compulsory psychiatric care 73 a maximum of eight hours. If there are special reasons, a decision on segregation may contain to a fixed period exceeding eight hours.9 According to the National Board of Health and Welfare’s regulations, the decision-making doctor must examine the patient before a decision is made on restraint for longer than four hours or on segregation for longer than eight hours.10 The provision is intended to ensure a legally secure assessment is made before a decision on extension of coercive measures. This should be seen as a minimum requirement and the premise must always be that the decision-making doctor conducts a personal examination of the patient also before, or as soon as possible after, an initial decision for a period of less than four and eight hours, respectively.11 Following this year’s inspections, the Chief Parliamentary Ombudsman has found reason to comment on the legal basis for the use of segregation. During the inspection of Helix, it emerged that on occasion the Prison and Probation Service’s patients are cared for voluntarily at the clinic and that they are initially placed in the observation unit, where they are segregated from other patients. Additionally, it emerged that newly admitted patients are initially segregated regularly for more than eight hours and that a reassessment is made by doctors during the rounds every morning. Following the inspection, the Chief Parliamentary Ombudsman stated that being placed in the observation unit, for a longer time period than is required for the registration process itself, means that the patient is segregated. The Chief Parliamentary Ombudsman emphasised that a patient who is cared for voluntarily cannot consent to segregation and she assumed that the clinic’s management would review the routines and ensure that such situations do not arise.12 Following the inspection of Helix, the Chief Parliamentary Ombudsman underscored that it is not sufficient that the care of other patients is disturbed or made more difficult or that such a risk is deemed to exist for a patient to be segregated. The legislative provision on segregation contains a seriousness prerequisite. In order to ensure that the prerequisites are met, the decision should clearly state the actual circumstances that mean the conditions for segregation are met.13 Following the inspections of Helix and Växjö Regional Forensic Psychiatric Clinic, the Chief Parliamentary Ombudsman also commented on the possibility of segregating a patient for a specific period exceeding eight hours with reference to the existence of special reasons. According to the provision’s le9 See Section 19 and 20 of the Compulsory Psychiatric Care Act (1991:1128). 10 10 See Chapter 3, Section 2 of the National Board of Health and Welfare’s regulations and general guidelines (SOSFS 2008:18) on compulsory psychiatric care and forensic psychiatric care. 11 See Compulsory Psychiatric Care and Forensic Psychiatric Care. Handbook with information and guidance for the application of the National Board of Health and Welfare’s regulations and general advice on compulsory psychiatric care and forensic psychiatric care (SOSFS 2008:18), July 2009, p. 50. 12 See the Parliamentary Ombudsmen’s report p. 16, ref. no. O 3-2019. 13 See the Parliamentary Ombudsmen’s report p. 16, ref. no. O 3-2019. A patient in care voluntarily cannot consent to being placed in segregation