According this decree of March 2published at Official newspaper of March 9, a unit for difficult patients (UMD) can, in the same way as a medico-psychological center (CMP), a day hospital (HDJ) or a specially equipped hospital unit (Usha), be established outside the site of the authorized establishment to which it is legally attached. The new text adds the UMDs to the structures that can be deployed outside the site holding the authorization, and already listed in the decree of September 28, 2022 setting the methods of care that can be deployed outside the authorized site provided for in article R. 6123-174 of the public health code:
– permanent reception centres;
– crisis centres;
– therapeutic apartments;
– therapeutic family care;
– medico-psychological centres;
– part-time therapeutic reception centres;
– home care;
– day hospitals;
– followingcare centres;
– specially equipped hospital units;
– regional medico-psychological services;
– health units in prisons.
As a reminder, a main principle of this reform is the issuance of an authorization by mention (and no longer by form of support). The new text indicates that the activity of psychiatry is exercised according to 4 mentions:
– adult psychiatry;
– child and adolescent psychiatry;
– perinatal psychiatry;
– care without consent.
The holder of the authorization must provide all the support (full-time, part-time, outpatient, including home care), either on its site or outside, “by conventionwith another structure.
• Find out more: Reform of authorizations in psychiatry, an instruction to guide the ARS; Reform of authorizations in psychiatry, the regulatory framework