Treat mental health patients with care and compassion not cruelty
There have been repeated failings in the use of force against mental health patients says Steve Reed MP, as he writes about the Mental Health Units (Use of Force) Bill, the Private Members Bill he has sponsored.
Seni Lewis, 21, was a physically healthy graduate with no prior history of mental illness. His parents found him one Sunday morning in a very agitated state, recognised it as a mental ill health episode and took him to the local hospital. They stayed with him until late evening before going home to rest.
Realising his parents had left, Seni became very anxious. He resisted attempts by hospital staff to restrain him and they called the police. Eleven police officers took Seni into a seclusion unit with his arms handcuffed behind his head, his legs in shackles, and held him face-down on the floor until he suffered a heart attack. Shortly afterwards, Seni died.
Serious failings by the Crown Prosecution Service and obstruction by the Metropolitan Police meant that no inquest into Seni’s death was held for a further seven years. It took a long campaign and questions in Parliament to get the inquest opened. Having lost their son, Seni’s distraught parents were left to fight the state simply to find out what had happened.
When the Coroner’s verdict finally came in June 2017 it was damning. It found that Seni had been subject to ‘prolonged disproportionate and unreasonable’ restraint. Training for police and hospital staff was inadequate, responsibilities were unclear, medical staff failed to respond to the medical emergency and the hospital was failing to follow its own policies on patient safety. The Coroner warned that without change further deaths could occur.
Change has arrived in the form of the Mental Health Units (Use of Force) Bill, known as Seni’s Law in honour of the young man whose death inspired it. According to the mental health charity Mind there have been 13 face-down restraint-related deaths since 1998 and over 1000 physical injuries. Inquests going back over two decades have repeatedly pointed to failings that have never been corrected.
Look at the faces of those who have died and it’s clear that young black men are disproportionately affected. This raises fears of unconscious bias, with anecdotal evidence linking their deaths to assumptions about young black men, drugs, psychosis and violence. But without hard evidence on how, when and why force is used against mental health patients, this is difficult to prove. There are widespread fears in the black community about racial bias in the mental health services. The Government’s own race disproportionality report, published last autumn, has statistics on deaths in prison and police custody, but is silent on mental health custody because the statistics don’t exist.
Seni’s Law will require every mental health hospital to keep a record every time restraint is used against a patient. For the first time, we will be able to compare hospitals with each other, and see whether some groups – young black men, women, the disabled – are subject to disproportionate levels of force. Every hospital will have a policy on reducing force, and a named senior manager accountable for its implementation, including training on de-escalation.
If the Bill as proposed is passed, police officers in mental health settings will have to wear body cameras. Every non-natural death will automatically trigger a fully independent investigation with legal aid for the deceased person’s family. The Government will publish an annual report summarising inquest findings and how lessons are being learnt.
This Bill is a major step towards ensuring mental health patients are treated with care and compassion not cruelty, and that the system learns when things go wrong. It enjoys the support of every professional body, patients’ group and trade union in the mental health sector. The Bill is due for its third reading in the House of Commons in June, and with cross-party support could be on the statute books by the end of the year. Nothing can bring Seni Lewis back, but Seni’s Law will make sure no one else suffers the way he did.
Steve Reed is Labour MP for Croydon North.