The longest period of restraint lasted for more than four days. Interviews with staff and medical records gave the impression that the hospital, as a general rule, restrained patients only when the legal conditions were met. Nevertheless, the Parliamentary Ombud found written decisions on the use of restraints that appeared unlawful.

“The shortcomings we found in the hospital’s documented assessments are serious, and information recorded in medical records indicates that some patients remained restrained unlawfully for extended periods,” says Parliamentary Ombud Hanne Harlem.

Read a summary of the report here.

Read the full report (Norwegian)

Twenty-four hours without assessment

The Parliamentary Ombud visited Sørlandet Hospital from 28 to 30 October 2025 and examined the use of restraints on patients admitted to the Psychiatric Emergency Unit and the Subacute Unit during the period from 1 January to 30 October 2025. The use of mechanical restraints, such as being strapped into a restraint bed, is permitted only to prevent harm in acute dangerous situations. It must be continuously assessed whether the legal conditions are met for as long as the restraint continues.

According to the documentation reviewed by the Parliamentary Ombud, very long periods could pass between each assessment carried out by the hospital. In one 72-hour restraint, we found only two written assessments of whether the belts could be loosened, and no assessments during the final 24 hours. One patient was described as showing “increasing agitation” after around 28 hours in restraints. Without any further description other than that she then appeared calm and subdued, the restraint was maintained for 14 hours more hours.

Reduction in the number of restraints

One positive finding in the investigation was that the total number of decisions regarding mechanical restraints decreased during the period from 2022 to 2025, according to the hospital’s internal records for the two relevant wards. This appeared to be the result of targeted efforts.

“The Parliamentary Ombud views this positively. Several staff members described the management as being concerned with reducing the use of coercion, and attitudes and knowledge at management level are crucial in prevention,” says Harlem.

Risk of inhuman treatment

The Parliamentary Ombud’s report concludes that there are several examples of the hospital failing to provide sufficient justification for why the restraints continued to be “strictly necessary”, as required by law. This entails a risk that patients were subjected to inhuman or degrading treatment.

In some cases, the lack of assessments was particularly clear.

This included one patient who was restrained to prevent him from pulling out a feeding tube. After some time, one of his arms was released. Nevertheless, no justification was given as to why the patient had to remain restrained for a further 16 hours. The report also shows examples of clearly objectionable ill-treatment of restrained patients. One patient was strapped into a restraint bed for 18 hours with a fractured hand, and the patient stated both before and after the restraint that he was in pain. In another case, an agitated and frightened patient was restrained without any clothing on the lower part of the body, without any record of why this was the case or whether anything was done to remedy the situation.

Background

  • Sørlandet Hospital was notified in September 2025 that the Parliamentary Ombud would conduct a visit before the end of 2026. The exact date of the visit was not disclosed.
  • In hospitals, the use of mechanical restraints such as belts is a coercive intervention that entails a high risk of inhuman or degrading treatment. The Parliamentary Ombud has therefore examined their use at selected hospitals.
  • In Norway, a public commission proposed in 2019 that the legal basis for mechanical restraints should be phased out over a period of three years and that the use of mechanical restraints should subsequently, as a general rule, be prohibited.
  • The Ministry of Health and Care Services has previously expressed support for the proposal to phase out mechanical restraints, but as of March 2026 the proposal has not been followed up.