NORWEGIAN PARLIAMENTARY OMBUDSMAN National Preventive Mechanism 20 21 USE OF RESTRAINT BEDS IN NORWEGIAN PRISONS From the supervision log ’18:55 – The inmate banged their head harder and harder against the brick wall [...] was transferred to a restraint bed to prevent the inmate from self-harming. [...] 23:45 – Wakes up and says that they are cold [...] we loosen the left arm a little. Everything is OK. 00.00 – Changed the t-shirt as 2 hours had passed since the inmate had vomited [...] The inmate is very cooperative. 01:45 – Says their arms are aching [...] 02:00 – Says they are cold [...] 02:45 – Wakes up and complains about pain in both arms. 03:00 – Permitted to stretch their legs after complaining about pain in their legs. Loosened one foot at the time. 03:30 – Complained about pain in the arms. Permitted to stretch them one at a time. Was told to try to get some sleep. 03:45 – Says they cannot take it anymore. Wants to loosen one arm from the restraints for the rest of the night. Is told that this is not possible. Suddenly manages to free one of their arms. Is told to move it about now, because it is going to be a long time until the next time. This was ok. The inmate is calm and cooperative. 04:00 – The inmate keeps moving but is calm. 04:15 – The inmate is asleep, snores occasionally. 04:45 – Wakes up. Complains about pain in both arms. 05:15 – Complains that both arms are aching. 05:30 – [...] says their back is hurting, and that they have a prolapse. Asks what time it is. Says they can make it until the day shift arrives [...] 06:45 – Says they should have been examined by a doctor as they have been restrained for longer than eight hours. 07:00 – Managed to loosen one arm. Says they had to because they were in such pain. Supervision Inmates with Mental Illnesses Supervision is vital to preventing harm in these ­situations, and for ensuring a continuous ­assessment of whether the measure remains n ­ ecessary. In its ruling from 2012, the ECtHR ­stated that one of the conditions that must be present in order to use a restraint bed is that checks are periodically carried out.37 The ECtHR ruling from 2012 pointed out that people with mental illness are particularly vulnerable, and that this must be considered when determining whether Article 3 has been violated.38 Since 2019, the guidelines pertaining to the Execution of Sentences Act have outlined a requirement for continuous supervision in the event of the use of a restraint bed. The requirement was previously that supervision had to be conducted at least once per hour. Many of the supervision logs showed more frequent supervision. Although most of the prisons underlined that continuous supervision was their established practice, this was not documented in the supervision logs. During the Parliamentary Ombudsman’s visits, we have learned that staff at some prisons are ­instructed to limit conversation with inmates placed in restraint beds. The reason for this is the idea that limiting human contact would ensure that the restraint bed does not become more attractive to inmates than the security cell. In one prison, the restraint bed was placed in a way that prevented the person in restraints from seeing whether anyone was keeping an eye on them. Such circumstances can reinforce the feeling of being powerless and isolated when the inmate is already subject to a highly intrusive measure. We know from Norwegian studies that inmates in general have a high rate of mental illnesses.39 When inmates are put in a restraint bed in order to prevent self-harm, this produces a clear risk of additional trauma and worsening of their mental health. The UN Special Rapporteur on Torture points out that ‘any restraint on people with mental disabilities for even a short period of time may constitute torture and ill-treatment'.40 One of the supervisory logs stated that the ‘inmate had childhood traumas concerning restraint beds’. The inmate was nonetheless placed in a restraint bed. In another decision concerning restraint beds, it emerged that the person placed in restraints had been declared unfit to serve the sentence, due to extensive trauma after serious sexual abuse in their youth. ‘The inmate says they are psychotic and in pain. Unfortunately, we cannot help the inmate right now. Asked the inmate to try to sleep until tomorrow.’ From the supervision log Several of the prisons' supervision logs lacked information that could document whether and when medical personnel had seen the inmate. 07:05 – [Inmate is released from the restraint bed.] The inmate was placed in restraints for a total of 11 hours and 50 minutes. 37 Bures v. the Czech Republic, application no. 37679/08, judgment of 18 October 2012. 38 Bures v. the Czech Republic, application no. 37679/08, judgment of 18 October 2012, paragraphs 85 and 88. 39 Cramer, V. (2014). Forekomst av psykiske lidelser hos domfelte i norske fengsler. Oslo: Oslo University Hospital. 40 See the UN Special Rapporteur on Torture Juan Mendez’s report to the UN Human Rights Council 1 February 2013, A/HRC/22/53, pages 14–15, section 63 and page 23, section 89 b).