27 Selected topics from 2017 A review of the documentation indicated that segregation was carried out in an unsystematic manner. The hospitals had not set out in writing how they expected segregation to be implemented, such as what kind of treatment and activities the measure was to include. There was no differentiation between segregation for treatment purposes or out of consideration for other patients. At one hospital, the procedures merely consisted of a list of the objects that were not to be found in a segregation room. With few exceptions, segregated patients had little opportunity to engage in activities adapted to their interests and level of functioning. They also had limited access to entertainment such as radio, music and reading materials, and many patients said they were bored. The lack of such entertainment was said to be based on the need to limit sensory impressions, but nor were they made available to other segregated patients. The Ombudsman has pointed out that it is the responsible mental health professional’s duty to ensure that segregation measures are not more invasive than strictly necessary. Research on isolation in prison has shown that limiting human contact, sensory impressions and self-determination can be harmful to health.7 Segregation, particularly if it takes place over a long period of time, poses a risk of inhuman or degrading treatment. Mental health care institutions should therefore give particular consideration to the risk of harmful effects of isolation in their practice. Findings indicate that many segregation measures are in effect over a long period of time. Pursuant to current legislation, segregation can be maintained for up to two weeks at a time, and for some patients, segregation is extended a number of times. Some patients were subject to segregation over many months. If segregation is maintained over a long period of time without any change in the circumstances that led to segregation being considered necessary, this may indicate that the patient requires a different form of treatment. — — Segregation measures were implemented in ways that meant that the intervention clearly resembled isolation or had to be considered isolation. 7 For a summary of research findings, see Sharon Shalev, A Sourcebook on Solitary Confinement, LSE/Mannheim Centre for Criminology 2008.