Visits, Follow-ups and Results in 2020 43 St. Olav’s Hospital, Child and Adolescent Psychiatric Clinic, Lian In February 2020, the Ombudsman’s NPM visited St. Olav’s Hospital, Child and Adolescent Psychiatric Clinic, Lian 24-hour units. This psychiatric clinic had two 24-hour units: one emergency unit with six beds and one assessment and treatment unit with eight beds. There was a limited range of activities for patients at the emergency unit, and the unit was generally structured to accommodate shorter stays. We did, however, find several instances of patients who had been at the emergency unit for a longer period. At both units, children were normally admitted together with their parents. Consequently, the premises and patient rooms appeared cramped. The emergency unit had its own segregation zone. This had a stark and sterile appearance. We found instances of segregation for prolonged periods, and some of the patients were simultaneously subjected to other restrictions. In total, these interventions represented major intrusions into the private lives of these patients and their opportunities for self-deter­ mination. Some were also subjected to a significant degree of physical coercion. One of the bedrooms in the segregation zone contained a restraint bed. The restraint bed had not been used in recent years. The Ombudsman recommended that the hospital removes the restraint straps from the bed. The adolescents’ bathrooms and cupboards for storing luggage were locked for the first 24-hour period after their arrival. This was justified by safety concerns, and therapists were required to conduct an assessment of the adolescent before bathrooms and cupboards could be unlocked. The Ombuds­ man finds it questionable whether the Mental Health Care Act permits routine locking away of personal possessions and limitation of access to toilets during the first 24 hours for all patients. One of the buildings of St. Olav’s hospital, child and adolescent psychiatric clinic, Lian. Several adolescents we spoke to stated that they found the staff to be attentive and interested in their opinions. However, at the time of the visit, there were few systematic efforts to ensure active participation of the adolescents, particularly in the emergency unit. Some of the adolescents felt that they had not received sufficient information about their rights and opportunities for appeal. It was also noted that adolescents did not receive written copies of the decisions concerning coercive measures. Nor did their parents, in many cases. At the time of our visit, we also found that the institution had no routines for ensuring systematic evaluation interviews with patients who had been subjected to intrusive coercive measures, as required by law. There was no common approach to manage escalating situations between adolescents and staff members. At the time of our visit, there was no systematic evaluation or follow-up of staff members who had been involved in the use of coercion. The hospital had started a new form of treatment for eating disorders, known as “family-based treatment”. Many staff members said that they did not feel competent in carrying out the tasks they had been assigned in respect of these patients. Several staff members also believed that the new treatment would involve greater use of forced tube feeding. They felt it was difficult to carry out treatment with such a strong element of coercion. In summary, our findings gave cause for concern, as the treatment methods at the time of our visit