They first sent me to Windsor, and then to Stoke on Trent
In a holding cell in Liverpool three days and nights I spent
My solicitor can’t find me and my family don’t know
I keep telling them I’m innocent; they say “come on son, in you go”.
— Billy Bragg, “Rotting On Remand”, 1988
These words were written about the state of Britain’s prisons in the mid-1980s, when overcrowding was a problem and prisoners were moved frequently, including remand prisoners who were awaiting trial and thus often innocent. Much the same is still true of the treatment of some of our young people in Britain’s mental health system, where someone on section can be moved on the say-so of a consultant psychiatrist who believes that their behaviour has got a bit too much for his staff. This is what enabled the transfer of Claire Dyer, then aged 20, from Swansea to a private medium-secure unit near Brighton in 2014; she was released from there after less than three months. Many people with learning disabilities, particularly autism, and mentally-ill young people are not so lucky and face years in multiple locked or secure units because of lack of funding for home-based care or a community placement, or because the consultant in charge does not understand their condition.
Lately I’ve been in contact with the mother of one of these young people. Joshua is a 13-year-old boy from south London who has autism and Tourette’s syndrome, and is prone to tic attacks which particularly (though not only) happen when he is stressed. He had been at a boarding school for children with various types of learning disabilities in Surrey, but was sectioned by CAMHS when his mother was at his father’s bedside following an accident that has left him paralysed, and sent to a unit in Manchester. He remained there for more than a year until he was transferred to a hospital in Birmingham, where his mother has been able to visit him more, take him out into the local area and where it was hoped he would remain until a placement was found in his home area.
However, last week, the consultant told his mother that they were looking at transferring him to a low-secure unit outside Norwich, following an incident in which he hit and later scratched a teacher during a tic (having warned people that this is what would happen if he had a tic at that time). It was claimed that the teacher had refused to continue to teach Joshua as a result, something the family doubt as she had made some effort to build up a rapport with him and his family and had been working with him quite happily in the time after. As a teacher in a children’s mental health unit, it is inconceivable that this was her first experience of this sort of behaviour (his mother believes that her “refusal to teach him” was the management’s invention). After that incident, staff decided to nurse Joshua in his room, claiming that he was free to leave his room any time (something which he would not do; at his previous unit he refused to come out for several months). They are having someone from the unit in Norfolk (run by the same company that runs the unit where Claire was held in 2014) this week.
The situation is not quite as dire as with Claire, as the increased distance from home (Claire lived in a local unit in Swansea most of the period from 2012 to 2014) is not enormous, but it will mean a sudden change of scenery for Joshua and probably a much more confined existence, as he has been allowed out a lot in the local area with his family since moving to Birmingham (an important parallel with Claire Dyer, who had been allowed out with her family nearly every day and had spent weekends at home after being sectioned in 2013, unheard of for sectioned mental health patients) and he is unlikely to even be allowed outdoors for the first several weeks, as was the case with Claire. And all this over some fairly small incidents which the staff of a children’s psychiatric unit should be able to cope with.
A year ago this week, Thomas Rawnsley was on his death-bed from a heart attack following years of abuse and over-medication in various ‘homes’ and hospital units in Yorkshire (he died on the 5th). Young people and those with learning disabilities who are in the mental health system are still being sent miles from home, sometimes transferred several times in the space of a few months, still receiving dreadfully poor care and remaining stuck in the system for years because their rights and well-being are not paramount: the right of a person who is not a convicted criminal to a place near one’s family and to the least restrictive form of care possible seems not to be a priority, either for clinicians making decisions about patients’ lives or for the bosses who sell NHS local facilities to property developers. There is simply no excuse in a wealthy country for children to be sent out of large cities, especially a city with the population of a small country, for extended periods for mental health care; we do not do this for any other kind of healthcare other than highly specialised surgery. People have a right to family life under the European Convention on Human Rights; any forced separation from their family that is not necessary is an abuse in itself.
Joshua has his assessment for the unit in Norfolk this week. If they decide he is not suitable for them, other arrangements will be made, which could mean a worse unit even further from home. He and his family have no power to prevent this, because he is being held under section. This aspect of mental health law also needs urgent reform: the right of clinicians (not all of whom have a sound understanding of autism) to make huge decisions about a patient’s life, and for them to have no effective appeal and for the clinician to be unaccountable for the consequences. All of this must change. The rights and well-being of children and learning disabled people must come before the convenience of the staff.
Joshua’s mother asked us to share the page for her campaign; it can be found on Facebook here.
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