fundamental and human rights �.� national preventive mechanism against torture In the Ombudsman’s opinion, it is possible to employ security guards for duties permitted by the legislation on private security services in the common areas of serviced housing units. The issue is with the tasks appointed to the security guards or stewards and whether they have the required authority to perform the services ordered by the serviced housing unit. The Ombudsman has stressed that private guards may not take part in measures related to the client’s care, which have been appointed to the nursing staff by law. Measures that restrict the client’s right to self-determination must be deemed to constitute care-related tasks in which security guards cannot, as a rule, participate. On the other hand, security guards may, within the limits of their authority, secure the nursing staff ’s physical integrity and the safety of their work (1871/2018). 3.5.16 HEALTH CARE In the health care sector, an accurate number of health-care units that fall under the NPM’s mandate is unavailable. According to information received from the Ministry of Social Affairs and Health, there are approximately 50 psychiatric units that employ coercive measures. In addition, there are health-care units other than those providing specialised psychiatric care where coercive measures may be used (emergency care units of somatic hospitals), or where persons deprived of liberty are treated (health care services for prisoners). In the health care sector, collaboration partners include the National Supervisory Authority for Welfare and Health (Valvira) and Regional State Administrative Agencies (AVI). Before visits, as a rule the competent regional state administrative agency is contacted in order to gain information on its observations about the facility in question. In recent years, it has also been customary to invite the Regional State Senior Medical Officer of the competent AVI to the visit debriefing. The final visit report is also delivered to the AVI for information. The inspection visit of the psychiatric 116 unit of Kainuu Central Hospital serves as a good example of such cooperation. The Regional State Senior Medical Officer who participated in the debriefing made follow-up visits to the unit in three and five months from the original inspection visit. On the last visit, the Officer reviewed the recommendations made in the NPM’s visit report and the measures taken by the hospital together with representatives of the profit centre. The Regional State Senior Medical Officer notified the Ombudsman of his observations. Background information is requested from the health care unit’s patient ombudsman before each visit. The final visit report is also routinely sent to the patient ombudsman for information. Owing to the large number sites to be visited, certain prioritisations must be made with regard to the allocation of resources. The NPM has therefore mainly elected to visit the units where most coercive measures are taken, and where the patient material is most challenging. These include the state forensic psychiatric hospitals (Niuvanniemi and the Old Vaasa Hospital) and other units providing forensic psychiatric care. The aim is to make regular visits to these units, which in practice means a visit every couple of years. The aim is also to make regular visits to units that conduct research on and treats underage children who are difficult to treat (units in Tampere and Kuopio). Otherwise, the selection of sites will depend on when the place was previously visited and the number of complaints made about the unit. As a rule, visits to units providing health-care services are almost always attended by an external medical expert. In the reporting year, only the visits to the Health Care Services for Prisoners unit (VTH) was not accompanied by an external expert. Involving a medical expert in the visits has made it possible for the NPM to address the use of restrictive measures from a variety of angles and to explore ways of preventing their use. In 2018, the NPM also trained two experts by experience and employed their expertise in four health care visits. Visits to psychiatric units are nearly always unannounced. However, the unit is notified by letter that a visit will be made within a certain period