NORWEGIAN PARLIAMENTARY OMBUDSMAN National Preventive Mechanism 18 The lack of administrative decisions prevents the ­possibility for the inmate to file a complaint and limits ­appropriate internal control and oversight by external supervisory bodies. A lack of reasons for a decision also constitutes a threat to the legal safeguards of inmates. ‘Wanted to go back to the cell. [Officer] talked to the inmate. Must remain in the restraint bed until tomorrow. This is for their own good. Calm – accepts this. From the supervision log The requirement of strict necessity applies to the entire restraint process. The ECtHR has established a violation of Article 3 in a case where an inmate, who was described as calm, was not released from the restraint bed.31 ­This requirement has been violated in a significant number of cases where restraint beds have been used in Norwegian prisons during the past six years. ‘There is reason to be concerned that the use of security cells in reality can contribute to creating a situation that results in an inmate being placed in a restraint bed.’ 19 USE OF RESTRAINT BEDS IN NORWEGIAN PRISONS In two of the prisons, inmates were described as calm for most of the time spent in the restraint bed, in all the decisions made. In one prison, this applied to half of the decisions, while in other prisons this applied to several of the decisions. During many of the incidents involving the use of a restraint bed, the inmates slept in the restraint bed. The Parliamentary Ombudsman has in several reports following visits to mental healthcare ­institutions criticised the fact that patients were asleep while in restraints, as patients who are asleep no longer constitute a situation where the requirement of ‘strict necessity’ is fulfilled.32 In some cases, the straps were loosened to let the inmate use the bathroom, make a call or ­shower, before being strapped back into the restraint bed. In these situations, an explanation was not provided for why the person should be placed in restraints again. Most of the decisions lacked documentation that other less intrusive measures had been attempted before using the restraint bed. The supervision logs showed that most of the inmates were transferred to a restraint bed from a security cell. A security cell is an intrusive isolation and sensory ­deprivation measure. The Parliamentary Ombudsman has in several instances expressed great concern over the fact that people who are suicidal are placed in solitary confinement in security cells.33 There is reason to be concerned that the use of security cells in reality can contribute to creating a situation that results in an inmate being placed in a restraint bed. 31 Julin v. Estonia, application no. 16563/08, judgment of 29 May 2012. 32 See, inter alia, the Parliamentary Ombudsman's report after visits to Østfold Hospital, psychiatric unit on 9–11 October 2018, Stavanger University Hospital, 9–12 January 2017 and Akershus University Hospital, emergency psychiatry department, 2–4 May 2017. 33 Special Report to the Storting on Solitary Confinement and Lack of Human Contact in Norwegian Prisons, Report 4:3 (2018/19). ‘I called the accident and emergency unit for the second time and informed them that the situation had deteriorated. I found it uncomfortable to listen to a person banging their head against the wall. The doctor at the accident and emergency unit understood this but believed that there was no need to take the inmate to the psychiatric hospital in this case. I further informed the doctor that the inmate was suffering from an increasing headache and was nauseous. The doctor responded that this was normal as they were banging their head against the wall. As I was talking to the doctor on the phone, [the prison officer] came in and said that the inmate had vomited. I communicated this to the doctor, who answered that this was also a reaction to the head being banged against the wall. I explained to the doctor that I had to take the inmate's safety into consideration and that it might entail the use of a restraint bed. The doctor consented to this.’ From the supervision log Duration The ECtHR has in several judgments stated that the risk of a violation of Article 3 increases the longer a person is placed in restraints.34 In a ­decision from 2009, the Court found that a ­violation of Article 3 had taken place in a case where a person had been placed in a restraint bed for 10 hours.35 In a decision from 2012, the ECtHR found a violation of Article 3 in a case concerning a person being placed in a restraint bed for 9 hours. ECtHR stated the following: View into a cell equipped with a restraint bed through a ­surveillance mirror over the door to the cell. "Confinement to a restraint bed, […] should rarely need to be applied for more than a few hours […]" and "Having regard to the great distress and physical discomfort that the prolonged immobilisation must have caused to the applicant, the Court finds that the level of suffering and humiliation endured by him cannot be considered compatible with Article 3 standards".36 Almost half (39) of the incidents concerning the use of restraint beds lasted for longer than ten hours. A significant number of these cases (13) lasted for longer than 19 hours. The supervision logs for 12 of the cases regarding the use of restraint beds did not contain information about the duration of these measures. The figures may therefore be even higher. In most of the cases, neither the decision nor the supervision logs provide any documentation as to why it was necessary to use the restraints for so long. 34 Julin v. Estonia, application no. 16563/08, judgment of 29 May 2012, Bures v. the Czech Republic, application no. 37679/08, judgment of 18 October 2012, M.S. v. Croatia (no. 2, application no. 75450/12), judgment of 19 May 2015. 35 Wiktorko v. Poland, application no. 14612/02, judgment of 31 March 2009. 36 Julin v. Estonia, application no. 16563/08, judgment of 29 May 2012.