The government must take action now to protect patients who are forced into isolation, sometimes for years, in mental health facilities with damaging effects on their care and wellbeing.
As a public law and human rights lawyer, I fight for the rights of people who are detained in mental health inpatient units under the Mental Health Act. My clients are autistic and/or have learning disabilities.
When detained, many find themselves in long-term segregation or seclusion because of behaviour caused by the distress of being detained in an environment that cannot meet their needs.
A large proportion are also detained in ‘out of area placements’. This means they are unable to mix freely with other patients in the unit and have fewer opportunities to spend quality time with family and loved ones.
This forced isolation can last for years. In 2021, a BBC investigation found that 100 people with learning disabilities had been held in seclusion for over 20 years. Such severe isolation can have significant psychological and physical impacts, and violate patients’ human rights. In individual cases, it can amount to inhuman and degrading treatment in breach of Article 3 of the European Convention on Human Rights (ECHR).
It is disappointing that the government is not doing enough to ensure that patients’ human rights are protected. After the abuse of patients detained at Winterbourne View Hospital in 2011, the government promised to reduce the number of autistic people and/or those who have learning disabilities in mental health inpatient units by half by March 2024. It has failed to do so.
The current number, according to statistics released in February 2024, is 2,045. In March 2015, the number of those detained was 2,900. In making little progress to reduce this number, the government has abandoned autistic patients and/or those with learning disabilities. Moreover, I am concerned that many of the people held in these units are in long-term segregation.
The Law Society recommends that the Care Quality Commission (CQC) is notified within one working day of a decision being made that a patient should not be allowed to mix freely with other patients on a ward or unit on a long-term basis.
Our recommendation would improve oversight of how mental health units manage their use of force. The CQC would have an opportunity to visit the patient to ensure legal frameworks and their rights are being respected. They could also support providers to take steps to ensure they were not breaching their obligations, for example by providing patients with enough opportunities for human contact.
Long-term segregation can have a severe impact on mental health. I urge the government to take action to make our recommendations a reality and ensure that vulnerable patients have their human rights respected.
Find more information about the Transforming Care programme here.
Kirsty Stuart is chair of the Law Society Mental Health and Disability Law Committee
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