The NPM points out several shortcomings relating to the buildings, services and treatment offered to patients, and procedures for administrative decisions to treat patients without their consent at Telemark Hospital.
The NPM visits all places where people are detained for the purpose of preventing the risk of torture and ill-treatment. On 8–10 April, the NPM made its second visit in the mental health care area, this time to Telemark Hospital in Skien.
The visit covered the hospital’s sections for geriatric psychiatry, emergency psychiatry and rehabilitation. During the visit, the NPM talked to patients, the management and members of staff, reviewed documentation and inspected the psychiatric inpatient wards.
Building in poor condition
Among other things, the visit report documents that the rehabilitation section’s security unit 3A appeared to be in poor condition. The air quality in the corridor was poor, and one of the communal bathrooms smelled of mould. There were signs of mould and water damage in one of the shared showers. The security unit had no activity room, exercise room or library that the patients could use. The patients at the security unit have no access to any separate outdoor area, garden, playing field, balcony or veranda.
The physical conditions and low staffing levels resulted in patients at the security unit not always being given the possibility for daily outdoor exercise and physical activity. This gives cause for concern, and reference is made to the minimum requirement of one hour of outdoor activity per day for inmates in Norwegian prisons who, like patients under compulsory mental health care, are deprived of their liberty. The situation is even more serious because the average stay for patients in the security unit is longer than the average stay for other patients at the psychiatric department at Telemark Hospital.
Not informed about administrative decisions
The report also points out that documents from the geriatric psychiatry section indicated that patients are not informed of all administrative decisions. Occasionally, patients with administrative decisions for treatment without consent are given medications hidden in their food or drink without their knowledge. Such practice is a serious intrusion of individual autonomy, and could involve a risk of ill-treatment.
There was no visible information about the supervisory commission, the County Governor or the Parliamentary Ombudsman in the inpatient units, and patients were not always aware of their rights. The supervisory commission also stated that it is not always given the opportunity to talk to patients alone. This could weaken patients’ ability to raise their case with the supervisory commission.
Recommendations to the hospital
On the basis of these findings, it is recommended, among other things, that Telemark Hospital ensure that the physical conditions facilitate health-promoting therapeutic measures and prevent ill-treatment. The hospital should also ensure that patients at the security unit are given access to daily outdoor exercise and physical activity. Patients should always be informed both verbally and in writing about administrative decisions to use force and of the specific grounds for such decisions. If the patient’s health condition is such that he/she is unable to receive this information, the patient should be re-informed when he/she is better able to understand it.
The hospital has been asked to inform the Parliamentary Ombudsman about its follow-up of the recommendations in the report by 1 December 2015.