Detaining children and young people with learning disabilities and/or autism in mental health hospitals is often inappropriate, causing suffering and long-term damage, a committee has warned.
The Joint Committee on Human Rights condemned the “horrific reality” of conditions and treatment under which many young people with learning disabilities and autism are detained in mental health hospitals, “inflicting terrible suffering on those detained and causing anguish to their distraught families”.
Rt Hon Harriet Harman MP QC, Chair of the Committee, said: “This inquiry has shown with stark clarity the urgent change that is needed and we’ve set out simple proposals for exactly that. They must now be driven forward, urgently."
The Committee says it has “lost confidence that the system is doing what it says it is doing and the regulator's method of checking is not working", having heard evidence that the detention of young people with learning disabilities and/or autism was so “stark” and consistent.
It adds that “a regulator which gets it wrong is worse than no regulator at all,” in relation to the Care Quality Commission.
Too often, families of children with learning disabilities and/or autism are considered to be the problem when they ought to be the solution and families must be recognised as human rights defenders, the committee says.
The right housing, social care and health services needed to prevent people being detained inappropriately are simply not being commissioned at local level.
The Committee describes the “grim”, predictable pathway to inappropriate detention in these potentially “brutal” circumstances. It explains that early family concerns raised with the GP or school lead to lengthy waits for assessment and diagnosis while the family struggles on alone, trying to cope. Then a trigger, which could potentially be a home move or a parent falling ill, unsettles the young person and their condition deteriorates.
Professionals meet to discuss what should happen, but parents are not included. The child is then taken away from their home and the familiarity and routine which is essential to them, and often many miles away and placed with strangers.
Desperately concerned parents are treated as hostile and as a problem.
As a result of these conditions, the young person unsurprisingly gets worse and is then put through physical restraint and solitary confinement - which the institution calls “seclusion”. As the child gets even worse, any plans to return children home are shelved. The days turn into weeks, then months and in some cases even years.
A mother Julie Newcombe, whose son Jamie was detained for 19 months, said: "He had his arm broken in a restraint, the right humerus bone. His arm was wrenched up behind his back until the bone snapped. He was then not taken to accident and emergency for 24 hours, even though his arm was completely swollen."
The committee urges:
- The establishment of a Number 10 Unit, with cabinet level leadership, to urgently drive forward reform and safeguard the human rights of young people with learning disabilities and/or autism.
- Families of those with learning disabilities and/or autism to be recognised as human rights defenders.
Changes to the law including:
- The creation of legal duties on Clinical Commission Groups and local authorities to ensure the right services are available in the community.
- Narrowing of the Mental Health Act criteria to avoid inappropriate detention
There should also be substantive reform of the Care Quality Commission's approach and processes:
- This should include unannounced inspections taking place at weekends and in the late evening,
- Where appropriate, the use of covert surveillance methods to better inform inspection judgements.
Harriet Harman concluded: "It has been left to the media and desperate, anguished parents to expose the brutal reality of our system of detention of people with learning disabilities or autism. We must not look away. The horrific reality is of whole lives needlessly blighted, and families in despair. What we saw does not fit our society’s image of itself as one which cares for the vulnerable and respects everyone’s human rights. It must not be allowed to continue."
The detention of young people with learning disabilities and/or autism