51
First five years – some results
This is a breach of the duty to make an individual
administrative decision for intrusive measures
such as manual restraint, and it will in many
instances be a breach of the conditions required
by law for using restraints. In a separate thematic
report on segregation, we emphasised this issue
in addition to several other problematic findings
concerning hospitals' use of segregation.10 The
Directorate of Health has now specified that it is
not allowed to use manual restraint to initiate or
maintain the segregation of a patient, apart from
gentle physical leading.11
New draft legislation on the use of coercion
in the health and care services
A new draft legislation proposal on the use
of coercion in the health and care sector was
presented in June 2019.12 The Committee
responsible for drafting the proposal referred
several times to the Parliamentary Ombudsman’s
preventive work, in particular with regard to the
use of segregation. 13,14 In our thematic report
on segregation in mental healthcare institutions,
we concluded that the current use of segregation
constitutes a risk of inhuman treatment.15 The
Committee finds that the current legal regulation
of segregation is unsatisfactory. The Committee
proposes raising the threshold for segregation as
a form of treatment, for instance by ensuring that
the legal requirements are the same as for other
forced treatment.
Our reports on degrading conditions in many
of the segregated units also appear to have
influenced the Committee, which specifies that
segregation rooms should be furnished in the same
way as an ordinary patient rooms, if reasonable
in relation to individual risk assessments.
In several reports, we have pointed out that
restraint beds should not be placed in segregation
units. They create a sense of insecurity among the
patients, and easy access to them can increase the
risk of restraint beds being used. The Committee
recommends phasing out the use of mechanical
restraints over the course of a three-year period
after the law has entered into force,16 and that,
in the meantime, ‘mechanical devices should not
be kept in the vicinity of the ward in question when
not being actively used’.17
A room in a segregation unit in a psychiatric hospital
ward visited by the NPM.
10 For a more detailed description of segregation, see the thematic report ‘Skjerming i psykisk helsevern
– risiko for umenneskelig behandling’ (‘Segregation in mental healthcare – risk of inhuman treatment’ – in Norwegian only), 2018.
11 Circular Mental Health Care Regulations with annotations, Section 18, fifth paragraph.
12 Tvangsbegrensingsloven. Proposal for common rules on the use of coercion and intervention without consent in the health
and care sector. Norwegian Official Report 2019:14.
13 Norwegian Official Report NOU 2019:14 Chapter 6: Experience of using the sets of rules, sub-chapter 6.2.5.
The Parliamentary Ombudsman’s National Preventive Mechanism. Our annual reports and thematic reports on segregation
in mental healthcare institutions are summarised here.
14 Norwegian Official Report 2019:14. Sub-chapter 25.6.3.2 Criticism of the use of segregation.
15 Thematic report on segregation in mental healthcare – risk of inhuman treatment (2018), see sub-chapter 8.7
Segregation and human rights.
16 Draft legislation Section 4–3 third paragraph.
17 Draft legislation Section 4-4 third paragraph.
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