fundamental and human rights �.� national preventive mechanism against torture The Deputy-Ombudsman recommended the patient to be compensated for their treatment while in seclusion The Deputy-Ombudsman felt that the way in which the patient had been treated in seclusion violated patient´s dignity. A person with impaired mobility due to cerebral palsy was forced to take their meals in the psychiatric inpatient ward’s seclusion room by sitting on a thin mattress on the floor. The plates, cups and utensils were also unsuitable for the patient. The complainant wore diapers during the seclusion which lasted for more than 24 hours. The Deputy-Ombudsman recommended that the Welfare District compensate the complainant for the violations of fundamental and human rights to which the complainant was subjected (3287/2017*). The Welfare District reported that it would pay the complainant EUR 4,500 in compensation. Decreasing the use of coercive measures Every psychiatric unit that employs coercive meas-ures should have a plan with quantitative and qualitative targets for decreasing their use. It is equally important to inform the entire staff of the plan and monitor its realisation constantly. The hospital did not have a dedicated programme for decreasing the use of coercive measures. The Ombudsman recommended that the hospital continually monitor the implementation of restrictive measures and draw up a plan or guideline for the reduction of the use of coercive measures. He also suggested familiarising the entire staff with the plan or guideline (5338/2017). The authority reported that, in addition to the restriction notifications made to the AVI, the psychiatric outpatient wards will start compiling statistics on the use of restrictive measures and a monitoring procedure for restrictive measures will be drawn up. Once the availability of this base data has been secured, a programme and targets for decreasing the use of coercion will be drawn up. The induction of personnel in the targets and measures of the plan will constitute a part of the programme. Guidelines 120 for discussing seclusion with patients will also be drawn up for staff. During the visit, the NPM did not see convincing evidence of active attempts to decrease the use of coercion. The hospital did not have a dedicated programme for decreasing the use of coercive measures (727/2018). The authority reported that restrictive measures and their use and documentation had been reviewed with the staff. Restrictive measures will only be employed when other measures will not suffice. The staff was also instructed to document in detail any alternative methods employed to resolve the situation before the use of restriction or seclusion. A training programme for the staff will start soon. There are also dedicated guidelines for decreasing the use of coercion and improving safety in the psychiatric ward, and every staff member has read and signed the guidelines. A specific programme for decreasing coercion and monitoring the use of restrictive measures is being planned. The psychiatric ward uses psychiatric advance directive forms. This voluntary system has been developed to improve the patients’ right to self-determination when they are incapable of making decisions for themselves. If an advance directive has been made, it will be respected whenever possible. The new instructions for patients also include written information on the possibility to make an advance directive on psychiatric treatment. Use of mechanical restraints The instructions on the use restrictive measures did not state how often physicians should assess the state of restrained patients. The patient documents indicated that, in one case, the physician had only assessed the restrained patient’s state once per day. The Ombudsman found this interval to be excessive (727/2018). All of the inpatient ward’s seclusion rooms were equipped with restraint beds as standard fixtures. All new hospital beds ordered for the ward also included the option to install restraints. The Ombudsman felt that this could lower the threshold for using restraints. Some of the patient