NORWEGIAN PARLIAMENTARY OMBUDSMAN National Preventive Mechanism ANNUAL REPORT 2019 30 Being strapped naked to a restraint bed with prison officers of the opposite sex in the same room, can be a very humiliating experience and increase the risk of trauma. It is important to underline that this can apply to inmates of both sexes. Gender Gender is a point of vulnerability. The UN Rules for the Treatment of Women Prisoners and Non-Custodial Sanctions for Women Offenders (the Bangkok Rules) underline the importance of good policies and regulations for staff working with female inmates.41 We know that many female inmates have been the victims of abuse and different forms of sexual exploitation.42, 43 These are factors that can exacerbate the sense of humiliation from being placed in restraints. Over 30% of cases of inmates being placed in restraints in the period concerned women. This included some of the longest periods spent in restraints. Additionally, the decisions analysed showed that female inmates who had been put in restraint beds, more often had been restrained several times, compared to male inmates who had been put in restraint beds. Five of the seven inmates who had been put in restraint beds four times or more, were women. Language A lack of opportunity to communicate with those the inmate depend on, is also a point of vulnerability. Foreign inmates are entitled to information in a ­language they understand.44 The prison must ­ensure that the inmate has understood the grounds for the decision and understands the information that is provided. One of the supervision logs showed that the prison did not call an interpreter, although the inmate in the restraint bed requested an interpreter. Juvenile inmates The threshold for placing juvenile inmates in restraint beds is higher than for adults – it must be ‘absolutely necessary’. In one instance, a juvenile inmate remained strapped to, and at times, asleep in, the restraint bed for over 13 hours without medical supervision. This incident is mentioned in one of the Parliamentary Ombudsman’s visit reports.45 A review of the prison’s procedures on the use of restraint beds also showed that they did not include separate points on the use of restraint beds in cases regarding juvenile inmates. Summary and Recommendation The use of restraints in prison in order to prevent inmates from harming themselves or attempting suicide, raises important human rights and health-related questions. The revision of 82 decisions, alongside experience and the data collected from visits to several prisons, identified the following main issues: Risk to life and health The use of restraints involves a risk of both somatic injuries, including fatal injuries, as well as a risk of trauma and serious psychological distress. Despite this, in most of the cases where restraint beds were used, they were used with minimal supervision by medical personnel. Qualified medical personnel are generally neither present at the start of nor during the time spent in restraints. 41 The UN Rules for the Treatment of Women Prisoners and Non-Custodial Sanctions for Women Offenders (the Bangkok Rules), adopted by the UN General Assembly on 21 December 2010, A/RES/65/229. 42 Directorate of Norwegian Correctional Service (2015). Likeverdige forhold for kvinner og menn under kriminalomsorgens ansvar. 43 Report No 37 to the Storting (2007-2008). Punishment that works – less crime – a safer society. 44 The UN Standard Minimum Rules for the Treatment of Prisoners (Nelson Mandela Rules), adopted by the UN General Assembly on 17 December 2015, Rule 61 No 2. The recommendation of the Council of Europe’s Committee of Ministers, Rec (2006) 2 to the member states about the European prison rules (The European Prison Rules), principle 38.3. 45 The Parliamentary Ombudsman's report after its visit to Bergen Prison 2–4 May 2018.