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Visits in 2017
not routinely given to patients. New templates for
administrative decisions pursuant to the legal amendments made in 2017 appeared, however, to ensure
that the grounds were also given to the patients, as
the grounds are now included in the decision itself.
The unit had a relatively low prevalence of the
use of mechanical restraints, and had focused in
recent years on preventing their use. Findings made
during the visit indicated that the employees received
training and refresher training in ensuring that
restraints were used in the safest and gentlest way
possible. The mental health professional responsible
for administrative decisions performed evaluations
with patients after restraints were used. There were
also examples of patients sleeping in restraints, and
it emerged that mobile restraints had previously been
used when patients went outdoors to smoke if they
were considered to pose an escape risk.
Many patients had experience of being segregated,
and segregation was perceived by the patients as the
primary coercive measure in use at the unit. Findings
indicated that segregation was often of a short
duration, sometimes for just a few hours or 1–2 days
in other cases. Segregation appeared to be carried out
in a flexible manner, and the staff were aware that it
may have harmful effects on or distress the patient.
Some of the patients in the ordinary parts of the units
could be subject to ‘agreements’ that required them to
spend long periods in their rooms during the course
of the day. It varied whether a segregation decision
had been made when such day plans were used,
although the patients felt they had little say in these
‘agreements’. In some cases, the patients were alone
in the segregation unit, while the staff sat outside a
closed glass door in the ordinary section beside one
of the high-risk units.
At the psychosis unit, segregation was primarily
carried out in the patients’ own rooms rather than
using the segregation unit, as it was regarded as
being unsuitable for longer stays. Segregation in
patients’ own rooms at the psychosis unit could entail
patients spending long periods of time in their rooms,
without contact with the staff.
There has been an increase in the number of administrative decisions concerning forced medication
at the unit in the past year. The extent to which the
patients felt that they had received sufficient information about the effects and possible side-effects
of the medication varied. Administrative decisions
concerning forced medication contained very
thorough grounds, but the actual conditions on which
the intervention was based were not well-enough or
specifically described in many of the decisions. New
templates for administrative decisions pursuant to
the legal amendments in 2017 ensured this was
addressed to a greater extent.
Findings made during the visit indicated that
visit control was occasionally practised through
employees being present in the visit room, without
consideration being given to whether the strict
conditions for such control pursuant to Section 4-5 of
the Mental Health Care Act were met. Some patients
also described how they were not allowed visits
from various people, again without administrative
decisions being made.
Child welfare institutions
Hedmark youth and family centre,
unit Vien 4-25
10–11 May 2017
Vien 4-25 is one of three emergency units at Hedmark
youth and family centre. The unit admits adolescents
aged between 13 and 18 and is approved for the
placement of three adolescents under the Norwegian
Child Welfare Act Sections 4-25. Vien 4-25 is a closed
unit. This means that the doors are locked and leaving
the unit is only permitted by agreement with the staff.
Main findings
The unit appeared to limit the use of body searches.
In addition, the unit had prepared new procedures for
body searches, which implied that the adolescents did
not have to be completely naked, but could remove
their clothing in two stages. This practice is in line
with the CPT’s recommendations.
In some cases, adolescents were excluded from
the community rooms and the company of the
other young people after admission. In one case
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