Would you allow this to happen to you or people you care about? We should stop it now!

  1. Mark Neary posted a blog today titled Knife edge Decisions which prompted this. He talks about his and other families’ experience. He reflects on the position of the families of many of the 3500 still incarcerated facing a treck on Christmas to spend time with their relative in a completely inappropriate setting comparing it with what’s happening to Stephen thankfully released but only thanks to the Court of Protection. He also compares the treatment of people with learning disabilities if they go off the rails in their adolescence with other young people. It made me think harder about the Mental Health Act which is too often what is used (or mis-used) and I have to question what people are doing included here IF THEY DO NOT HAVE A MENTAL ILLNESS? How can it be right to put people into hospitals under a section when their only diagnosis is learning disability or autism alongside behaviours that need understanding and responding to, not controlling with locking people up?

    So most worrying that so many don’t have a Mark to fight & speak out and so many families are struggling to be heard – like Lynn, mother of Chris stuck in Calderstones recently judged to have serious  issues by CQC.

    So the flaw seems to be the inclusion of people in the Mental Health Act solely by virtue of a learning disability/autism with challenging behaviours,  such that a psychiatrist and AMHP can section them even though they don’t know them. This also raises issues for me about the extent to which they listen to the family about the problems before applying a section and whether professionals in mental health actually have the experience, knowledge and skills needed. Do they in fact have good knowledge of community services which can work with challenges and importantly care? Have the community specialist learning disability health services survived the constant health reorganisations and cuts sufficiently to be able to support crisis as they once could in our area with a dedicated challenging behaviour team including some hands on support – now no longer there? What about the local authority – out area has already had somewhere between 30 and 35% cuts and will have more than 50% cuts by the end of this government’s plans – with no protection to adult case budgets? Could we blame some for burying their heads about need, and they should know all the people coming up in school who present challenges and will need planning for. Why would they be eagerly developing highly expensive skilled community placements ready when health colleagues might turn their backs on making any contribution? After all if Health have to act in crisis then they also have to foot the bill of these shockingly expensive assessment and treatment monopolistic placements – average said to be £3500-£4500 per week!! and one of the women in Winterbourne cost £10k per week. Imagine what sort of community placement could be developed for this. It is time the government listened and insisted that the a&t placement money was put into the community. When people were resettled from long-stay hospitals in the 80’s on in the North West they frontloaded money – the government need to think whether they claw it back from these units once community services are redeveloped and bespoke [placements are developed for people at home.

    Under the MHAct action seems to run out on admission. Not clear how they can assess in such weird surroundings – assessment needs to take place in the community – and then as we move to a ‘treatment’ section there isn’t any. How could the ‘treatment’ regimes in general be relevant? How can the  ‘treatment’ of Stephanie Bincliffe who died being “treated” with years of seclusion, lack of exercise and fed to death be right? Her family would have been prosecuted if  they had done this to her! It would have been grounds to take her away from them. How was Connor being left in the bath for hours or of Chris in Calderstones restrained face down, (his mother thinks) in the mud (which is the nearest he has to a garden) be “treatment”. There can be physical intervention to hold a situation until the person starts to actually see the life they imagine starting to happen, but how can this work locked away in an institution.

    So I wonder about the accountability of the MH Tribunal and the Managers’ meetings – are they equipped with the right knowledge and skills to judge whether people’s mental health needs are indeed being met in the least restrictive way as the law demands? How can this be true when we know with the right help and support, the vast majority of people currently incarcerated in assessment and treatment units can be supported and get the right “treatment” in the community with people who care (and there are providers who care and work well with people who have challenged just as much) and who have the skills and work WITH families.

    The use of assessment and treatment units feel like psychiatric professionals have taken the power this gives them and if I’m kind might say it’s because they are so institutionalised them selves that they just don’t know that people can be worked with effectively in the community. They should come out and look at all those people who come nowhere near them, whose behaviours have been just as risky and challenging but who’ve been fortunate enough to have had a relevant response and a service that actually cares, is skilled and strives to listen and involve families and respond to their needs and the way things need to happen for the person. It can Mark include Positive Behaviour Management – but only in the context of it being properly trained and managed to understand and so prevent behaviours by such as ensuring good communication relevant to the person, a context in which the person has as much real control and choice as they can, skilled support staff who care ad genuinely like and value the person and the development of a life and activities, relationships etc that are what the person wants or is willing to explore.

    3500 people stuck in units feel like a function of people – professionals – who fail to care, fail to get past behaviour, fail to understand it or even try, fail to listen to families and people who do, fail to have any humility about the limits of their professional skills, maybe fail to have the skills, fail to know what’s possible in the community – and worryingly don’t have community experience being incarcerated themselves in the institution. The legal framework needs questionning but so do those supposedly administering it and the commissioners who should have bene planning for discharge as soon as someone is admitted. The “readiness” model applied in a unit which is nothing like the community and offers little of relevance to the person, means people could be stuck there for ever. There is a community treatment order which should be used if we really imagine recall to the unit is needed – I would hope once out everything is done to ensure they ever go back unless a mental illness crisis.

    I do wonder if many of the unit professionals would survive outside in the community? I’d like to see a requirement that all of them have to do some work in the community.

    We must also let the public who don’t know of the shocking facts of what is being done to people’s families. Ask them to imagine if it were them or their family/friends. And we’re doing this to people who don’t have the same cognition to understand, who need more help in the community not less – which makes the #LBBill essential – so I’m in. Are the rest of you?

    We need action urgently…. so all please support #LBBill and #JusticeforLB and join your voices to those in the LDA trying to bring us all together to have a single more powerful voice to DEMAND our government and the next one deals with this. Surely we should have an amazing electoral power if we all joined our voices?f you? We need all people’s rights really being upheld – professionals under the law should involve families in major decisions.