No way to treat people with autism

Published by The i paper (7th January, 2019)

The stories sound like something from a cruel military dictatorship or those hideous asylums we assumed had been banished to the distant past. Innocent children and young adults ripped from their families by the state and stuck in secretive hellholes where they are physically abused, forcibly drugged and locked up in lonely solitary confinement. They are denied the most basic human rights as their bodies are often battered, their minds shattered and their spirits crushed. At least 40 have failed to emerge alive in the past four years alone.

Yet this inhumanity takes place in Britain today. The victims are people with autism and learning disabilities despatched into psychiatric institutions, often after struggling families sought help from the state. Perhaps they have different mindsets and perceptions to most of us – but this does not mean they should be incarcerated in places meant for patients with severe mental health sickness. Distraught parents are powerless, sometimes even silenced by courts, as sons and daughters are sent into unsuitable institutions that only make their conditions spiral out of control.

It is like a particularly callous version of Catch-22. This is a scandal that shames Britain. Yes, scandal is an overused word but it is a fitting description of such state-sanctioned barbarity. Cases emerging in recent weeks have been shocking: one man held for 18 years, another moved 65 times, the teenage girl fed through a hatch like a dangerous animal, the young man who became obese stuck in seclusion without even a toilet. The private sector has moved in like sharks to feed on fees of up to £730,000 per patient per year while often paying care workers on the frontline a pittance. Yet it tends to be cheaper, more effective and is certainly kinder to provide support in the community.

These cases expose wider attitudes towards people with learning disabilities in a society that dehumanises citizens for being different and then denies them rights. Yet it is also an issue that highlights much that is wrong with our political system, which places spin over substance and focuses on the Brexit farce while far more serious issues bubble beneath the surface. It shows the toxic impact of disunited public services when cash-strapped local authorities dump their costly problems on the NHS even if this ultimately costs more for taxpayers. And it raises issues about wasted public cash, flawed mental health services, alarming lack of accountability and frighteningly unfettered capitalism.

But ultimately this is a glaring example of Westminster failure and hypocrisy – as shown again by the government’s heavily-promoted ten year plan for the NHS. Health Secretary Matt Hancock claims to be disturbed to see how some people with autism and learning disabilities are treated, accepting they spend far too long in hospital and suffer over-medication. ‘Enough is enough,’ he says rightly. So what is he doing? He has requested another report to join all the others gathering dust in his department, which is not due for delivery for another 14 months, and claims to have set an ‘ambitious’ target in the review that is ‘seeking’ to reduce the number of such people in hospital by half in five years.

This is such a limp response it sounds like a bad joke. Bear in mind this barbarism was first exposed in 2011 when the BBC’s Panorama showed horrifying abuse of people with learning disabilities at Winterbourne View. It was called ‘a watershed moment’. The health department promised ‘rapid reduction in hospital placements … by 1 June 2014.’ After this failed, prime minister David Cameron said: ‘We have got to do more to get people out of hospitals and into loving and caring homes in the community.’ Sir Simon Stevens, the NHS chief executive, called several times for ‘radical changes’ to challenge institutional care and close facilities.

There has continued to be lots of talk of transforming care but not enough action. The issues are complex but soluble with drive and determination. Yet the number of adults with autism and learning disabilities in supposedly short-stay assessment and treatment units has fallen only slightly since 2015 while use of restraint soared and the number of children held more than doubled. This ignores those stuck in other grim psychiatric units, such as the one in Devon for adolescents described as ‘worse than Broadmoor’ by a whistleblowing mental health nurse. And for all the sanctimonious pledges to stop such incarceration, private firms and a controversial charity are investing in new secure centres.

It gets worse. For this scandal raises sharp questions about conflicts of interest when psychiatrists employed by private operators have power to hold individuals in hospital almost indefinitely. Yet the government, while professing concern, is rushing through reform of mental health laws under cover of Brexit that reduces scrutiny and weakens the rights of patients with learning disabilities in psychiatric detention. And while an independent review last month accepted autism “is not a mental health condition”, autism looks set to remain defined as a mental disorder in law which ensures it is sufficient grounds alone to lock someone in hospital.

It is hard to retain much faith in Westminster amid the Brexit debacle. Yet it is even harder when politicians accept there is appalling and dangerous injustice towards a group of disempowered citizens yet show such pathetic complacency, endlessly kicking this issue into long grass while mouthing platitudes and chanting mantras of change. How many people must die, how many families must be destroyed, how many lives must be wrecked before they finally show genuine desire to stop this abuse? Or should we conclude that civil servants, health chiefs and politicians simply do not really care about people with autism and learning disabilities?

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