A 17-year-old autistic girl has spent the best part of two years isolated in a 12 ft square seclusion room in Northampton – because the hospital she is staying in does not have the trained staff to look after her.
Beth, whose surname cannot be revealed, has Pathological Demand Avoidance, a part of the autism spectrum, which means everyday routines can cause her extreme anxiety and often boil over into aggression and self-harm.
At least 13 different attempts to look after Beth in a community setting in her hometown of Walsall have failed because, the family believe, none of her care teams specialised in dealing with PDA.
It meant that, in December 2016, she became a patient at St Andrew’s’ Fitzroy House in Northampton and was subsequently sectioned under the Mental Health Act.
Because of a lack of appropriate staff at St Andrew’s, she now spends more than 23 hours a day in a seclusion room behind a locked door with little else but a foam bed and a foam chair.
Contact with her family takes place regularly – but they are faced with kneeling down and talking to her through the small feeding hatch in the door.
The family says that due to lack of exercise, Beth’s health has deteriorated to the stage she now has type 2 diabetes.
Up until recently, a biro was lodged in her arm where she self-harmed.
Her father, Jeremy, who has not been able to hug his daughter in months, believes her condition is deteriorating as a result of the isolation and is fighting to see her moved to a residential setting.
"I don’t know how she survives in that room with hardly anything to do,” he said.
“She has started seeing imaginary friends. She talks to imaginary aliens. It’s heartbreaking.”
Jeremy says the family is in a desperate Catch 22 scenario where their local council and the NHS in Walsall are not providing her with residential care, yet St Andrew’s is ill-equipped to look after her.
Though Beth is troubled by meeting new people, staff assigned to her in the evening are often from an agency, meaning she regularly has to confront unfamiliar faces.
But in May this year, a placement arranged by Walsall Children’s Services fell through days before she was due to move, meaning Beth is likely to remain in isolation for weeks, if not months.
Beth’s family have also made a number of complaints about the hospital since she was sectioned in 2016.
Reports seen by the Chronicle & Echo show how, on one occasion, she was dressed in a plastic raincoat during this year’s heatwave when the hospital ran out of clean clothes for her to wear.
Looked After Child Reviews carried out by Walsall Metropolitan Borough Council (WMBC) show the hospital admitting to keeping Beth locked in seclusion because of a lack of staff.
That review went on to even demand of the hospital that “there should be no instances where seclusion is used to manage staff shortages”.
Jeremy said: “The care is just not centred around Beth.
“It is centred around what they can do, but that’s not right for her.
“She is not getting better.
“The reports completed by St Andrew’s Healthcare states she needs to be in the community and has to be able to do the things that keep her calm.
“This includes therapeutic activities like being around animals, going on day trips to her favourite places like the circus.”
St Andrew’s Healthcare says it cannot comment on individual patients.
But a spokeswoman said: “For those patients who are referred to our hospital environments at a time when they are at their most vulnerable, our role is to provide care as best we can and proactively advocate on their behalf when we believe it is right for them to move on.The needs of our patients can and do change over the course of months.
“All patients have their progress monitored regularly by their care team.
“St Andrew’s is only meant to be a part of a patient’s care pathway. However, there are occasions where patients may have their placement extended due to no suitable onward care available for them. We work with the NHS and the wider care teams to facilitate a smooth transition for patients leaving St Andrew’s when an appropriate placement is found which meets their needs.”
Last Wednesday, St Andrew’s promised to provide Beth with a team of staff.
The plan includes moving her from the seclusion room into another, less restrictive, form of isolation nursing.
A team of experts has been bought in by the NHS Transforming Care Commissioning Team to look at suitable long-term placements in the community.