Claire Dyer is free
Today Claire Dyer and her family found out that she had been released from her sectioning under the Mental Health Act, and will not have to return to the medium-secure unit to which she was sent on 1st August. Claire Dyer is a 20-year-old autistic woman who had been in an NHS learning disability unit in Swansea who had earlier fought off an attempt to transfer her to St Andrew’s hospital in Northampton; the unit she spent more than two months in was near Brighton, which was even further from her home than Northampton. She had been on extended leave from the hospital for the past three weeks and was due to return for an MHA tribunal this Wednesday. This will now not be necessary. (There is an update from Claire’s mother here.
Someone on one of the Facebook groups where these issues are discussed asked what the Brighton unit did differently. I responded that it was not Brighton that did something differently but the unit in Swansea that she had come from: it was they who misused the Mental Health Act for their own convenience, to try and transfer her to Northampton and later to Brighton without Claire or her family having the ability to prevent it. The Brighton unit management just did their jobs: they must have quickly identified Claire as someone whose condition was nothing like those of their normal clientele, who were women with serious mental illnesses or personality disorders, some of them sent there on hospital orders after convictions for serious offences including manslaughter. The unit also must have known that there was publicity surrounding Claire’s case and that her family and supporters were connected to other prominent campaigners who had had to fight the system on behalf of their autistic sons and daughters, some of whom had died, and that the unit and its corporate owners would have faced a blaze of hostile publicity if the same had happened to Claire.
Nobody should be under the illusion that this unit is any model of good practice, despite a good CQC report (following a dreadful one a year earlier); local mental health outreach teams avoid placing people there, as it is expensive and there have been safeguarding concerns. In the first month after she arrived, Claire was only allowed to see her family in the unit’s visiting room, and only for two hours at a time. While Claire was used to talking to her family over FaceTime before going there (which was essential as her sister is deaf), her iPad was taken away and, despite promising that Skype was available for these purposes, it took weeks to set up. The loom bands that were her main hobby before being moved were taken away as a supposed precaution against self-harm; she was not allowed crayons in her room unless she ate them. She was not allowed outdoors for several weeks; she was given grounds leave, but on the first occasion this was not passed on and so she did not get it; on other occasions it was cancelled because of meltdowns. After about a month there, she was allowed out with her family, but this too (including the first one) was sometimes cancelled for the same reason (and the family had to travel for five hours each way to see her). It was after these trips out began that the staff came to realise that the stories they had been told, among other things that she was not safe at home.
I would like to see a thorough investigation of the decisions that led to Claire being sent away. The family have not named the unit in Swansea or its responsible clinician, but the authorities know who he is. It was he who sectioned Claire in September 2013 and then told the family that he intended to move her to Northampton a couple of weeks later. He also told the family that if Claire were released from the section at the tribunal earlier this year, she could not stay at the unit at a time when the family felt that Claire could not live at home (as she had done for five weeks in early 2013 after an earlier care home placement broke down); he claimed that she should remain under section as she behaves better when on section than off it. He continued to allow Claire out with her family almost every day, and home for weekends, as he had done since imposing the section, and did so even after deciding that Claire needed a medium-secure unit — this is unheard-of, and entirely inconsistent.
The first draft of the so-called LB Bill, named after Connor “Laughing Boy” Sparrowhawk who died due to staff negligence in an NHS learning disability unit in Oxford in July 2013, was published last week; you can view the full text, explanatory notes and two easy-read books on the LB Bill website. The eighth clause of the draft Bill removes people with autism and other learning disabilities from the scope of the Mental Health Act unless they also had a diagnosis of a recognised mental illness; any detention would have to be done under the Mental Capacity Act. This is because there have been numerous incidents of machinations involving the MHA being used to transfer learning disabled people to places far away from their families against their wishes or their best interests. It places far too much power in the hands of psychiatrists; it takes only two of them to make the decision and it takes a lot more effort and time to challenge it, and sometimes the tribunal can outlive the section, as it did in Claire’s case, and the patient is back to square one. An autistic person usually does not need a highly secure environment; they need a familiar environment with consistency and support. It is an extremely common mistake to confuse an autistic person’s behaviour in the unnatural and stressful environment of a locked unit with their behaviour when in familiar surroundings and without stress. The conflicting laws which allow clinicians to abuse their power must be reformed.
As for Claire, she will be at home for the foreseeable future; support is being put in place and a long-term placement in the area looked at, although there is no date set for this. As someone who has been on a section 3, she is entitled to aftercare under section 117 of the MHA, which is more than she would have had before being placed on section; but the same was true before she was sent to Brighton. It was entirely unnecessary. There are so many young people with autism in the UK who are still suffering in unsuitable or badly-run units and hospitals, and it seems even prisons, often hundreds of miles from home, some of whose conditions are deteriorating and some who have been attacked and abused, as was reported on Channel 4 News last week. Learning disability and mental health are united in being underfunded, “Cinderella” specialities that can be cut and people moved from pillar to post without attracting much protest, as may have been anticipated by the management who transferred women’s beds to male use in Lancashire last month. But they are separate, and an autistic crisis should not get someone stuck in the mental health system.
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