level (73% versus 46%, Chi² (1)=3.5, P=0.06).

Systematic judicial review of involuntary hospitalization represents a major evolution in the patients’ rights field. This study shows that their experience and understanding of the hearing with the judge ruling on civil detention cases are quite mixed. In clinical practice, informing the patient about the upcoming hearing may allow the physician who initiates the hospitalization to reassure him/her as the intervention of a third party will be required to confirm the legality of involuntary admission. Furthermore, such information about the judicial intervention might avoid unproductive confrontation between the patient and the physician when the person remains opposed to the hospitalization. However, some patients may be disappointed as they are heavily invested in the preparation of their “defence” and have high hopes in the intervention of a judge who most often maintains the hospitalization.