Seven Days of Action: poor excuses for poor care
This week sees the third Seven Days of Action event to raise awareness of the people with learning disabilities who are trapped in psychiatric units, usually so-called Assessment and Treatment Units, sometimes for lack of more suitable provision and sometimes because the units’ management refuses to accept that release is possible. Yesterday and today, the BBC featured the issue (though not the campaign, by name) on their Breakfast programme; yesterday the story of one man and one young boy being held in units a long way from home; today they featured the case of Stephanie Bincliffe, a young woman with autism who died in a unit run by the Huntercombe group after seven years living in a windowless cell; for 18 months of that, she ate and toileted in that room and was ‘washed’ only with wet wipes. This appalling excuse for ‘care’ cost the public purse roughly £4.5m, or £1,761 per day. (The profiteering of these companies — Priory Group being the other major party involved — is found in more general adolescent mental health care, and the same problems exist there: extended stays, being forced a long way from home, punitive and degrading treatment especially of girls, lack of understanding on the part of professionals, leading to people being ill over very long periods, requiring repeat admissions, and some serious self-harm and even suicides.)
The segment, including an interview with Stephanie’s mother, was shown twice, and each time a statement from Huntercombe was read out which included the usual statement of regret and condolences to Stephanie’s family but also a couple of excuses: one being that Stephanie’s case was complex and her “aggressive tendencies” prevented any treatment other than that which killed her; the other was that a coroner had conducted a rigorous inquest and concluded that there was no neglect. This second excuse is a classic case of the “argument from authority” fallacy, in which someone is told they have to accept something because someone ‘important’ says so. This obscures the fact that that someone’s knowledge may be defective, in the case of a coroner because the remit of his or her inquiry was limited. In this case, the fact of why someone was being held for over seven years in a facility which could not even allow her a room with a window and fresh air (and why an institution with only a windowless room was even allowed to take another patient in) could not be considered, only whether they had looked after her needs in the few hours before she died.
In 2014, when Stephanie’s inquest concluded, the fact that the coroner found no neglect pushed it out of the news as producers decided that the verdict meant it was not a story, and cancelled interviews on the case, and questions such as “why was she there after seven years” were not asked; nor was the role of anti-psychotic drugs in causing the obesity that led to her death, nor whether her treatment and living conditions were the major cause of the aggression that was used as an excuse for not remedying it. Being held in these conditions would have an adverse effect on anyone’s mental health, so what sort of effect could it have had on that of a person with a learning disability who was held for years longer than might have been justified by the original incident (indeed, from what I have heard about the original incident, it would certainly not have attracted a seven-year sentence for anyone else)? No; they just blame the victim: she was her own worst enemy, she was aggressive, she was fat, we couldn’t treat her. This from people with advanced degrees who were paid £4m to treat her.
The enormous amount of money being spent on such abysmal treatment is only one aspect of what is wrong with the way we treat those with learning disabilities in this country; the long stays and long distances are another. But outright abuse, degrading conditions and the lack of competence among mental health staff in dealing with autism that bring these about, are surely what do the most damage, and cause death: it is a fact that people with learning disabilities have a reduced life expectancy, that women’s life expectancy is lower than men’s (the opposite of the general population), and that these early deaths are often the result of neglect and lack of understanding. Even today’s Breakfast programme only scratched the surface of why Stephanie Bincliffe was allowed to die such a wretched and long-drawn-out death: we must not allow them to hide behind a coroner’s verdict. There is just no legitimate reason for professionals, much less professionals paid this amount of money, to let someone languish in a windowless room for years, in conditions in which it would be illegal to keep a dog, and then die. If you cannot do a job properly, and somebody’s long-term health or life is at stake, don’t take the money and pretend to do it. Leave it to someone who can, so that the person affected can get the care they deserve.
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