One year ago I talked to Jeremy, an affable lorry driver from the West Midlands, about his daughter. Her name is Beth. She was 17 when we first spoke, a teenager who loved music, animals and being outside in the fresh air. Yet she was caged like a dangerous creature, trapped in a tiny cell for months on her own where she was fed three times a day through a hatch and watched permanently. I will never forget her father telling me of walking along a row of rooms filled with distressed young women to see his beloved child, comparing it to the scene in Silence of the Lambs when the agent Clarice Starling goes down the corridor to see Hannibal Lecter.
This was the moment I finally understood the horrors lurking behind locked doors of secure hospitals. Our sanctified health service is incarcerating hundreds of people with autism and learning disabilities in hideously abusive detention. These unfortunate citizens are held in solitary confinement, violently restrained by teams of adults and forcibly drugged by the state due to its failure to provide decent community support that is cheaper, kinder and far more effective. These are actions we thought consigned to the grim past. Meanwhile desperate families are legally silenced while multinational firms profit from a cruel trade in human misery.
I wrote a furious column about her case, arguing that Bedlam was still in Britain. It was raised by Labour’s care spokeswoman Barbara Keeley in Parliament and led to pledges of intervention from Matt Hancock, the Health Secretary. Yet Beth’s tragic tale is just one among many. I have talked to many more families, activists and patients over the past year for a barrage of investigative articles and columns. I was told again and again of families turning to the state for help, often at adolescence, only to see their sons and daughters end up in secure hospitals that make stresses escalate despite teenagers not suffering mental illness. One man has been detained for almost two decades, spending more than half this time in seclusion.
Warehoused out of sight
Shameful human rights abuses are taking place as people with autism and learning disabilities are warehoused out of society’s sight. This systemic failure is destroying lives, tearing apart families and exposing wider failures in the mental health system. These issues first erupted in public eight years ago with the BBC exposé of criminal abuse at Winterbourne View care home. Over the past year, there have been more disturbing revelations on both the BBC and ITV. Yet for all the fine words, for all the inquiries, for all the promises of urgent action, almost nothing is done to stop abuse that most admit is medically flawed, morally wrong and wasteful of resources.
The scandal is a damning testament to state inertia. And it starts from the top. Hancock emotes yet has done almost nothing concrete to stop abuse funded by his department. A draft of the review he ordered into Beth’s case admits people are being shoved into “inappropriate” hospitals that worsen their state of mind – yet most suggested actions simply echo previous probes.
Wendy Burn, the president of the Royal College of Psychiatrists whose members play a key role in incarcerations, even had the gall to suggest last week we need another inquiry. At least five major reviews have been launched over the past year alone.
Yet the progress seen would leave a snail depressed by its pace. Another task force established to reduce “reliance on inpatient care” for children has seen numbers more than double since 2015. At a local level there is more awareness of the issues. Some people have been freed, showing they can thrive with proper community support. Most significantly, the culpable Care Quality Commission watchdog has started taking tougher action to shut down dire units while hitting out at wider care failures at the core of these issues. Despite its own review into restraint, however, use of these restrictive techniques recently hit record levels.
But we do not need more reviews, more reports, more hollow promises. We know the problems. We know the solutions, for all the complexities of many cases. As the campaign group Rightful Lives says, three things could start making an instant difference: a review and planned path to freedom set out within a year for each of the 2,255 people with autism and learning disabilities locked in secure units; ring-fencing of funds for shifting patients into community care and total transparency on the number of cases and costs in each local area.
Beth is still suffering
This scandal highlights how society views an excluded group of citizens when even the Health Secretary admits people are “treated like criminals” just for being different. If this was any other minority, the outrage over such barbarity would drive Brexit off front pages. Yet even the worst criminals have more rights than these patients – as proved by Beth, now an 18-year-old adult.
Last week her father won a landmark legal battle against this broken system, forcing an apology and damages from the NHS, local authority and mental health charity that held her in such grim conditions.
Yet this damaged young woman is still suffering. She is locked in seclusion again, this time in Wales, held in one dismal room in a privately run unit. Some carers are kind and play with her, but others just sit outside “like security guards” ignoring their patient. She says some shout at her and mimic her actions. She has a thin plastic mattress, but only after her family fought to replace a mat provided for sleeping. When it is time to eat, she must sit behind a line on the ground while staff place her food on the floor like for a dog. At least there is no hatch, I said to her father. His reply, once again, was chilling. “I can’t even hold her hand now,” he said sadly. “She is utterly neglected – and they call this care.”