health care 3.10 Health care In the health care sector, an accurate number of health-care units that fall under the NPM’s mandate is unavailable. Information has been requested from the Ministry of Social Affairs and Health (1164/2/2016). According to the response, there are 50 psychiatric units in which coercion is used. One indication of this is provided by the statistics of the National Institute for Health and Welfare, according to which there were 26,561 patients in specialised psychiatric care in Finland in 2013, with a total of 38,000 inpatient stays. In addition, there are health-care units other than those providing specialised psychiatric care where coercive measures may be used (emergency care units of somatic hospitals), or where persons deprived of liberty are treated (health care services for prisoners). The NPM also made a visit to the sobering-up station, which was linked to the practice of using personnel from the sobering-up station in the care of persons deprived of freedom and detained in the police prison. Owing to the large number sites to be visited, certain prioritisations must be made with regard to the allocation of resources. The NPM has therefore mainly elected to visit the units where most coercive measures are taken, and where the patient material is most challenging. These include the State psychiatric hospitals (Niuvanniemi and the Old Vaasa Hospital) and other units providing forensic psychiatric care. The aim is the make regular visits to these units, which in practice means a visit every couple of years. State psychiatric hospitals provide treatment for most forensic psychiatric cases in Finland, in addition to whom the units treat difficult-to-manage patients transferred from other psychiatric units. The terms of treatment of forensic and difficult-to-manage psychiatric patients are longer. The aim is also to make regular visits to units that care for difficult-to-manage minors (units in Tampere and Kuopio). Otherwise, the selection of sites will depend on when the place was previously visited and the number of complaints made about the unit. As a rule, visits to units providing health-care services are always attended by an external medical expert. Of the 2017 visits, only the one to the Vantaa health-care clinic was made without a medical expert present. Involving a medical expert in the visits has made it possible for inspectors to address the use of restrictive measures from a variety of angles and to explore ways of preventing their use. As in the case of social services, the intention is to carry out visits to health-care units in 2018 accompanied by experts with experience. The NPM made a total of eight visits to health-care units in 2017. In addition, as part of the preparation for visits in Ostobothnia, the NPM paid a visit to the social welfare and health-care division of AVI Western and Inland Finland. Only the visit to Päijät-Häme Joint Authority for Health and Wellbeing was pre-announced. This decision was made because the inspection team included a delegation from the Estonian NPM, which required some special arrangements from the unit as well. Otherwise, the visits were made either completely unannounced or the unit was given prior notice of the NPM’s arriving within a certain period of time, but not the exact date. 77