5 Foreword In the child welfare sector, we continued visits throughout 2018 to emergency and long-term institutions. One troubling finding highlighted in one of the thematic articles in this annual report, is the routine use of coercion. The NPM's visit to several child welfare institutions have revealed illegal use of coercive measures and restrictions. It is a matter of concern that several of the institutions we have visited have had a weak understanding of the legislation, which in some cases has led to violations of the law and a high risk of integrity violations. With respect to mental healthcare, we have visited different types of adult psychiatric departments at four hospitals. We have covered emergency psychiatric units, psychosis units, local security sections at psychiatric units and geriatric psychiatric units. The visits over the year showed that many hospitals have challenges relating to prolonged use of mechanical restraints. This appears, among other things, to be related to an extensive use of mobile restraints, which may contribute to the normalisation of coercive measures and prolonged use of mechanical restraints. The visits in 2018 also clearly showed that good institutional culture is an important element of preventing inhuman and degrading treatment. Outreach activities have been an important element of the NPM’s prevention efforts also in 2018. We have had meetings with civil society, lectured at a number of conferences and seminars, and continued our dialogue with the authorities. This type of ­national dialogue is an important means of spreading knowledge of the prevention of torture and inhuman treatment, of our findings and recommendations from visits, and to increase the NPM’s potential to influence and make a difference in the institutions we visit, as well as in the public administration. Although we see a great deal of good work and good practices during our visits, our findings show that there is a significant risk of people deprived of their liberty being subjected to inhuman or degrading treatment also here in Norway. To regularly be under international scrutiny, as has been the case in 2018, is therefore both important and beneficial. The annual report shows that preventive monitoring makes a difference. The institutions we visit generally follow our recommendations in a thorough and timely ­manner, as do regional and national administrative bodies. This helps reduce the risk of inhuman or degrading treatment in Norway. We present several examples of how our recommendations have been followed up in Chapter 5. We also note that supervisory bodies use the NPM’s findings and recommendations in their work. In addition, we have seen that when we point out positive practices in our reports, other institutions become aware of the practices and use them constructively. This is also a very important part of the mandate of prevention. Aage Thor Falkanger Parliamentary Ombudsman Photo: Anders Bakke and focused on solitary confinement and time spent outside the cells. The conditions in the A-øst unit where inmates had a very limited range of activities were particularly worrying. For four of the week's seven days, inmates were isolated in their cells for 22 hours or more, despite the prison defining this as a community unit.