Let them all out now

Published by The Mail on Sunday (13th January, 2019)

A mental health nurse has revealed she saw staff in a secure psychiatric unit restrain a patient with learning disabilities so violently that they broke his neck – then left him lying in his own waste over a weekend.

The man was only taken to hospital two days later, after doctors intervened, and was found to be paralysed.

The senior team leader, who does not wish to be identified but I will call Elaine, says she was then asked to assist a cover-up at the NHS hospital but refused and quit her job instead.

‘I had to leave because this incident and the aftermath went against everything I believe in,’ she told The Mail on Sunday. ‘These places are horrific, they are barbaric – we have created a system that is simply geared to abuse.’

The whistleblowing nurse, an expert in restraint techniques, stepped forward following our campaign to stop the routine locking up of teenagers and young adults with autism and learning disabilities.

Last week, two other nurses and a senior carer blew the lid on what they called ‘shameful institutionalised abuse’ taking place behind the locked doors of a different institution, Meadow Lodge, a privately run unit in Devon funded by the NHS.

Ian Summers said he saw patients more often violently held down, attempt suicide and forcibly drugged while working in the unit holding vulnerable teenage girls than when he looked after killers and psychopaths at Broadmoor high-security hospital.

This newspaper has spoken to more than two dozen distraught families – some breaking gagging orders – who have told how their children have been taken from them for years and stuck inside unsuitable secure units that only lead to mental deterioration.

Much of their anger has been focused on private firms charging up to £730,000 a year for each patient – but the hideous story revealed by Elaine took place in an NHS psychiatric unit in the South of England six years ago.

The victim was a 36-year-old man with mild learning disabilities. ‘He was lovely if treated the right way,’ said Elaine, who is in her late 30s. ‘But there were four members of staff who did not like him, so they wound him up and he became abusive in response.’

She said the carers held him down before dumping him in a tiny seclusion cell. ‘Normally he would pace up and down in there but he lay on the floor in his own faeces and urine. They said he was putting it on and left him there for two days.

‘Only when the consultant came in was he sent to hospital, where they found his top two vertebrae were broken. He was in agony.’

The man was left paralysed for two years, eventually recovering some ability to walk with sticks after intensive therapy at another hospital. Elaine claimed she was then asked to cover up the incident by colleagues. ‘I was supposed to say it was an accident and there had been proper restraint methods used. I refused, so they made it impossible for me to work and I quit.’

She was relieved to leave a system she had joined full of idealism, inspired by an autistic godson and a relative who killed himself, but came to hate over 12 years working in secure units and ‘short-stay’ assessment and treatment units (ATUs).

The nurse said there was frequent abuse and bullying of patients – one man with Down’s syndrome who loved drawing would have his crayons hidden by staff to infuriate him – and regular over-medication to sedate people. ‘There is this view that staff are normal people and patients are not, which leads to institutional abuse across these ATUs and secure units.

‘It is difficult not to get sucked in and become part of the system. I have worked in more than ten of these places and I wouldn’t put my dog in one. They should be bombed.

‘Everything is locked, there is lots of seclusion and restraint when six adults push someone on the floor. It’s horrible.’

The use of restraint in ATUs has soared in recent years, rising from 15,065 incidents in 2016 to 22,620 in 2017. There is also growing concern over use of long stretches in solitary confinement, with patients held in padded cells under permanent observation. ‘If someone shows signs of challenging behaviour they are secluded, which is awful,’ said Elaine. ‘Imagine being placed in a room 6ft by 6ft with a plastic mattress and no access to a toilet unless a full restraint team accompanies you.

‘You are fed through a hatch, spoken to through a hatch. How does this help anyone?’

She said such units were especially grim for people with autism. ‘None of them is a nice environment for such people since they respond well to routine, comfort, the security of a family environment. So this noise and chaos, with alarms ringing and maybe ten people in a ward all demanding help, is never going to go well for them.’

Families have complained that this kind of incarceration is ‘a spiral of cruelty’ since innocent people are shut in conditions that only serve to intensify their anxieties and stresses, which then makes it harder for them to win freedom.

Yet this latest whistleblower, who now works to free patients, said families do not have a clue what really goes on behind locked doors.

‘I tell parents they should never seek help from the system because they will lose control of their child,’ Elaine said. ‘Ask for help and you risk losing your child.’

This is a terrifying indictment of our public services. Yet it is one I have heard echoed by despairing families, such as one distraught man who asked for three days’ respite help only to have his autistic son locked away for three years so far.

Elaine believes a broken system is being fuelled by big profits, with private groups expanding operations despite Government pledges to move people with autism and learning disabilities back into supported living in the community.

There are 2,375 people with autism and learning disabilities held in assessment and treatment units at a cost of about half a billion pounds a year, with the number of children more than doubling over the past three years, and scores more are held in other secure units. One man is thought to have cost taxpayers £10 million after being held against his family’s wishes for 18 years.

More than half the patients in ATUs have been detained for at least two years, and almost one in six for more than a decade. ‘It is all about money,’ said Elaine. ‘Why else do they keep people in these conditions, costing maybe £7,000 a week, when other mental health services are struggling and community facilities crumbling?’

Elaine, who has helped extricate 13 people over the past five years working as a care partner with local authorities, added: ‘I once thought I could save every autistic person in the United Kingdom – but sadly I am only able to help a handful.’

Categorised in: Disability, Health, home page, Public policy