36 NORWEGIAN PARLIAMENTARY OMBUDSMAN National Preventive Mechanism ANNUAL REPORT 2018 Mental healthcare Reinsvoll psychiatric hospital 27 February–1 March 2018 Oslo Prison Oslo Prison 12–14 November 2018 The prison is one of the biggest in Norway with a total capacity of 240 inmates when all sections are in operation. Oslo Prison primarily houses inmates remanded in custody and is the prison in Norway with the highest number of such inmates. At the time of the visit, the prison had two sections in operation, Section B (Bayern) and Section C (Stifinnern). Stifinnern is a small special section, and the NPM only visited the Bayern section. Bayern comprises ten units of which the NPM visited seven. The report from the visit will be finalised in the course of 2019. During the NPM’s visit to the emergency psychiatry and psychosis treatment department at Reinsvoll hospital, a key finding was that the institutional culture at the department as a whole appeared to be characterised by respect for the patients’ integrity and needs. The department had systems in place for maintaining a good institutional culture over time, including good management, and a thorough process for recruiting new employees focusing on assessments of personal suitability. Several aspects of the department's operation should serve as an example to be followed by other mental healthcare institutions. The patients were offered varied activities adapted to their wishes and level of functioning, and good access to pleasant natural surroundings. The department’s inpatient units had well-maintained and pleasant communal areas. Many patients emphasised that they were received in a caring and welcoming manner. Rather than emphasising training in the practical use of force in a conflict that has already arisen, the department worked on preventing use of force by focusing on attitudes and communication that can prevent situations from escalating. Shortcomings were found in the department’s practice in relation to administrative decisions to use coercion, particularly decisions regarding treatment without the consent of the patient. Often, the administrative decision did not contain a satisfactory description of the actual circumstances and an assessment of whether the requirements were met. Since treatment without the consent of the patient is a very serious intervention, there was a need for further measures to ensure sufficient consideration and documentation of whether the legal requirements were met.