38 The county psychiatric department, Vestfold Hospital 10–12 April 2018 The main focus of our investigation during the visit to the county psychiatric department at Vestfold Hospital in Tønsberg was the emergency psychiatric units, including the psychiatric emergency unit, the general psychiatry emergency in-patient unit, and the emergency psychosis in-patient unit. There are plans to move the emergency wards when a new hospital building has been completed in 2019. The NPM's visit showed that the emergency psychiatric sections, particularly a number of the segregation units, showed signs of wear and tear and were not suitable for safeguarding patients’ safety and dignity. The sections had little or no information on their notice boards about activities, patient rights or control and supervisory authorities. The activity programme seemed poor and there were very limited possibilities of spending time outside in the fresh air. The county psychiatric department, Vestfold Hospital NORWEGIAN PARLIAMENTARY OMBUDSMAN National Preventive Mechanism ANNUAL REPORT 2018 The staff did not have a common understanding of the fact that activities can prevent violence and the use of force. The emergency sections had a high use of coercive measures compared with national figures. There was an increase in the use of mechanical restraints and short-term physical restraint at the emergency sections last year, despite measures to reduce the use of force. A review of the documents showed that the police had been involved in the use of mechanical restraints on patients twice. An inspection of the premises showed that the ­section for psychosis had an spit hood that could prevent patients in restraints from spitting. Despite it rarely being used, the NPM pointed out that using spit hoods is very invasive and that the availability of the mask in itself increases the chances of use. Several factors were identified in connection with the visit that indicated a real risk of excessive use of force. During the visit, we met a number of patients with cuts and bruises following confrontations with staff.