The TransPsyCo project

Coercion in psychiatry refers to practices such as seclusion, mechanical restraint (using straps to secure the patient to the bed), involuntary hospitalization, and the forced administration of high-dose treatments. However, these practices—and the abuses associated with them—are increasingly being challenged at international and European levels, and recently in France as well. Given their negative impact on patients and care teams, and the lack of sufficient evidence regarding their therapeutic benefits, it is now widely held that they should be restricted to extreme situations.

However, the use of these practices—particularly seclusion and restraintremains common in France, and has even been on the rise over the past twenty years; this trend is linked, in particular, to the social and political emergence of a security-oriented approach that impacts psychiatric care. Significant variations are also observed between hospitals, and even between different wards within the same hospital. Consequently, the use of coercion requires further study to understand how and why it is applied (the “factors”), to better grasp the consequences for both patients and healthcare staff (the “effects”), and to identify strategies and methods that can drive changes in practices and hospital operations (the “levers”).

Conducting these studies requires a multidisciplinary approach, given that the factors, effects, and drivers of coercion operate at individual, systemic (i.e., relating to care teams and hospital operations), and territorial levels (i.e., involving families, neighbors, municipal and prefectural authorities, and legal decisions). TRANSPSYCO therefore brings together researchers from various fields—including medicine, sociology, engineering, law, geography, and public health—to study the factors and consequences of coercion, as well as to devise strategies enabling hospitals and professionals to limit their reliance on such measures.

Project leaders:

Éric FAKRA

Éric Fakra is a psychiatrist and a University Professor and Hospital Practitioner (Centre Hospitalier Universitaire de Saint Étienne). He is the Head of the Saint-Étienne sector department (Saint-Étienne University Hospital) and a researcher affiliated with the Saint-Étienne Faculty of Medicine at Université Jean Monnet and the Centre de Recherche en Neurosciences de Lyon.

He leads the PSYR2 team (Psychiatric Disorders, Neuroscience Research, and Clinical Research) at the CRNL. He coordinates numerous research projects in the fields of psychiatry and neuroscience, including the PRESTO PREPS project on the development of early intervention in psychiatry.

Xavier BOUCHER

Xavier Boucher is a professor and researcher at the Chercheur au Centre Ingénierie et Santé de Mines Saint Etienne. A specialist in organizational science and decision support, he conducts research focused on the territorial organization of healthcare systems.

An active member of several international scientific societies (IFAC, IFIP, SAGIP, SOCOLNET), he has participated in various European projects and currently coordinates the CoDEMO project (2023–2026) on Organizations 5.0, particularly in the healthcare sector. Xavier Boucher has also coordinated two ANR projects.

Sébastien SAETTA

Sébastien Saetta is a sociologist and research fellow at ENSEIS Recherche. He is also an associate researcher at the CHU de Saint-Étienne (CHU) and theCentre Max Weber (UMR). His research examines and analyzes transformations within the fields of mental health and psychiatry. He currently coordinates two projects: PLAID-Care, which focuses on less coercive psychiatric facilities, and TADOPSY, which studies tobacco use among adolescents and young adults with mental disorders in institutional settings.

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