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Committee slams detention of children with learning disabilities or autism

Inquiry reveals 'horrific reality' of conditions these children face in detention

Published on 6th November 2019

The Joint Committee on Human rights has slammed the “horrific reality” of conditions and treatment under which many young people with learning disabilities and autism are detained in mental health hospitals.

The committee of MPs heard that the detention of young people with learning disabilities and/or autism was so “stark” and consistent that 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.

The detention of children with learning disabilities and autism is “inflicting terrible suffering on those detained and causing anguish to their distraught families”.

The committee urges an overhaul of inspections and changes to the Mental Health Act to protect those detained from “horrific reality”. It also calls for a Number 10 unit with Cabinet level leadership to urgently drive forward reform.

Furthermore, the committee condemns the fact that the abuse has been left to be exposed by the media, notably the BBC and Ian Birrell in the Mail on Sunday.

In relation to the Care Quality Commission, the committee states that “a regulator which gets it wrong is worse than no regulator at all”.

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.

"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," she added.

The committee's report describes the “grim”, predictable pathway to inappropriate detention in these potentially “brutal” circumstances: Early family concerns raised with the GP or school tends to lead to lengthy waits for an assessment and diagnosis while the family struggles on alone and trying to cope. Then some trigger, which could 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 excluding the parents who in turn become incredibly concerned but are treated as hostile and a problem. The child is taken away from their home and the familiarity and routine so essential to them, often many miles away and placed with strangers.

Under 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, plans to return home are shelved. Days turn into weeks, then months and in some cases even years.

The committee states it has no confidence that the government’s target to reduce the numbers of people with learning disabilities and/ or autism in mental health mwill be met. The biggest barrier to progress is a lack of political focus and accountability to drive change.

The inquiry found:

- The detention of children with learning disabilities and/or autism is often inappropriate and causes suffering and does long-term damage.

- The committee has “no confidence that the target to reduce the numbers of people with learning disabilities and/or autism in mental health hospitals, set out in the NHS Long Term plan, will be met”. The biggest barrier to progress is a lack of political focus and accountability to drive change.

- The right housing, social care and health services needed to prevent people being detained inappropriately are simply not being commissioned at local level.

Too often families of young people, who may be desperately trying advocate on behalf of their children are considered to be the problem, when they can and should to be the solution.

An anonymous parent told the inquiry: "My son was kept in seclusion for up to nine hours at a time. The rule was that he could not leave until he was quiet. With his anxiety and sensory presentation, there was no way this was possible. He started to bang his head against the wall and would bite the wood in the doorframe out of desperation."

The committee calls for 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 must be recognised as human rights defenders.

There should be changes to the law which includes the creation of legal duties on Clinical Commission Groups and local authorities to ensure the right services are available in the community.

The Mental Health Act criteria should be narrowed to avoid inappropriate detention, the committee adds.

It also urges "substantive reform" of the Care Quality Commission's approach and processes. Unannounced inspections should take place at weekends and in the late evening and, where appropriate, the use of covert surveillance methods should be used to better inform inspection judgements.

The Joint Committee on Human Rights
The detention of young people with learning disabilities and/or autism

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