compulsory psychiatric care
74
The need to segregate a patient for more
than eight hours
should only arise in
distinctive, exceptional cases.
gislative history, the intention is that this is an exceptional provision aimed at
certain extreme cases where a patient’s situation is so difficult that segregation
must take place for a period longer than a few days. Such a need should only
arise in distinctive, exceptional cases. The Chief Parliamentary Ombudsman
also referred to an earlier decision concerning Sundsvall Regional Forensic
Psychiatric Clinic, where the Parliamentary Ombudsman stated that a decision meaning segregation should apply for “a maximum of 72 hours” does not
reference such a specific time as pertained to in the law.14
During the inspection of Helix, it was noted that the clinic had a routine
which means that newly admitted patients were regularly initially segregated
for longer than eight hours. In the view of the Chief Parliamentary Ombudsman, this raised the question of whether the conditions are normally such
that the high requirements set for a segregation are met and that special
reasons exist. The Chief Parliamentary Ombudsman was strongly critical of
the way in which Helix has chosen to expand extensively the possibilities of
segregating patients during initial care by placing them in the observation
unit. Furthermore, the Chief Parliamentary Ombudsman assumed that the
clinic would immediately review its practices and adapt them to the current
legislation. With regard to the details that have emerged, the Chief Parliamentary Ombudsman announced that a follow-up inspection of the clinic would
be carried out during the first half of 2020.15
A patient segregated
or restrained must
be examined by a
doctor as soon as
possible
During the inspection of Växjö Regional Forensic Psychiatric Clinic, the issue of medical assessments in connection with restraint or segregation was
raised. The written routines state that doctors must individually examine the
patient on site before making a decision on restraint for more than four hours
and segregation for more than eight hours. In conversations with several of
the employees, it emerged that the doctors did not always come to the units
during the first decision on restraint or segregation. The Chief Parliamentary
Ombudsman recommended Kronoberg Region to take measures to ensure
patients are examined by a doctor as soon as possible in connection with a
decision to take a coercive measure.16
Patients segregated for lengthy periods
For several years, the Parliamentary Ombudsmen have followed how the
regions conduct the care of patients who are segregated for a lengthy periods. What has emerged concerning these patients’ living conditions raises,
inter alia, questions regarding which alternatives have been considered by
the clinics for the care and treatment of these patients. Following the OPCAT
inspection of Säter Forensic Psychiatric Clinic, the Parliamentary Ombuds14 See the Parliamentary Ombudsmen’s report p. 18 and 19, ref. no. O 3-2019 and report p. 17 and 18, ref. no. O 18-2019.
15 See the Parliamentary Ombudsmen’s report p. 22, ref. no. O 3-2019.
16 See the Parliamentary Ombudsmen’s report p. 23, ref. no. 3816-2017 and the Parliamentary Ombudsmen’s report p. 18, ref. no. O 182019.
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