As last week marked Mental Health Awareness Week, this article raises awareness of how disabled patients have been unnecessarily sectioned under the Mental Health Act where they have been traumatised, their human rights have been violated and they have been held against their will for far too long.
As of march this year 2045 people with autism or a learning disability have been detained against their will in secure hospitals. This is because the 1983 Mental Health Act deems Autism and learning disabilities to be mental health disorders.
This could not be further from the truth, neither Autism nor learning disabilities can be cured whereas many Mental Health conditions can. The criteria to section an individual includes:
- Posing a risk to their safety or the safety of others
- Being considered in urgent need of psychological help
- A risk that their health will swiftly deteriorate if not sectioned
Many individuals with these conditions are incorrectly categorised with these criteria when really all they need is a little more support.
The Realities of Being Sectioned Under the Mental Health Act
Ostensibly sectioning aims to offer a secure environment to recover and re-enter society. However, when you are sectioned, you cannot leave voluntarily. Depending on the aspect of the Mental Health act applied, you can be sectioned for six months initially. If you are not deemed fit to be released this is extended a further six months and then in increments of a year until you are considered recovered.
A Parliament Mental Health Act Reform Briefing found that 52% of sectioned inpatients with Autism or a learning disability had been detained for over two years. Often far from their families in hospitals that frequently do not have staff trained to handle these conditions.
Individuals with Autism do not handle change well and struggle to communicate. This is a terrible combination when sectioned and staff who do not understand these conditions will frequently resort to restrictive interventions. In December 2023 alone there were 5905 cases of restrictive interventions used on patients with these conditions including restraints, medication or seclusion.
Community Care: The Best Solution
Due to their communication issues these individuals often struggle to find support and engage with community care. When they do the care provided or available is often woefully inadequate. Hugh Constant of the Social Care Institute for Excellence explains that:
“The social care system can be complex and set up in ways that exclude or alienate people with autism. Problems are even worse for people whose behaviour is seen as ‘challenging’, or who have needs that cross the boundaries of several different services.”
Hugh Constant, Social Care Institute for Excellence
Experts argue that the inadequate community and social care services directly contribute to individuals with these conditions being sectioned. Were appropriate services in place and easy to access individuals would not spiral and be considered for sectioning.
A Mental Health bill was introduced that aimed to amend the Mental Health act by:
- Removing Autism and learning disabilities as criteria for detention
- Reducing the initial detention period to 3 months
- Prioritising community care for individuals with these conditions
However, this has since been shelved and would be looked at “when parliamentary time allows”.
“This is further evidence of how little regard the current UK government has for mental health. More than 50,000 people were held under the Mental Health Act last year, so it is incomprehensible that legislation which would help people at their most unwell has been de-prioritised.”
Dr Sarah Hughes, Chief Executive of Mind
Community care has been clearly shown to be better than hospital care for Autistic and disabled individuals. Primarily because it allows families and support systems to be much more involved. Community care can focus on the individual and not resort to restraints or medication. It should focus on supporting the individual to navigate and cope with daily life. A 2023 NHS review estimated that at least 41% of people with a learning disability or Autism in secure hospitals did not need to be there.
If this is to be effective community care needs greater specialisation and awareness of these conditions. Social care needs to understand that for these individuals self-harm or aggression result from inability to communicate and are expressions of distress or need. Community support leads to significantly better life quality than hospital detention.
Final Thought
The 2045 people detained in hospitals are isolated, alone and (at least as far as the government is concerned) forgotten about. We must stop the practice of shuffling difficult people out of society because they are too difficult to deal with.
As with pretty much any societal problem, prevention and early intervention are the best strategies. Sometimes all it takes for these people to function in society is support with simple tasks. For example, paying bills, filling forms or interacting with other people socially.
If we can create these support systems, we can prevent individuals from becoming isolated and lashing out. Some people may question the money needed for these reforms in tough financial times, but community care is almost always cheaper than hospital detention.
A light touch, a helping hand every now and then is always going to be better, easier and cheaper than having to monitor (or neglect) someone in a secure hospital for months or years on end. The Mental Health Bill needs to be revisited and enacted so that we can stop the suffering of the patients and their families.
This article was written by features writer Joshua Coyle, for more insight on health and social care policy, click here.
