Rachel Smalley: Moral shame of mental health unit isolation

The lead story in the New Zealand Herald this morning features the story of Ashley Peacock.

He's a 37-year-old austistic man and despite a number of warnings about his treatment and experts categorically agreeing that his treatment is a breach of human rights, he's been locked in an isolated mental health unit for five years.

He's spent more then half of that time locked in a room which has a plastic-covered mattress on the ground and a plastic bottle to pee into, and that's it. And he's given 30 minutes a day outside of that room to do some exercise. And that's for two and a half years - straight.

Ashley is not a criminal, but his story is a challenging one.

He has a schizophrenic illness coupled with an intellectual disability. He's detained under the Mental Health Act - and this is because he became aggressive in the unit where he was living. Those who've reviewed his case say Ashley has sensory issues - and the noise in that unit overwhelmed him so he lashed out at others.

So into seclusion he went - and that's where he's stayed for years and years.

The National Intellectual Disability Care Agency says he has to come out. The Human Rights Commission says he has to come out. The Ombudsman says Ashley has to come out. In fact, an investigation in 2013 by the Ombudsman found that Ashley's protracted seclusion was contributing to the ongoing deterioration of his mental health.

All say his living environment is not appropriate for his needs.

His parents aren't allowed to visit him in the unit. They were told he had broken his arm, but they weren't allowed to visit. He reacted badly to a new combination of drugs and barely moved for weeks - and they weren't allowed to visit.

Ashley's parents are elderly - and they fear something will happen to them while Ashley is still in this situation.

His mother points out that seclusion is typically used as a last resort - not as a form of ongoing treatment. And she's right. And her son, lets remember, is not a criminal.

Can you imagine being his parents? If that was your child, locked in a room, and you can't enter that unit. You're forbidden to. God only knows what's been going on in there. And it's your child - and every expert says he shouldn't be in there.

The Capital and Coast District Health Board disputes its a breach of human rights, and says they walk a fine line between protecting and upholding the rights of the individual, and protecting the community.

He was almost released following the Ombudsman's report, but there was tightening of funding apparently, and psychiatrists wanted Ashley to be less disturbed before he was released from seclusion. But it is seclusion that has led to his deterioration.

But no-one is suggesting Ashley be released into the community, but a seclusion room with a plastic mattress on the ground and a urine bottle is failing him and fuelling his psychosis, and it's failing us too, surely. Is that the best our mental health system can do? Apparently Ashley can spend hours in the room wiping the walls. His carers describe his behaviour as "unengaged". Not surprising, perhaps, given the atrocious circumstances that he is living in.

His needs, as I said, are complex - but he is not a criminal, so how is it, in this country, that we can sanction keeping someone in seclusion for over a half a decade? That, in itself, is a greater crime.

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