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4A, decisions, dispensations, local supervision, and coercion and restraint are concepts that are often used by professionals who provide or assess services for people with mental disabilities. This report illuminates these concepts and describes the extent and development of the use of measures of coercion and restraint during the period 2000-2007, with a focus on the differences between the counties.

In 1999, regulations were introduced to limit and manage the use of coercion and restraint for people with mental disabilities. At the same time, the Offices of the County Governors were allocated the task of registering data on the practice of the regulations, and at fi rst to report to the Ministry, later to the Norwegian Board of Health Supervision. A presentation and analysis of the data is given in this report. The data show that there has been an increase in the number of:

  • decisions about measures to prevent injury in emergency situations
  • decisions about planned measures to prevent injury in repeated emergency situations
  • measures to meet clients’ basic needs
  • dispensations from the requirement regarding the qualifi cations of staff.

What is the significance of these increases? Has registration of the use of coercion and restraint increased, or has use of coercion and restraint increased?  Are coercion and restraint used appropriately, or are they used to compensate for lack of competence? The data can be interpreted in different ways.

There are large differences between the counties. This may reflect differences in how often coercion and restraint are used. But inadequate and non-uniform registration make interpretation of the data difficult. The report presents no conclusions about what is correct practice. It is a source of information to stimulate debate about the registration system for data on the use of coercion and restraint. For the Norwegian Board of Health Supervision