Psychiatric services in French penal institutions have been reorganized in recent years; the government has changed its provision of health services because of fewer psychiatric hospitalizations and an increasing number of mentally ill offenders. The French prison system uses regional medical-psychological centers to respond more effectively to the special needs of mentally ill inmates. When it first opened in 1979, Switzerland's La Paquerette Center operated as a sociotherapeutic day clinic for offenders who had problems functioning in the regular prison system. In 1986, La Paquerette increased its program capacity to allow more inmates to participate. Inmates can now stay at the facility, rather than visit on a daily basis, to attend the program. Most patients treated at the center are impulsive, violent repeat offenders; display sexual deviance, anxiety, and depression; and feel they have not accomplished anything in life. Major crimes of inmates who have stayed at the center for more than 4 months include murder, serious bodily injury, sex offenses, arson, robbery, property offenses, and drug offenses. The main objective of the center's program is to teach offenders to take responsibility for themselves. In Scandinavian penal codes, a common principle is that persons found to be not responsible for their behavior cannot be punished. There is no consensus, however, on criteria for identifying criminal responsibility and classifying people as insane or severely mentally deficient. Mentally ill offenders who are found liable for punishment are treated by health services established in the prison setting. Mentally ill offenders may also be referred to involuntary treatment programs.