Several decades have passed since mentally disturbed people were shut away in places worse than prisons. Or so we thought. Kirsty Johnston's moving account for us yesterday of the life of an autistic man held in a secure unit at the former Porirua psychiatric asylum suggests not enough has changed. Ashley Peacock, 37, is tormented by internal voices and hallucinations and disordered sensory perception that makes loud noises unbearable. He knows this and does his best to control his response. But sometimes he lashes out with flailing arms and clenched fists. He needs people with him who know how to help him.
Placed in the secure wing at Porirua five years ago, he is locked in a building for all but 90 minutes a day when staff are able to accompany him outside. The building has a small lounge with a TV and a tiny enclosed courtyard with a wire mesh ceiling. The patient spends more than half his time inside locked in a bedroom consisting of a plastic-covered mattress on a linoleum floor. With nothing to do, he takes frequent baths and incessantly cleans his room. For long periods, his activity is recorded simply as "unengaged".
Nobody claims this custody is doing him any good. He was sent there when his psychotic episodes were becoming more frequent but that frustrating environment appears to be making him worse. Autism specialists, patient advocates, the Ombudsman and the Human Rights Commission agree it is not the right place for him. But where can he go?
Three months ago he was to be transferred to a community house and given sufficient supervision but there is no sign of that being done, or of funding for it from the district health board of the Ministry of Health. In response to our report yesterday, Opposition parties were quick to call on the Minister of Health to intervene and order the board to make the funding and facilities available without further delay. But while compassion and human rights are the paramount concern they are not the only concern. Public safety and public finances matter too.
When Mr Peacock is allowed out of confinement for 90 minutes a day he is accompanied by two staff members. Doubtless he will need that level of supervision around the clock in a more open environment. A community care agency envisages housing him in a quiet, rural location. The outdoors and animals seem to be therapeutic for him. It sounds like a very costly arrangement for one patient. The agency believes he could be joined by others eventually.
Mental disorders differ widely in the risk they present to the suffered and to others, and the treatments that might be helpful. It is hard for the public to know whether a case that may be rare in its particular circumstances is nevertheless just one of many requiring equally personalised attention. It may be beyond the means of the most compassionate state to provide the specific personal needs of each. But it ought to be possible to provide more humane conditions for all of them than this poor man has suffered for the past five years. We can do better.