general observations in connection with inspections 37 or kept in isolation. In this context, the new legislation that came into force on 1 October 2018, regarding specific authorities and right to spend time outdoors, will also be followed up on. Compulsory psychiatric care Compulsory psychiatric care in Sweden is conducted almost exclusively by county councils. At the end of 2017, there were an estimated 80 institutions for compulsory psychiatric care and forensic psychiatric care, with a total of around 4,000 placements. Persons who are subject to compulsory psychiatric care pursuant to the Compulsory Psychiatric Care Act as well as persons sentenced to forensic psychiatric care and who are cared for pursuant to the Forensic Mental Care Act are placed at these institutions. During 2015–2017, the OPCAT unit carried out ten inspections of places where compulsory psychiatric care is conducted. Coercive measures As outlined in the Compulsory Psychiatric Care Act and the Forensic Mental Care Act a care provider has the option of taking certain coercive measures against persons subject to compulsory care. This involves, among other things, the ability to strap patients down (bed straps), isolate them and perform body searches. It is also possible to administer compulsory medicine when the patient does not voluntarily take prescribed medicine. When it comes to bed strapping, it has been noted during several inspections that there are unclear points in the clinics’ procedures. One clinic’s procedural description contained wordings that, in the opinion of the Parliamentary Ombudsmen, could be interpreted as meaning that bed strapping is possible for disciplinary reasons. Such a measure may only be taken if there is an immediate danger of a patient seriously injuring themselves or someone else. It was also stated in the procedures that the patient should be given the opportunity for a few minutes to “accept” the coercive measure decided on. Against this background, the Parliamentary Ombudsmen has stressed that the use of bed straps must only be for the purposes of averting a sudden event and the measure must not be taken in order to prevent something suspected or occurring.51 When inspecting two general psychiatry sections, it emerged, that one of the sections had no capacity for strapping down patients. For this reason, the staff 51 Ref. nos. 643-2015 and 3302-2015. The use of bed straps must only be for the purposes of averting a sudden event and the measure must not be taken in order to prevent something suspected or occurring.

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