Annual Report 2015 Reducing the use of physical restraints and seclusion in the Healthcare System A small numbers of patients in the care for the disabled, care for the elderly and mental healthcare systems may be restricted in or deprived of their freedoms, being subjected to bed restraints or seclusion. As freedom-restricting measures may have a negative impact on the quality of life, the use of such measures must be prevented wherever possible. The Dutch healthcare institutions do all in their power to prevent the use of such measures as much as possible or to use them in accordance with the principles of subsidiarity, proportionality and efficiency. While a lot of progress has been made in the past few years, the NPM still finds that further improvements are possible. The NPM is of the opinion that too many patients are restricted in their freedom unnecessarily. Intimate Searches of Youths in Juvenile Detention Centres A section of the youths in Dutch juvenile detention centres may be systematically subjected to intimate searches 11. The NPM is of the opinion that systemic intimate searches constitutes inhuman treatment. Random searches 12 are permitted, as long as they are performed at a frequency of, on average, no more than twice per month. Youths may be searched more often in special circumstances and following a motivated decision thereto by the governor. It is important in this connection that the decision is made after due consideration and for each individual youth concerned. The NPM believes the systemic intimate search of youths to be unjustifiable if no sound motivation exists. Authorisation of the use of (physical) restraints and seclusion in Youth Assistance Services The juvenile court judge must issue an authorisation for the use of (physical) restraints and seclusion and the deprivation of freedom of, youths in healthcare institutions. The NPM has noticed an increase in the number of youths placed in wards with a closed regime while no authorisation for such placement was issued. It is, in the end, up to the juvenile court judge to judge whether a youth suffers from such severe problems that deprivation of freedom and the use of freedom-restrictive measures is necessary. This also applies to closed youth assistance within a "voluntary framework". A placement without an authorisation thereto and, thus, without the required legal assessment having been made, is unacceptable to the NPM. 11 This concerns a search of the body. A JJI staff member both examines the outside of the entire body and 12 This is the standard for searches following an inspection of the cell. searches for any banned objects in all body cavities (mouth, ears, anus). 9 Table of Cont