Legal use of Coercion and Restraint? Summary of countrywide supervision in 2005 of use of coercion and restraint for people with mental disabilities
Summary of Report of the Norwegian Board of Health Supervision 2/2006
In 2005, the County Governors carried out supervision of 53 municipalities, as part of countrywide supervision of legal safeguards associated with use of coercion and restraint for people with mental disabilities. It was investigated whether municipalities ensure that the services that clients receive according the Social Services Act § 4-2 a-d are changed in line with changing needs, and that conditions are adapted to ensure the least possible use of coercion and restraint.
Breaches of the law were detected in 21 of the 53 municipalities that were included in the supervision. These breaches related to the duty of municipalities to ensure that services offered to people with mental disabilities are changed in line with changing basic needs. In particular, deficiencies were found in administrative procedures, reporting routines and communication routines. Deficiencies in administrative procedures, responsibility, reporting and communication between different sectors lead to vulnerability and the risk of deficiencies in the services.
The Social Services Act Chapter 4A allows for the use of coercion and restraint in special situations. The Norwegian Board of Health established that when a decision about use of coercion and restraint had been made in accordance with statutory requirements, that coercion and restraint were usually carried out in line with the decision.
In 41 of the 52 municipalities that were included in the supervision, use of coercion and restraint was detected that was contrary to statutory requirements. These municipalities do not adequately ensure that solutions other than use of coercion and restraint are adequately assessed in a systematic way.
Many of the municipalities lacked adequate management and leadership of the services.
Report from the Norwegian Board of Health 2/2006 (Pdf in Norwegian)