Coercive and restrictive measures in municipal intellectual disability care: Legal compliance and practice in Norway

BACKGROUND: This study examined how use of formalised coercive measures imposed on people with intellectual disabilities aligns with Norwegian law. METHOD: Cross-sectional study including 70 people subject to coercive measures, mean age 44 years, 54% men. Data were collected through structured interviews, hospital records, and municipal decisions on coercive measures. RESULTS: Regional prevalence of people subject to coercive measures among people with intellectual disabilities was 8.5%. Municipalities sought exemptions from staff educational requirements in 97% of cases where people were subject to coercive measures, which were nearly always granted. On average, each person received care from 10 different staff members weekly. Twenty-three percent reported that care was not provided by a stable staff group. Notably, 29% of participants were subject to coercive measures without a legally valid authorisation. County-level governor inspections were rare. CONCLUSION: Discrepancies between legal care requirements and practice highlight the need for compliance, staff training, and stronger supervision.