37 Selected topics from 2020 serious mental health challenges. At the same time, it is not always the case that admission to mental healthcare is the better solution for adolescents. A stay at a child welfare institution with secure frameworks and stable personnel can be better than a brief admission to hospital where personnel work a three-shift pattern. However, this requires active follow-up from spe­ cialist health services with outpatient and advisory functions to ensure correct evaluation, treatment and optimal care for the adolescent. Specialist health services may experience that the needs of the young person are safeguarded by the child welfare services; however, they may not be aware that this is often with the use of intrusive coercion and control. They can also be unaware of other aspects of adolescent’s stay at the institution, for instance that the adolescent may live isolated from their peers or that a lack of stability among personnel can lead to insecurity. In some cases, a long time has passed without any initiation of cooperation between the institution and specialist health services.23 Weak legal safeguards for children who live alone In total, our findings indicate that children and adolescents who were placed alone in an institu­ tion with staff only, can be subjected to intrusive interventions that in some cases can amount to violations of their rights. In a report concerning children who live in child welfare institutions, the Ombudsperson for Chil­ dren describes many of the same risk factors we have observed during our visits, and recommends improved analysis and evaluation of children’s needs, in advance of their placement in an institu­ tion.24 In a survey carried out by the Office of the Auditor General of Norway, one of the principal findings was that the needs of several children were not adequately evaluated when selecting an institution.25 The Norwegian Board of Health Supervision’s report “Omsorg og rammer. Når barn trenger mer [Care and frameworks. When children need more] highlights some of the problematic aspects of separate placements of children.26 When children and adolescents live alone with staff, they become dependent on them in a way that can present challenges to legal safeguards. An example from one of our visits illustrates this: An adolescent was placed alone in a remote institution; a mobile telephone had been confiscat­ ed and no schooling arrangements had yet been made. The adolescent therefore had extremely limited opportunity to contact others. If the adoles­ cent wished to speak to a legal representative or to supervisory bodies such as the County Governor or The Parliamentary Ombudsman, a member of staff would hold the telephone while the adolescent was using it.27 This situation removed most opportuni­ ties from the adolescent to report unlawful issues or risk of violations. On the basis of the challenges that the Parliamen­ tary Ombudsman has thus far found in relation to children who live alone with staff in child welfare institutions, the Ombudsman believes it is likely that there will be a need to carry out several more visits to this type of institution. 23 See report from Norwegian Board of Health Supervision (9/2019). “Omsorg og rammer. Når barn trenger mer», where similar findings are also described in a review of cases with extremely serious consequences. See page 13. 24 Ombudsperson for Children (2020). “De tror vi er shitkids.” [They call us shitkids] Report on children who live in child welfare institutions. 25 Office of the Auditor General of Norway (2020). Document 3:7 (2019–2020). “Investigation into whether state child welfare authorities ensure the best for children in child welfare institutions” page 52. 26 Report from Norwegian Board of Health Supervision (9/2019). “Omsorg og rammer. Når barn trenger mer [Care and frameworks. When children need more]” 27 See the Parliamentary Ombudsman's report after visit to Stendi Nymogården, 12–14 November 2019.