NORWEGIAN PARLIAMENTARY OMBUDSMAN National Preventive Mechanism 12 13 USE OF RESTRAINT BEDS IN NORWEGIAN PRISONS 5 Use of Restraint Beds in Norwegian Prisons Figures for the Last Six Years (2013–2018) There are currently 31 high-security prisons in Norway. Of these, 18 have a restraint bed.19 None of the prisons have more than one restraint bed. The prisons have stated that restraint beds in the period 2013–2018 were used a total of 82 times for 51 persons. During that same period, the figures have varied between 8 and 20 times per year nationally. In the past two years (2017 and 2018), restraints have been used 15 and 13 times respectively. Of the 82 times restraint beds have been used, 27 cases concerned women, i.e. more than 30 per cent. During this period, the number of female inmates in Norwegian prisons has been approximately 6 per cent. It is not possible to conclusively establish the age of the persons placed in restraints, as the date of birth was lacking in 26 of the decisions we received. A restraint bed in a prison visited by the NPM. ‘The inmate says that they are tired. Wants to try to sleep a little. When asked if the inmate would like some food, they answer that they are not sure. They are afraid of becoming more awake if they eat. They do not want to have a lot of energy while they are placed in the restraint bed. They might want to have something to eat later.’ From the supervision log Because inmates are placed in restraints when they harm themselves or attempt suicide, there is reason to believe that there is an increased risk of such longterm effects. It can thus be concluded that inmates who are placed in restraint beds are subjected to an intervention that entails a clear risk of developing trauma in an acute life crisis. Neither the Execution of Sentences Act nor the Regulations define a duty of supervision. The guide­lines as amended in March 2019, now require continuous supervision by prison officers.18 The Correctional Service's guidelines previously specified that prison officers needed to check on inmates placed in restraints at a minimum of once per hour. 18 Directorate of Correctional Service (2002). Guidelines to the Execution of Sentences Act and its Regulations, section 38.7. Revised version of 15 March 2019. Bredtveit Detention and Security Prison used the restraint bed 13 times in total during the period studied by the Parliamentary Ombudsman. Several cases concerned the same person. Bergen Prison used the restraint bed ten times in total for ten different people during this period. Åna Prison, Stavanger Prison and Tromsø Prison used the restraint bed nine times each during the period. At all three prisons, the restraint bed had been used several times for the same inmate. The rest of the prisons used the restraint bed between one and five times throughout the period, and only two prisons stated that they had not used the restraint bed at all, including one of the juvenile prisons where the restraint bed was not approved. The longest time spent in a restraint bed was three days and 19.5 hours, while the second longest time was two and a half days. Inmates were placed in restraints for approximately 40 hours in several of the prisons, and in thirteen cases for more than 19 hours. Twelve cases lacked documentation of the duration of the use of the restraint bed. Procedures in Prisons Of the 18 prisons with a restraint bed, 17 submitted their written procedures for the use of restraint beds. Of these, eleven prisons had not revised their procedures for the use of restraint beds since the Correctional Service’s new guidelines to the Execution of Sentences Act entered into force in March 2019 (the prisons sent their procedures to us during July and August). Of the six prisons that had revised their internal procedures for the use of restraint beds, two had not updated the procedures in accordance with the new requirements for the information to be included in supervision logs. Poor procedures are demonstrated by the fact that approx. ten per cent of the incidents involving inmates being placed in restraints appeared to take place without an administrative decision. It is also demonstrated by the fact that many of the prisons lacked important information in both the administrative decisions and the supervision logs. Some supervision logs lacked documentation over a period of several hours. This is discussed in more detail under the subtitle Restraint Beds and the Prohibition against Inhuman Treatment. The Role and Procedures of the Health Service Medical personnel must not be involved in decisions to use coercive measures, such as using restraint beds.20 They are only responsible for safeguarding the patient's health and welfare in accordance with the 'primum non nocere' principle of preventing harm. The Nelson Mandela Rules set out detailed rules about 19 One of the prisons stated that it had an old restraint bed in the prison, but that the prison decided in 2016 to stop using it due to its age and standard. Another prison stated that its restraint bed is not approved, as is required, and has therefore never been used. The Directorate of Correctional Service has also stated that Arendal Prison, Evje Section, has ordered a new restraint bed. 20 The Mandela Rules, Rule 46 No 1.