International audience In mental health as in other domains, confinement practices and secure settings are often conceptualized as being part of the post-disciplinary societies tendency to manage populations through risk assessment. This paper examines units for difficult patients in France as an original configuration between confinement, dangerousness and care. A documentary analysis, combined with interviews and observations, show how professionals in the unit define dangerousness as contextual and incorporate security measures as care practices. All the way, psychiatrists maintain the unit's tie to the general mental health care system. The analysis sheds light on the contemporary transformations of confinement in relation to psychiatric practice.