Kirsty Johnston is an investigative reporter at the New Zealand Herald.

Autistic man locked in isolation for five years: 'He's had everything stripped from him'

Ashley Peacock loves animals and the outdoors. But for the last five years he has been locked in an isolated mental health unit, allowed out for just 90 minutes a day. Experts warn it's a breach of human rights and his family are desperate to see him free.

Shoulders slumped and eyes glazed, Ashley Peacock plodded slowly down the empty road, his rhythmic steps tracing the same short route he followed almost every day.

Next to him walked his father, Dave. Two burly psychiatric staff tailed close behind.

When their small group reached the paddock with the ponies, Ashley pulled bits of carrot from a plastic bag, gently offering each piece and waiting for the animals to take it, their lips soft and whiskery against his flattened palm.

"Good," he said, ruffling their manes in turn. "Good girls."

Sometimes Ashley lingered with the little horses, who he'd named "Honey" and "Gorgeous". But today he was listless. Once the carrot was gone the men trudged the 400 metres back to the hospital grounds.

His father said goodbye. Ashley was taken inside a white block building. The door was locked behind him.

It has been five years, five months, and three weeks since Ashley was put in seclusion.

He is allowed outdoors for just 90 minutes a day.

A patient under a compulsory order of the Mental Health Act, Ashley is kept locked in the "de-escalation" wing of the Capital & Coast District Health Board's Tawhirimatea unit, set on the sprawling grounds of the former Porirua Lunatic Asylum.

The area has three rooms, a bathroom, a small lounge with a TV behind perspex and a tiny enclosed courtyard with a mesh ceiling nicknamed the "chicken coop".

Ashley has spent more than half his time on the wing locked in a cell-like room.

It is a place so isolated his parents have never been allowed inside, even when their son's arm was broken, and even when he reacted so badly to a new cocktail of drugs he barely moved for weeks.

The room measures about three by four metres. There is a plastic-covered mattress on the linoleum floor, some papers, piles of clothes, a couple of Garfield comics, a bottle for urine, and nothing else.

The door is heavy and the walls are thick, but not thick enough to block out the sound of a person in the next room screaming. Ashley sleeps there, and when staff order it, he is locked in.

At one point, he did two-and-a-half years straight, his only respite a daily 30 minutes outside.

Ashley is 37. He loves fly fishing, surfing, animals and nature.

He has red hair, a goofy grin and a thick Kiwi accent.

Ashley loves fishing, diving, and the outdoors. This picture was taken in Kapiti before he was locked up. Photo / Supplied
Ashley loves fishing, diving, and the outdoors. This picture was taken in Kapiti before he was locked up. Photo / Supplied

He is not a criminal. He is autistic, intellectually disabled and mentally unwell. He experiences what experts call an "abnormal internal world", which can include bizarre hallucinations and frightening voices, and is both traumatising and unpleasant.

Ashley, who was the subject of a documentary last year, is a compulsory patient under the Mental Health Act.

He also has disordered sensory perception, and finds loud noises overwhelming. He does his best to cope, but can sometimes lash out at those around him, usually with clenched fists and flailing arms.

Psychiatrists placed Ashley in the secluded wing in 2010 due to the increasing frequency of such psychotic episodes. The idea was that he - and others - be kept safe until his mental illness stabilised enough so he could transfer into community care.

However, since he was locked up Ashley's health has not improved. His psychosis persists. He has put on weight, is often tired and his assaults on staff have increased.

A report to the National Intellectual Disability Care Agency this year found, however, he is rarely reported to have hit anyone outside hospital grounds.

The three expert reviewers decided much of Ashley's impulsive and unpredictable aggression was due to the mismatch between the care he needs, and the service he was getting at Tawhirimatea.

They described how Ashley was commonly denied requests due to a lack of staff, such as watching a DVD, having a cup of tea or going for a walk. Instead he takes frequent baths, or cleans his room, spending hours wiping the walls.

Long periods of time go by marked down as, simply, "unengaged".

"It is a boring and grey place," the review said. "Ashley likes the outdoors, likes nature, and likes being busy. His current environment is not a good fit with what matters to Ashley."

The report confirmed what Ashley's parents already knew.

It agreed with what the Ombudsman, the Human Rights Commission, advocates and lawyers and autism experts have been saying for years.

It said Ashley needs to come out.

"It is a decision which we now deeply regret."

Ashley grew up in rural Gisborne, an only child, surrounded by animals, farmland and an orchard. He learned to fish, and to dive for crays. The family remember his childhood as a happy time, but despite this, they say life with Ashley was a challenge from the start.

Marlena Peacock with her son Ashley as a baby. Photo / Supplied
Marlena Peacock with her son Ashley as a baby. Photo / Supplied

"He didn't sleep at all for the first two years," his mother Marlena said. "He was a terribly anxious child."

At school, Ashley struggled. His parents thought initially that he would catch up to his peers, but by intermediate, Ashley's marks were consistently below average - despite his parents staying up till midnight to help with assignments.

Back then, autism was barely heard of. Dave and Marlena didn't know their son's single-mindedness was a telltale trait of the diagnosis to come.

Ashley went through several jobs after he left school at age 16, but none lasted. At the supermarket's fish counter, he was fired for telling customers the catch wasn't fresh. A job mowing lawns ended when he was caught emptying clippings on council land.

His behaviour and sensory issues escalated. He would run away. Once, he decided to go surfing in the middle of the night, and swam across the harbour in the dark. The police were called to find him.

Ashley loved diving for crayfish on holidays as a teenager. Photo / Supplied
Ashley loved diving for crayfish on holidays as a teenager. Photo / Supplied

Then, in June 2001, Ashley was in the tearoom at his father, Dave's, workplace while a noisy game of darts was going on in the background. Overwhelmed, he lunged at a staff member and was put in a secure ward at Tairawhiti Hospital, his first experience of seclusion.

In response, Ashley went on a hunger strike. It lasted intermittently over three months. "It was terrible," his mother, Marlena, said. At times, Ashley would break into heart-rending sobs, while his parents tried to soothe him.

Things spiralled downhill after his release, despite the help of medication. Ashley began trying to control his parents, including cleaning the house obsessively. Marlena and Dave would come home to find their possessions piled up, the floor awash in water.

He would get angry when they tried to stop him. By 2003, the couple had run out of options and decided that Ashley be placed in Timata Hou, a residential facility for people with intellectual disabilities.

They thought he would benefit from specialist care.

Just five years later, Ashley's parents would find cause to write to health authorities, saying: "It is a decision which we now deeply regret."

"This isn't the place for Ashley"

In the back room of the Peacocks' windswept flat at Titahi Bay in Wellington are boxes and boxes of documents about Ashley's care. They moved from Gisborne, giving up their lifestyle block and kennelling their dog, to be closer to their son.

Dave and Marlena Peacock with a portrait of their son Ashley, who has spent more than five years locked in virtual seclusion at a mental health unit. Photo / Mark Mitchell
Dave and Marlena Peacock with a portrait of their son Ashley, who has spent more than five years locked in virtual seclusion at a mental health unit. Photo / Mark Mitchell

Marlena and Dave have been married for 45 years. Dave is tall and thoughtful. Marlena is small and sharp.

They are staunch in their decision to fight for their son's rights, but both are growing increasingly frail. Their biggest fear is that something will happen to them before Ashley is released.

The documents detail how Ashley has bounced through the health system - first in residential care for the intellectually disabled, and then in hospital wards when doctors decided he needed heavier medication for his psychosis. His compulsory treatment order was made indefinite by a judge.

At one point, he spent 15 months in a seclusion room at the Henry Bennett Centre in the Waikato, a situation the District Inspector of Mental Health called "a concern". He was tested and diagnosed and re-diagnosed.

Psychiatrists disputed his intellectual disability, to be told by psychologists that, yes, Ashley did have a low IQ.

He needed a service tailored to people with "complex needs", ideally one that had both disability and mental health services combined, they said. No such service was available, however.

Instead, it was decided Ashley should go to Tawhirimatea.

Before Ashley was transferred, Dave went down to have a look with a friend. They walked in, took in the cold, clinical surrounds, turned to each other and said: "This isn't the place for Ashley."

"The place is like a prison," Dave said. "Ashley hated the idea of being in a prison even then."

A reminder of a bygone era

Porirua Lunatic Asylum was closed in the 1970s. Pictures show a huge gothic structure that at its peak housed 1400 patients, including babies taken in by the asylum at birth.

The former Porirua Lunatic Asylum, built in 1887. Photo / Pataka Museum Collection,  Porirua Library
The former Porirua Lunatic Asylum, built in 1887. Photo / Pataka Museum Collection, Porirua Library

On a winding road around the old asylum farm, past the unmarked patient graves, is one remaining historic building, an abandoned psychiatric ward re-purposed as the Porirua Hospital Museum.

In an empty corridor, behind a small door, is a tiny, dark room where the cold seeps up through the floors. A yellowed straightjacket, canvas mattress and pillow are on display.

There are names scratched in the wooden wall, and deep gouges in the door. It is an historic seclusion room, kept as a reminder of a bygone era. It is just 400 metres from where Ashley lives.

Seclusion, defined as placing of a patient alone in a room or area with the door shut so that they cannot freely exit, is these days supposed to be used only as a last resort.

The United Nations labels it torture and against human rights. The Mental Health Foundation wants it gone. The Ministry of Health has guidelines aimed at reducing its use, saying it is traumatising for staff and patients.

In New Zealand, the use of seclusion is monitored by Crimes of Torture Act Inspectors from the Ombudsman's Office. They, alongside the Human Rights Commission, have repeatedly highlighted Ashley's case as one of concern.

In 2013 Ombudsman Ron Paterson undertook an investigation, finding "no patient should be managed through seclusion to the extent and for the duration that Ashley has experienced".

"There seems little doubt that the protracted use of seclusion has contributed to an ongoing deterioration of his mental condition," he wrote.

A series of Catch 22s

After the Ombudsman's report, Ashley seemed very close to release. A provider, Community Connections, was found. Plans were made to find him a home, to design an individual funding package, and to train specialist staff.

But it never happened. Reports mention a "tightening" of funding. Psychiatrists also wanted Ashley to be less "disturbed" before he was allowed out of the seclusion ward, and to try living in another part of Tawhirimatea with more patients for a while.

The courtyard nicknamed the "chicken coop" at the Tawhirimatea Unit of the Ratonga Rua o Porirua campus, where Ashley lives. Photo / supplied
The courtyard nicknamed the "chicken coop" at the Tawhirimatea Unit of the Ratonga Rua o Porirua campus, where Ashley lives. Photo / supplied

To Dave and Marlena that plan did not make sense. Dave calls it a "Catch 22", saying it is ridiculous to wait for Ashley to get well to be let out, when being locked up is part of what's making him unwell.

Often assaults occur because he is upset at going back to what Dave calls "that terrible place". If he does attempt to assault staff, he is punished, by being frogmarched into a room, and sometimes tranquilised. And then, when he is let out again, he is often still angry, and so hits out with his fists again.

The Peacocks find much of the health system like this - contradictory, absurd and unfair.

There are dozens of examples - Ashley being considered dangerous, but staff suggesting he go on public transport when the hospital van was busy. Ashley liking to host guests, but not being allowed to make tea.

Last year, Ashley had five sessions of equine therapy. A video filmed by his care workers shows him on a farm, gently grooming the horse, and then taking it for a walk to a stream.

At one point Ashley plunges sideways into the water, emerging dripping wet and roaring with laughter. "This is beautiful!" he shouts. Dave weeps quietly as he watches the film.

The funding for the therapy was not continued.

Ashley laughs after diving into a stream during equine therapy. Funding for the sessions was discontinued. Photo / Supplied
Ashley laughs after diving into a stream during equine therapy. Funding for the sessions was discontinued. Photo / Supplied

There is also the matter of Ashley's teeth. His parents requests he see a dentist were refused. The hospital said he was too dangerous to treat without sedation, and the Health and Disability Commissioner agreeing that to sedate him would "undermine" his relationship with staff.

When, a month ago, he was finally allowed treatment, Ashley was found to have significant dental decay. It broke Marlena's heart. "He used to have such a beautiful smile," she said. Eight teeth were removed.

The Peacocks try to maintain dignity and a working relationship with clinicians. But sometimes it is too much. They feel that both the psychiatrists and the Mental Health Act have too much power over an individual's life.

Once, in a meeting, a psychiatrist told the couple the hospital "owned" Ashley.

Marlena's frustration spilled over and she stood up, shouting: "You may monitor his every poo, and every pee, and every phone call, but you do not own my son." A grovelling letter of explanation from the psychiatrist later arrived in the post.

More recently, an advocacy group of disability specialists has been helping the couple bear some of the load. Wellington mum Kim Hall, whose middle son is autistic, saw a documentary about Ashley and thought she could help.

"I was horrified," Ms Hall said. "I saw what happened and thought, 'I don't want that for my son'. I didn't even know that kind of thing could happen in New Zealand."

Kim Hall with Vinny, aged 4, left, and Eddie, 2, at her home in Miramar, Wellington. Vinny is autistic and Eddie has a social phobia. Photo / Mark Mitchell
Kim Hall with Vinny, aged 4, left, and Eddie, 2, at her home in Miramar, Wellington. Vinny is autistic and Eddie has a social phobia. Photo / Mark Mitchell

"This is what normal people do"

When the recommendations of Ashley's latest review landed in March, the Peacocks felt a surge of hope.

The team was unanimous that a transition was practicable, and recommended work on a bespoke service run by Community Connections began straight away. It advocated employing a project manager, and developing a "day base" away from Tawhirimatea in the interim.

There was no need to transition him through another ward first, it said.

"Our view is that the only viable solution will be for Ashley to be transitioned directly out of [the unit] to a community placement."

And yet.

Three months on there is no project manager. There is no day base. Funding is yet to be finalised between the health board and the Ministry of Health.

The Peacocks, and their advocates, are concerned that a recent spate of high-profile killings involving mental health patients has affected Ashley's case. The Coroner is currently investigating four deaths, with three of the four cases involving mental health patients from Capital & Coast.

Concerns outlined in health board documents include funding, and the risks to public safety if Ashley is let out.

In response to questions about Ashley's case the health board said that in such cases there was "always a tension" between protecting and upholding the rights of the individual, and the rights of members of the community to protection and safety.

There is also the risk to the responsible clinicians. In the review paper, the Ministry of Health's acting mental health director, Dr Anthony Duncan, wrote while it was okay for Ashley's advocates to embrace risk "it won't be [them] who are going to be in front of the inquiry process if things go disastrously wrong".

The head of Community Connections, John Taylor, says, however, he is confident the community placement will work.

"My view is that Ashley needs a shot at this sooner rather than later. There are no guarantees. But it's not working well where he is now. Every dollar spent on him now is wasted. He's not getting any quality of life."

Mr Taylor envisages a house somewhere secure and semi-rural. A garden. Ponies and chooks. Initially Ashley would have to live on his own with staff, but eventually, Mr Taylor thinks there could be others living there too.

Ashley Peacock feeding the ponies nicknamed "Honey" and "Gorgeous" on his daily walk. Photo / Mark Mitchell
Ashley Peacock feeding the ponies nicknamed "Honey" and "Gorgeous" on his daily walk. Photo / Mark Mitchell

What he describes is all the Peacocks want, and what Ashley says he wants too. He has talked about living in a "fisherman's hut" where he could use the flies he painstakingly makes from feathers and beads to catch trout.

Dave says he is fearful his son will give up hope of leaving Tawhirimatea.

"He's lost control. He's had everything stripped from him. His dignity taken from him. Our dog is treated better at the kennel. I think most people would have committed suicide."

Occasionally, he still asks about getting out. "We say, 'we're still trying, Ashley'. But you feel pretty shit about it."

There have been a few bright spots lately. Community Connections support workers take Ashley out on weekdays. They've learned that instead of using restraint, a simple hand on his arm will calm him down. If he raises his arms, they will lower them, gently. It works most of the time.

Ashley has also been on three recent trips to McDonald's. Each time, he has cried, telling staff: "This is what normal people do."

During his walk to see the ponies, Ashley does some gardening at the chapel near the old museum, and has plans to sweep up the fallen leaves from the lawn during winter.

Sometimes, he goes inside the church, when it is empty. The chaplain doesn't think he's interested in Jesus. But the chapel has high vaulted ceilings, and is always quiet. The door is never locked. Ashley likes to sit there in the light, open space.

- NZ Herald

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