Government action needed to end the institutionalisation of Disabled people

Fri,21 June 2024
News Equality & Rights Health & Social Care Housing
A new report “Building the Right Support” has been published by the Voluntary Organisations Disability Group.

VODG represents over 100 leading not-for-profit organisations that provide services to Disabled people.

The report criticises the continuing detention of autistic people and people with learning disabilities in secure hospital settings, noting that despite multiple commitments to tackle this issue over many years, another government deadline was missed in March 2024.

Almost ten years ago, the NHS published its first strategy to reduce the number of people in Assessment and Treatment Units (ATUs) and the VODG have pointed out that all subsequent deadlines to cut the numbers of autistic people and people with a learning disability living as inpatients in mental health ATUs have been missed. The latest target was to reduce the 2,905 people detained in such settings in 2015 by March 2024 at the latest.

Published figures show that the reduction made is only around 30%, with 2,045 people still living in Assessment and Treatment Units at the end of March. Of the 2,045, 1,380 (67%) are autistic people. This is a 116% increase in the number of autistic people without a learning disability being detained, since March 2015.

VODG note that people are often placed in ATUs against their will, and often long distances from their families, communities and friends. This causes distress and despair, which often prompts a further deterioration in behaviour. This deterioration becomes, in turn, a rationale for continuing to keep people as inpatients. What started as a supposed short-term intervention to make things better, becomes a long-stay placement for someone deemed unmanageable in the community. 

VODG note that Inpatient placements in ATUs are expensive. Mencap research suggests an average cost of £237,000 a year. In 2019, VODG research indicated that much of the market for this type of provision was controlled by companies supported by overseas – usually American – investment. It follows, then, according to the report, that companies running such facilities have a vested interest in maintaining the considerable income made from long-stay care.

Solutions proposed to the crisis include:

  • An urgent need to build social care provider capability and capacity to deliver community-based services for people needing complex support. Good commissioning should invest to save over the longer term – resourcing prevention by partnering with community providers and housing suppliers. It should draw on the insight of people with lived experience and their families, who articulate consistently what they need – well-managed transitions between services, investment in community-based services close to families and friends, skilled staff. 
  • More development of suitable housing. Much can be achieved when NHS and local authority commissioners work in partnership with third sector providers on capital investment programmes that enable the right kinds of accommodation to be secured.

There is a large and strong coalition of user-led, special interest and third sector provider and membership bodies who want to see the end of inappropriate detention of autistic people and people with a learning disability. The issue must be a political priority to drive the change needed.

Dan White policy and campaigns officer at DR UK said, “The next Government must be more determined to reduce the number of autistic people and people with a learning disability in mental health hospitals. There must be a dramatic and speedy reduction of inpatient care.”

“There needs to be investment in prevention and community services to deliver better support to individuals in their community, to live independently. There must be an end to the disgrace of inappropriate, cruel and costly inpatient placements.”

For more information, please support Free our people now” which is a campaign led by People with learning difficulties and Autistic People supported by Inclusion London.

Support Disabled people everywhere but reading and sharing our Disabled peoples manifesto.