Visits, Follow-ups and Results in 2020 Main entrance to the mental healthcare facility for children and adolescents, Stavanger HF. The County Governor in Rogaland has previously concluded that it is unlawful to use reinforced segregation rooms as general day rooms. The County Governor has instructed that the rooms shall be made into ordinary rooms and that segregation rooms otherwise should be given a more appropriate design. Findings from the visit indicated that there had been a positive development with increased involvement of children and adolescents in recent years. However, some of the adolescents felt they had limited opportunities to influence their treatment, and several staff members believed there was room to improve children’s participation. The wards did not have proper written information concerning ­children’s and adolescents’ rights, and several youths were uncertain about their rights. In the children’s ward activities were part of the treatment. The activities were organised by environmental therapists and were well adapted to the children’s needs. In the adolescents’ wards, the range of activities was limited and largely left to be organised by the families. The lack of recreational opportunities will in particular affect adolescents who lack contact with family or those who are admitted long-term. According to the clinic statistics, the use of coer­ cive means and segregation has been significantly reduced in recent years. Despite the fact that the figures appear to be partially unreliable, they overall pointed in a positive direction. The adolescent wards had previously applied more segregation measures than many adult psychiatric wards, and 45 it was therefore important that the use of segrega­ tion was significantly reduced in 2019. The County Governor has previously highlighted that the use of segregation and mechanical coer­ cion means against a child under 16 years of age, constituted a breach of the law. The section had carried out several measures to follow up the issue, including additional training of staff. There were no findings of further cases of unlawful use of coercive means against children under 16 years of age. During the visit we discovered that the police, in certain cases, had applied intrusive use of coercion in connection with admission to the section. Several members of staff also experienced that the police had a low threshold for the use of handcuffs and had seen several young people with sore wrists ­after handcuffs. The police, on at least two occasions, had used a spit hood on adolescents who were brought to the section. The use of spit hoods on children is humiliating and can lead to anxiety and panic, particularly in vulnerable children. This type of coercive action creates a high risk of inhuman and degrading treatment. In one of these cases, the hospital had complained to the police. At the time of the visit, no formal cooperation agree­ ment was in place between the section and the local police. Several of the management acknowl­ edged the need for closer dialogue with the police. It also became evident that the Control Commission did not visit the children and adolescent wards themselves or speak to the patients directly. The regular routine was that the commission was notified by staff if children and adolescents wished to speak to them. Talking directly to patients is a key element of a supervisory visit. Failing to do so increases the risk that serious issues within the ward go undiscovered.

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