This Christmas, 2,000 people with learning disabilities and/or autism will spend the festive period in long term detention.
Indeed, for six in ten of those currently locked up, it will be at least their second consecutive Christmas in hospital away from their families.
Despite the ongoing failure of the Transforming Care programme since it was launched in the wake of Winterbourne View 10 years ago, this is not an insoluble problem.
That is why, this Christmas, we are sharing seven policies that together, will deliver on the original vision of Transforming Care – that people belong in homes, not hospitals:
1. Fix the perverse financial disincentives to discharge patients by reducing the health dowry to 2 years or less – ensure funding always follows a person.
2. Introduce meaningful fines for any Assessment and Treatment Unit (ATU) or similar long stay facility supporting a person without an in-date Care and Treatment Review (CTR) plan including a plan for discharge – this should be statutory.
3. Ensure that every CTR participant (from Multi-Disciplinary Teams) has a register of local organisations with experience of supporting people with both a mental ill-health and forensic history out of ATUs
4. Implement an outright ban on for-profit organisations running ATUs
5. Strengthen family networks through low levels of funding to independent advocacy groups; information sharing between families is key.
6. Invest in the specialist housing market; housing is cited as the major barrier to discharge
7. Fund the social care system in line with the Local Government Association’s assessment of need
Katrina will spend Christmas with her family this year. In fact, she can see them whenever she wants.
But for much of the past decade, Katrina has been locked up away from her family in numerous Assessment and Treatment Units. As the Government’s own Health Select Committee has acknowledged, long term detention like this is fundamentally a human rights issue – the right to a family life.
Today, International Human Rights Day, Katrina describes hospital environments where rude staff would wind patients up just to get a reaction. One resulting incident led to a bone in Katrina’s hand breaking when a restraint went wrong. In one hospital, incidents would result from patients being barred from going to the toilet during mealtimes. Just a couple of the many daily provocations that shape long stay hospital life.
Katrina got out in June, since when she has been supported in her local community by not-for-profit support provider Dimensions, but many of her fellow inpatients have not been so lucky. “A couple of people I know have been in for more than 10 years,” she reflects, “That’s a lot of Christmases locked up away from home.”
In fact, it is likely that over 2000 people with learning disabilities and/or autism will be locked up this Christmas. For nearly 6 in 10 of those, this will be at least their second consecutive Christmas away from their families. Horrifyingly, 100 have been locked up for 20 years or more.
How many are, like Katrina, pissed off and upset? How many react unwisely to the daily provocations, prolonging their stay further? How would you react, locked up away from all your friends and family for reasons you perhaps don’t understand?