69 Visits in 2019 Bergen Hospital Health Trust, Sandviken Psychiatric Clinic The clinic has also stated that the segregation units shall be designed so that the patients can take part in meaningful social interaction, and that the clinic will alter the segregation units and establish segregated living rooms in the units. The clinic has also decided to discontinue the use of rooms set up with restraint beds that were located in the segregation units during the ­Parliamentary Ombudsman’s visit. According to the letter sent by the clinic in ­December, changes have begun on the layout and a collaboration has been initiated with an interior architect. The opportunity to spend time outdoors will become a regular item in the milieu therapy plan for all patients. A decision had been made to improve the available outdoor areas, and they also plan to improve the indoor areas and set up a music therapy room. In the report, the Parliamentary Ombudsman expressed concern over the extensive practice of using transport restraints as a mechanical restraint and pointed out that it constituted a risk of ­lowering the threshold for using coercive ­measures. We found that spit hoods had been used in exceptional cases to cover the patients’ faces while they were being restrained. As a result of the ­Parliamentary Ombudsman's visit, new procedures were implemented to avoid prolonged use of restraint belts, and the spit hoods were removed from all the clinic’s units. A review of the decisions on forced medication revealed several weaknesses in terms of how the decisions were written. The clinic has subsequently changed its procedures by ensuring that the person responsible for making the decisions always evaluates whether forced medication is strictly necessary and proportionate. Following the Parliamentary Ombudsman’s recommendations, the clinic has also changed its internal procedures for the use of electroconvulsive therapy (ECT) on the grounds of necessity and introduced a checklist for every ECT treatment on the grounds of necessity. In the report, the Ombudsman pointed out that the patients’ right to information and participation was not satisfactory. As part of the follow-up, the clinic has designed a common standard for information material for the clinic's patients. This included information about how the right of appeal can be safeguarded.