Closure of the independent living fund and the negative impacts of funding shortfall for maintaining individuals’ care packages has been the centre of disabled peoples independent living campaigns since 2012. Whilst cuts to state-funded assistance have been blamed on austerity, there is one area of care that is rolling in cash, hundreds millions of pounds being thrown into assessment and treatment units and psychiatric hospitals for people with learning difficulties and autism. Research by Mark Brown at Lancaster University’s Centre for Disability found that the Government spent £477m last year on incarcerating 2,500 people with learning difficulties and autism in ATUs ; in cash terms the state is prepared to pay £190,800 per year or £525 per day for institutionalized care for one individual.
Let’s not be under any illusion, whilst the numbers of disabled people being detained under the Mental Health Act (MHA) has reduced from 3500 to 2150 between 2011 to 2017, the trend for young people is going the other way: in 2011 young people made up 7.6% of the total of disabled people detained under the MHA but by 2017 this had risen to 13%. Many of these are people with learning difficulties or autism who are admitted for short-stays that then become long-stay placements. This is caused by the systematic failures of Local Authorities and Clinical Commissioning Groups to adequately fund local education, health and social care services that would facilitate disabled individuals’ participation in their local mainstream education provision whilst living with their families. These figures do not include people with learning difficulties or autism who have restrictions placed on their freedoms whilst living in institutionalised psychiatric and social care settings as a result of deprivation of liberty safeguard order issued under the Mental Capacity Act 2005.
No, this is no longer austerity, it’s now ideological. The Government does not believe that disabled people have a place in society and have developed polices that will turn us back to the era of Victorian asylums. Let’s not kid ourselves – these places are dehumanising and brutal as highlighted by practices exposed by BBC Panorama’s under-cover investigation into Winterbourne View. Since then there has been various investigations into abusive practices that have taken place in a range of ATUs. Disabled people with learning difficulties and autism have been killed in these institutions by toxic medication, neglect and total abuse inflicted by management and staff. Institutionalisation and forced overmedication are grave and systematic violations of disabled people’s human rights.
The psychiatric regime is rooted within the individualised and medical model of disability/mental disorder where its focus is on fixing, mending and curing the disabled person. Anti-psychotic medication infringes a disabled person’s autonomy, and control over their body and mind, altering personality and interfering with personal identity and life-style. When not medicated, inpatients will undertake a whole range of therapeutic activities that place an emphasis on developing individual’s coping strategies and where possible to help the person minimise or reject their disability identity and their sense of being, thinking and feelings; the patient is forced to follow neuro-typical patterns of being, thinking and feeling. Patients are self-obsessed with analysing and reviewing their own performance with no allowance given as to how institution and other powerful forces impact on their wellbeing.
Whilst working as an advocate for ATU inpatients with learning difficulties and autism wanting to get out of these institutions, I am increasingly finding that the Independent Living movement’s priorities are not the radical solutions needed if we are going to advocate for all disabled people rights to independent living, not only those with capacity. We are witnessing a resurgence of institutions for people with learning difficulties and autism – not a week goes by and there is a spanking new facility opening up to lock them up and throw away the key.
We can talk about all the cuts we like to independent living provision and dream about alternative models of care all we want, however this means little if we do not speak out against the millions of pounds being spent on creeping institutionalisation of disabled people. There are some cuts that we should all be advocating for, ones that prevent us from having a full life, on par with our non-disabled peers. Disabled people will always be threatened with institutionalisation and incarceration as long as ATUs and other institutions exist and are permitted under the Care, Mental Health and Mental Capacity legislation.
Disabled people whose capacity is not being questioned by the state cannot be complacent either – with savage cuts to care packages, disabled people are being institutionalised within their own homes or within residential and nursing homes. And as such institutionalisation is on the way back for all disabled people.
The UNCRPD committee review of the United Kingdom’s (UK) progress in implementing the UN Convention on the Rights of Persons with Disabilities observations and recommendations included the tackling of increased state-sanctioned institutionalisation and compulsory treatment of disabled people.
We need to take the lead and act now – change our focus of our campaign work to a big NO to institutionalisation and their oppressive practices together with highlighting how such places have and will continue to violate disabled peoples human rights as set out in the UN Convention Rights for Persons with Disabilities articles. We need to be campaigning against the setting up and continuation of these institutions and the legislation that gives the state power to force disabled people out of their own homes and communities alongside full implementation of the UNCRPD underpinned by the 12 pillars of independent living. Alongside a plan to phrase out ATUs, we need to be strongly advocating for our right to be provided with the support and services (including mental health ones) we need to live fulfilled lives.
By Simone Aspis (Changing Perspectives and Free Our People Now Advocate)
I am a disabled person who is acting as an advocate for detained in-patients with learning difficulties and autism who want to be released from psychiatric hospitals. I have over 20 years experience campaigning for disabled peoples’ human and civil rights, working for People 1st, the United Kingdom’s Disabled Peoples Council and the Alliance for Inclusive Education and Not Dead Yet. Anyone wants to contact me please do so via Ellen Clifford at ellen.clifford@inclusionlondon/org.uk.