Last January I wrote about Claire Dyer, a young autistic woman in Swansea who was at the time being threatened with transfer to a secure hospital in Northampton. Then as now, she was living mostly in an assessment and treatment unit, which is a mental health unit for people with learning disabilities, in Swansea and spending much time at home or out and about with her family, despite being detained under section 3 of the Mental Health Act. Her family were appealing against the section, which ultimately expired (but was renewed), and for a while it appeared that the Northampton option was “highly unlikely”, and bespoke placements (where she would occupy a bungalow and have support staff) were being looked at. This week, however, things have taken a serious downturn, and staff have ‘agreed’ (with other clinicians that have never met Claire) that she should be transferred to a secure unit, which could be anywhere in the UK, as soon as a bed is available. The family have invoked the “nearest relative” method to get her released (this means that if the unit do not discharge her within three days, a tribunal must be held within a month). She has since been denied a routine day out because of medication given in the evening, something that has not been done before and which neither she nor her family were warned of.
Claire, her parents, an advocate and a solicitor attended several tribunals earlier this year which were intended to challenge the section imposed last September. During this time, the management were banned from transferring her. A team from Northampton visited her unit, but this was on a day when she normally went out, and to disrupt this would have caused Claire a lot of distress and possibly a meltdown. I believe that the Northampton team got the distinct impression that Claire and her family were opposed to her moving there and that maintaining family relations was all-important, and could not have been done there to anything like the same extent as if she remained in her home region at least. In March her section was renewed, but focus appeared to shift to finding Claire a bespoke placement in or near Swansea, most likely a bungalow with dedicated support staff. However, this was always going to take time as the bungalow has not even been built.
Many of us suggested that they bring Claire home, but Claire herself did not want to live at home permanently as her parents will not live, or indeed be able to care for her, indefinitely and she feared what would happen then. Meanwhile, the unit allowed her to come home most days (Tuesday and Thursday she would spend most of at home or out with her family) and spend the weekend at home, and provided respite so that they did not always have to look after her and could get other things done (including working on her case). This arrangement worked until Claire broke down after seeing another woman who was in her unit go back to her care home, something she has been waiting for since she was re-admitted to the unit in April last year. This has led to an upsurge in violent outbursts, and she has reduced her trips out (not spending a night at home the past three weekends, for example) because she wanted to “keep home a happy place”. Unfortunately, the unit staff judge her on her behaviour in the unit, and hardly take any account of what goes on outside.
The family were told of the new plans at a multi-disciplinary team (MDT) meeting on Monday. Her mother, Cath Dyer, wrote:
Such a shame that after a meeting today, which even the solicitor and advocate felt we were all being ambushed when we were told all the clinicians have taken advice from other clinicians about Claire’s behaviour and violence to people and property at the moment, and all feel she needs a medium secure unit, but could be anywhere in the UK. (These are people who have never met her, and others who have only seen her in the unit, which is a hospital and therefore a trigger for her behaviours). We have said that this will destroy her, especially as she relies on and loves coming home and spending time with her family, and visiting the community, and seeing her friends, but nobody seems to care about that.
Claire has not been told of the plans to move her. Today she was prevented from going home, as she normally does on a Thursday, because of medication she was given last night which supposedly requires 24-hour monitoring (which the family had not been previously told about). The demand for a nearest relative’s discount was submitted this week, and as of this writing, they have not heard back.
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