Learning Disability Today
Supporting professionals working in learning disability and autism services

NHS spending £534 million a year to ‘lock away’ people with learning disabilities

The NHS is spending more than half a billion pounds per year to detain people with learning disabilities and autistic people in mental health hospitals, according to new research.

The research from ITV News and Mencap shows that in 2022/23, the NHS spent £534 million on inpatient mental health care for people with learning disabilities and/or autism even though 41% of people in these hospitals could have their needs met in the community. It is likely the real cost is even higher as this figure is for basic costs alone and not additional needs.

The government’s target to halve the number of people with a learning disability and/or autistic people in mental health hospitals by 1 April 2024 is also going to be missed, with Mencap and ITV News estimating that the target will not be reached until June 2030 – six years later than promised.

People in mental health hospitals at higher risk of restrictive practices

Mencap says many people with a learning disability and/or autism end up in mental health units not because they need inpatient treatment, but because of a failure to invest in the right community support with a focus on early intervention and preventing crisis.

People detained in mental health hospitals are at increased risk of abuse and neglect and subjected to over-medication, inappropriate restraint, and seclusion, often resulting in lasting trauma.

This is highlighted by Isabelle Garnett’s son, Matthew, 23, has a learning disability. Matthew was told he needed assessment and treatment for 12 weeks in hospital, but this turned into an 18-month hospital stay 190 miles away from his family.

Isabelle said: “Under this provider’s so-called care, our son was overmedicated, restrained and secluded. This did not help him get better. It resulted in a catastrophic deterioration in his mental health caused by their neglect and abuse.

“It reportedly cost £13,500 per week to detain my son in this unit. The cost of his care now, living in the community, is significantly less than this. £13,500 a week for neglect, abuse and traumatisation is not a good use of money.

“This money could have made a positive difference had it been used earlier to build the right support for him to live in the community near his family…Instead, my son – and us his family – will have to live with the trauma of what happened to him for the rest of our lives.”

Some NHS trusts making progress but widespread improvement is needed

Some NHS Trusts have made huge progress in helping people to avoid inappropriate admission to mental health hospitals, but sadly, this is not widespread.

For example, Black Country Healthcare NHS Foundation Trust previously ranked among the worst NHS trusts for avoidable mental health hospital admissions. Now, the Trust has set up an emergency response team, which last year prevented 53 people from being admitted to hospital.

Wendy Ewins, Head of Commissioning, Case Management and Keyworking for people with a learning disability and autistic people at Black Country Healthcare NHS Foundation Trust, said: “Our Commissioning Team is on-call 24/7 to help families and staff support people through crises. Our offer includes a 24/7 Emergency Response Team and Crash Pads.

“Our clinical and social care teams then wrap additional support around the person, wherever the person might be. We aim to provide support from the Emergency Response Team within 2 hours and have round the clock support from the Crash Pad where people can stay for a few hours or up to several weeks if that’s what they need.”

Wendy says this is helping the Trust to save money while also providing a better life for people who would have otherwise been ‘locked away’.

“This isn’t just about money; this about recognising that our citizens have the best chance of leading happier, healthier lives with secure connections and a firm sense of belonging, if they are able to remain at home, or very close by (at the Crash Pad) when they are distressed or unwell,” she said.

‘A human rights scandal’

Mencap and the Challenging Behaviour Foundation, along with people with lived experience and other organisations, have now launched a petition calling on the government to bring this human rights scandal to an end.

Jackie O’Sullivan, acting CEO at learning disability charity Mencap said: “Failing to invest in the right community support and leaving people with a learning disability and autistic people, some of whom are only children, locked away in mental health hospitals for years on end, where they are at increased risk of harm and abuse, is morally reprehensible.

“It’s crucial the government says what they will do after March to free people and end this human rights scandal once and for all. There must be investment in community support to stop avoidable admissions and prevent people being detained in mental health hospitals when they could be living fulfilling lives in the community.”

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