42 recently upgraded in 1995. Most of the patient rooms in Building 4 were equipped with a washbasin only, and the patients had to share bathroom and toilet facilities. Among other things, this posed challenges related to the patients’ privacy and self-care, and health personnel’s care for the patients. The rehabilitation unit’s secure treatment unit 3A was located on the first floor of Building 3. The unit was in poor condition. The air quality in the corridor was poor, and there were signs of mould and water damage in one of the communal showers. The secure treatment unit had no activity room, exercise room or library that the patients could use. The patients in the secure treatment unit had no access to any separate outdoor area, garden, ball game area, balcony or veranda. It emerged during the visit that the physical conditions and low staffing levels resulted in patients in the secure treatment unit not always being given the possibility for daily outdoor exercise and physical activity. The situation was particularly serious because average stays for patients in the secure treatment unit were longer than the stays of other patients at the Clinic for Mental Health Care and Substance Addiction Treatment. Telemark Hospital NORWEGIAN PARLIAMENTARY OMBUDSMAN National Preventive Mechanism against Torture and Ill-Treatment ANNUAL REPORT 2015 Patients in the geriatric psychiatry unit were not informed of all administrative decisions, and in some cases, medication was administered to patients subject to decisions that they were to be treated without their consent by hiding the medication in their food or drink without informing them. One patient in the emergency psychiatry unit had experienced short periods of restraint without any formal decision to that effect having been adopted. Some patients had their luggage searched on admission. An administrative decision to conduct such a search had not been made in the case of any of the patients that the NPM spoke with. The hospital management informed the NPM that, when patients are admitted, the staff searched their belongings as a matter of routine. Luggage searches were based on the patient’s consent. There is no legal authority under applicable regulations to carry out routine searches of the patients’ belongings on admission. Nor does the patient’s consent form an independent basis for carrying out a search under Section 4-6 of the Mental Healthcare Act. Even though a large and well-equipped activity building was located next to the secure treatment unit, it was seldom used by the patients because of the low staffing level. Patients in the geriatric psychiatry unit were offered a daily opportunity to take part in a simple morning exercise programme and often had the possibility of going for a walk afterwards. Several of them stated that the afternoons and evenings could feel very long, however, due to the lack of activities after lunch. According to the use-of-force records, one patient had been placed in restraints during the current period of admission. A review of use-of-force records indicated that patients were generally placed in restraint beds for short periods only (a few hours). The use of a restraint bed is a very invasive measure that in itself entails a high risk of ill-treatment. This risk increases with the length of time the patient is restrained.

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