People with complex mental health needs are hidden away


Disabled children deprived of right to an education and community life

Call for system-wide changes to improve care and support

A review of the care of disabled children and young people with challenging behaviour and complex mental health needs is calling for urgent action at a national level to prevent these children being institutionalised at an early age, at huge cost to the taxpayer and with low ambitions for improving their lives.

The review, conducted by Dame Christine Lenehan from the Council for Disabled Children on behalf of the Department of Health, drew evidence from civil servants, clinicians, managers, parents and young people. 

It found that despite numerous Government initiatives, accelerated since the abuse of people with learning disabilities was uncovered at Winterbourne View, there is not a clear vision for the treatment of children with complex needs involving challenging behaviour and a mix of mental health problems, learning disabilities and autism. A lack of ownership or accountability across a fragmented system of care is depriving children of their right to an education, and community and family life.

Data to be published in the spring, finds that there were 170 under-18s with learning disabilities and/or autism in inpatient care and 635 aged 18 to 25. Over a thousand children (1,129) were in 52-week residential schools. The costs of inpatient care and treatment for each of these children could amount to hundreds of thousands of pounds each year.

The review confirms that this is not a group of children ignored by Government programmes, and there are examples of excellent inpatient care from highly committed staff, but despite this the system is failing to significantly improve lives.

“There’s a well-worn path for this group of disabled children, away from their home communities into long-term placements that often act a last resort”, says Dame Christine. “Hidden and separated from the rest of society, these children become ‘special cases’, for whom the aspirations we have for other children and young people don’t apply.” 

Dame Christine is calling for a shift in thinking “so that ‘these’ children are recognised as ‘our’ children, as members of our communities with exactly the same rights to health and education, and family and community life.”

Respecting rights

The review looks at what could be done by the Government and other national bodies to improve the system. It says the right to a childhood, conferred by the United Nations Convention on the Rights of the Child, must be upheld for disabled children with complex needs and behaviour that challenges, with these rights recognised by the NHS Constitution, Department of Education (DfE) , Department for Health and local commissioners.

The Review calls on the DfE to look at provision in special schools and colleges for this group of children. The DfE has agreed and have commissioned Dame Christine to conduct this work in 2017. The call for views on this review is open until 17 March (see “Your views sought on residential special education”, page 8). The Department for Health and NHS England should also undertake an urgent review of the number of these young people aged 18 to 25 currently in inpatient provision.

The DfE should work with Transforming Care Partnerships, the Association of Director’s Services and the Local Government Association to develop an effective model of what care for these children should look like, the review argues.

Better commissioning of services is also identified as a priority and the review urges greater professional responsibility, saying that every one of the children in an in-patient setting, or at risk of going into one, should have a named key worker from either health or local authority services to help them and their family navigate the system. The Royal College of Psychiatrists, the Royal College of Paediatrics and Child Health, the Royal College of General Practitioners and other royal colleges should clarify the responsibility of medical and other professionals for these children, and jointly develop guidance to ensure respective roles are widely and consistently understood.

To read the review, These are our children, click here.

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