37 Visits in 2017 Akershus University Hospital, the emergency psychiatric department 2–4 May 2017 The emergency psychiatric department is part of the hospital’s mental health care clinic. The department has 73 beds and six wards were visited. Main findings The six wards under the emergency psychiatric department were housed in an older building on the hospital grounds. The wards’ communal areas were pleasantly furnished, but the building showed signs of wear and tear and the arrival area did not give newly arrived patients or visitors a positive first impression. A number of patients had limited opportunity to spend time outdoors, particularly patients subject to restrictions on being outdoors and patients in the segregation units. The wards had no direct access to outdoor areas from the communal areas or segregation units. The department employed two physiotherapists who offered both individually adapted physical activ- ity and weekly activities for all patients. Other than that, the range of activities available to patients was limited, and there were no alternatives for patients who did not wish or were unable to participate in physical activity. There were weaknesses in the documentation of the use of force. The concrete grounds for each decision, and particularly decisions regarding treatment without the consent of the patient, were not specific enough and partly based on the wrong conditions. The patient's right to receive the administrative decision was not adequately safeguarded, and the patients were not routinely given the concrete grounds for the decision. There had been a reduction in the number of times mechanical restraints had been used in the past year. The staff had received training to ensure that patients were restrained in the safest and gentlest way possible. However, conversations with patients who had been placed in restraint beds indicated that many patients did not feel well taken care of while being placed in restraints. It was also worrying that many patients had been strapped to a restraint bed Akershus University Hospital, the emergency psychiatric department