NORWEGIAN PARLIAMENTARY OMBUDSMAN National Preventive Mechanism ANNUAL REPORT 2017 54 Due process protection relating to use of a chair in connection with forced nutrition Recommendation ››The adolescent psychiatric clinic at Akershus University Hospital had a separate room with four chairs attached to the floor for use in connection with forced nutrition. The room also contained a padded restraint for the patient’s chair in the middle, which was sometimes used. The padded restraint was secured across the patient’s thighs to make it more difficult for him or her to use his/her legs to resist. After the visit, the Ombudsman raised the question of whether the chair, in cases where this padded restraint was used, is to be considered a coercive measure that is not covered by an administrative decision for short-term holding. It was recommended that this should be looked into. Follow-up ››Following the visit, the hospital has stated that it has considered whether the chair used for tube- feeding is a coercive measure. It was decided that, when used with a padded restraint, the chair is to be regarded as a coercive measure and that an administrative decision must be made on the use of a mechanical restraint, cf. Section 4-8 of the Mental Health Care Act and Section 24-26 of the Mental Health Care Regulations. Information about this has been given to all the staff at the section. Suicide prevention Recommendation ››It emerged during visits to Ila Detention and Security Prison and Stavanger Prison that many inmates were unsure of whether they had been asked about suicide risk and mental health just after their admission. The Parliamentary Ombudsman therefore recommended that the health services should ensure that suicide risk is always assessed during the initial admission interview. Follow-up ››The health services at Ila Detention and Security Prison and Stavanger Prison have stated that the procedures for mapping and dealing with suicide risk have been changed so that all new inmates are asked about their mental health and whether they have suicidal thoughts on admission. At Stavanger Prison, a 24-hour visitor project has also been initiated for new prison inmates in cooperation with the Norwegian Red Cross. This also applies to remand inmates subject to court-imposed restrictions. The project entails that all remand inmates can immediately receive a visitor from the visitor service, and a phone line has been established at the Red Cross for this purpose. Activities and outdoor areas Recommendation ››Most of the wards the Ombudsman visited at Stavanger University Hospital’s special unit for adults had no direct exit for patients who wanted to spend time outdoors. The patients had limited access to outdoor areas, and the situation was particularly challenging for patients in the segregation units. Following the visit, the Ombudsman recommended that all patients should have the opportunity to spend at least one hour outdoors every day. It was also recommended that the hospital, in consultation with the patients, should ensure a varied range of activities adapted to the individual patient's level of functioning and interests.

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