36 NORWEGIAN PARLIAMENTARY OMBUDSMAN National Preventive Mechanism ANNUAL REPORT 2020 On the way to a child welfare institution visited by the NPM. establish a foundation for good treatment.21 When adolescents live alone with staff, they have no one else who can help them experience stability and security in their daily lives. The adolescents we spoke to told us about situations where they felt like outsiders and alone. This was particularly applicable for children who had few daily activities, children who did not have access to their own telephone and children who had been relocated far away from parents, siblings or other family or social network. Being relocated far away Sometimes adolescents who are placed alone, are relocated far away from their home. This is sometimes done to remove the young person from a social environment considered destructive, often due to drug or alcohol abuse. To be relocated to a remote institution, in some cases to a small house in a completely different part of the country, can be a dramatic and frightening experience. Adolescents we have met have informed us that it was a huge shock and a frightening experience to be forcibly brought to an unknown part of the country. In some cases, relocation had taken place with police transport for several hours or they had been accompanied by police on flights. The experience can be even more traumatic if it takes place suddenly and without involvement of the adolescent in question. This relocation process is a poor starting point for establishing a sense of safety and good relations. If the adolescent is also placed in a remote location with conditions or circumstances that are completely unknown, it can lead to a feeling of abandonment and loss of their right to self-deter­ mination. This will be exacerbated if the adolescent in addition is subjected to a range of restrictions and has inadequate access to activity and school. These circumstances can make it difficult to achieve the changes desired when an adolescent is placed under institutional care without their consent for a longer period of time.22 Adolescents with mental health challenges We have seen on several visits that adolescents who live alone with staff face mental health challenges. Staff in child welfare do not necessarily have the competence required to safeguard the mental health of adolescents who struggle with 21 See report from Norwegian Board of Health Supervision (9/2019). “Omsorg og rammer. Når barn trenger mer [Care and frameworks. When children need more] , page 11: “Several children also stated that they wished to have a few and caring adults to look after them. In some of the cases instead they felt they were surrounded by many untrained, temporary staff and a large number of shifting staff.” 22 See e.g. A summary of the significance of autonomy in psychotherapy in Jung, H. T. and Vollestad, V. (2018). “Autonomi i psykoterapi – mer enn en etisk forpliktelse? [Autonomy in psychotherapy – more than an ethical obligation? A qualitative study of psychotherapists’ perception of the concept “Client’s autonomy” and reflections concerning safeguarding of autonomy in therapy. Thesis, Institute of psychology, Oslo University, page 6.