23 Selected topics from 2016 Mental health care institutions During visits to mental health care institutions, the NPM has focused on the patient’s right to receive information about the legal basis for the use-of-force and a clear justification for the decision to use force, in addition to the right to appeal the decision. This is important in order to safeguard patients’ right of appeal. In the administrative decision there should be a clear justification for the use of force. It must clearly describe how the statutory conditions for the use of force are met in each case, and a detailed description shall be provided about attempts to use milder means.9 Most of the hospitals the NPM visited had a practice whereby the patients received a schematic administrative decision on the use of force where the legal basis was stated, but no justification for why the decision was made. The justification was entered in the hospital records. In order to get information about the grounds, the patient had to request access to the records. The Parliamentary Ombudsman has, in order to prevent arbitrary use of force, consistently recommended that all patients should be routinely informed, both orally and in writing, about the grounds for use-of-force decisions. Administrative decisions and record entries should contain a justification and detailed information about the grounds for the use-of-force. They also should contain information about attempts to use milder means. The patients should not have to request access to their own patient records in order to get information about the grounds for the decision on use-of-force. Following multiple NPM recommendations related to the right to information and the use of force, the Directorate of Health clarified the legislation in a letter to all the supervisory commissions in Norway in autumn 2016. The letter highlighted patients’ right to information about decisions on the use of force, information about the right of appeal, and access to informational materials.¹0 The Directorate has also recently stated that work is under way on a technical solution that will ensure that the record entry is always printed together with the decision. — The patients should not have to request access to their own patient records in order to get information about the grounds for the decision on use-of-force. — 9 The Mental Health Care Act Section 4-8 first paragraph. 10 The letter from the Directorate of Health is published on the Parliamentary Ombudsman’s website: https://www.sivilombudsmannen.no/aktuelt/helsedirektoratets-oppfolging-av-sivilombudsmannens-besoksrapporter-fra-20152016-article4563-1555.html (in Norwegian only).