COMMENT:

It is sadly rare that a mental health story has a happy ending.

The case of Ashley Peacock however is an exception. The Herald reported this week that after a long campaign to secure his release from effective isolation, the 40 year old was moving from what essentially was a cage to the freedom of the countryside.

Peacock, who is autistic, intellectually disabled and has psychotic episodes, was made a compulsory patient under the provisions of the Mental Health Act. That meant for 20 years he was kept in institutions.

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The most degrading detention Peacock endured caught the attention of the Ombudsman, who described the confinement as "cruel and inhuman."

Amnesty International and the Human Rights Commission joined in criticising the circumstances of Peacock's seclusion, which saw him spend an unconscionable amount of time locked in a 10m sq room, out of sight and out of mind.

The longest time he spent in these degrading surroundings was two and a half years, allowed outside for just 30 minutes a day. Care providers defended the arrangements on the basis that Peacock was violent towards staff.

A senior doctor at Capital and Coast District Health Board described Peacock as "the most assaultive patient we've ever had" who had attacked staff and patients at the Tawhirimatea secure facility in Porirua.

His parents maintained their son's aggression was a result of his being in seclusion, which left him angry and confused. Ashley Peacock's history has been well documented, and it is clear he tested carers and clinicians.

His life has not been easy, with experts saying he has an "abnormal internal world", which could include bizarre hallucinations and frightening voices, and was both traumatising and unpleasant.

But it is hard to escape the conclusion that without the tireless efforts of his parents, the intervention of mental health advocates and, to be fair, news media accounts of his treatment then Peacock could still be in a cold, grey room.

There has been some comment to the effect that the cost of Peacock's care package — $850,000 a year — is excessive. In fact the bill comes in below the cost to the public healthcare system for his previous care behind locked doors where all the assessments concluded that his mental and physical health was suffering and even worsening.

In other words, the costs of his care in the bleak surrounds of an isolation unit were unlikely to fall, and may even have increased.

It is a challenge for any society to care for its disabled members. Suitable arrangements require adequate funding and suitably trained staff.

But New Zealand expects that when citizens are subject to the care of the state a decent level of support will be provided. In the Peacock case this basic assumption was not met, and those responsible for his care at various times can be justly criticised in that regard.

Organisations which hold people in detention — such as district health boards — have a duty to protect the human rights of patients in their care, and to be accountable to monitors who act as society's watchdogs.

For the first time in two decades, Ashley Peacock will experience life outside confinement. His spirit, at last, will be released.