48 Mental health care for children under the age of 16 is based on parental consent. This means both that the admission is considered voluntary regardless of the child’s opinion, and that use of force by clinic staff will in many cases be registered as voluntary because it will be based on parental consent. The fact that admissions based on the consent of the parents and not the child are registered as voluntary raises a number of ethical and treatment-related challenges. The Convention on the Rights of the Child states in Article 12 that children have the right to express their views and to be heard, and that their views shall be given due weight in accordance with their age and maturity. The Children Act states that children’s opinions shall be heard from the age of seven. The Patient and Users Rights Act states that children should be allowed to express their opinion on matters relating to their own health from the age of 12. Nevertheless, children aged between 12 and 16 can be admitted to inpatient institutions against their will. The Act does not entitle young people aged between 12 and 16 to be heard in connection with mental health care admissions. The fact that the principles of the Convention on the Rights of the Child have not been incorporated into the Act creates a risk that the child’s case will not to a sufficient extent be considered in relation to the strict conditions stipulated to protect personal integrity. At the same time, the visit left the impression that the clinic manages the admission issue well and applies discretion within the legal framework. These decisions are stored in electronic patient records, which also contain separate record entries stating the grounds for each individual decision. The grounds are not stated in the decisions themselves. NORWEGIAN PARLIAMENTARY OMBUDSMAN National Preventive Mechanism ANNUAL REPORT 2016 The clinic management was not sure whether the patients routinely received the written grounds for the administrative decision (the patient record note) together with the decision. In cases concerning young people under the child welfare service's care, it is the head of the relevant municipality's child welfare service who is responsible for giving consent to admission. In the clinic's experience, none of the heads of the municipal child welfare services in Ahus’s catchment area have an out-of-hours duty phone, which means that they can only be reached during ordinary working hours. This has occasionally caused problems in connection with emergency admissions in the evening or during weekends, when the clinic has lacked formal consent to the admission until the next working day. This gives cause for concern, since in reality it means that a patient can be admitted for up to two and a half days without a lawfully made administrative decision. The clinic had furnished a special room with a medicine table and four chairs bolted to the floor for use in connection with forced nutrition. The room also contained a padded restraint for the chair that was sometimes used. It was secured across the patient’s thighs to make it more difficult for him or her to use his/her legs to resist. This raises the question of whether the chair, in cases where this padded restraint is used, is to be considered a coercive measure that an administrative decision for short-term holding will not cover. After the visit The visit report was published in December 2016, and the Parliamentary Ombudsman has asked to be informed about the follow-up of the report's recommendations in March 2017.