Two reports released yesterday underline the risks of rights violations in institutional settings.
The first, a leaked report obtained by the BBC, tells of a 17 year-old disabled girl who was living in a residential health setting in Plymouth. She was sedated and flown to an adult setting in Dundee, as she approached her 18th birthday in 2007. The BBC reports that no consent was sought or obtained from the girl, either for the medication or the transfer to Scotland. Her parents were also not consulted. The girl’s advocate opposed the actions but was ignored. Dr Gabriel Scally, the former head of public health in south-west England, fought to get an investigation into the unlawful treatment and was refused a copy of the subsequent report.
No information is contained in the BBC news piece about any recommendations the report may have made about wider implications for policy and practice. Clearly this case raises questions about the power of advocates to take action to defend the rights of children when there is an immediate threat of violation.
The second report was published by the prisons inspectorate and is a review of the Minimising and Managing Physical Restraint (MMPR) system introduced in secure training centres from 2013 and due to be used in all young offender institutions by July 2016. As the chief inspector of prisons explains in his introduction, MMPR was developed following the restraint-related deaths of two boys, Gareth Myatt and Adam Rickwood, in secure training centres in 2004. The review found:
- Prison officers in young offender institutions regularly inflict severe pain as a form of restraint. These techniques would only be lawful in extreme situations, yet the inspectorate found “pain used for non-compliance and failure to obey staff instructions immediately. In one use of force record, the reason for use of pain was recorded as ‘refusal to move back to cell. Needed to move [child] to continue with the regime’.”
Another shocking case concerns a child with a broken wrist (inspectors don’t say whether the injury occurred during restraint). The boy was threatened with pain because he refused to follow orders. Inspectors concluded, “Poor recording and unclear CCTV footage meant that we were unable to verify if a pain-inducing technique was actually used on the boy.”
Spot checks on general restraint records revealed that pain had been used more times than the prisons had officially recorded.
- Frequent reports of children struggling to breathe during restraint, with some staff sceptical that children are telling the truth when they complain of being unable to breathe. The report reminds readers that Gareth told the three officers holding him down that he couldn’t breathe. They refused to believe him, retorting: “If you can talk, you can breathe” and Gareth died within minutes.
- “Several examples” of children having all of their clothes removed whilst being restrained. A case study graphically highlights the assault on children’s dignity: “One boy we spoke to was restrained after threatening staff with a broken plastic knife. Once staff had restrained him and taken the knife, he was moved to a special cell and asked to remove his clothes: ‘When they got me to the special cell they asked me to take my clothes off. I said I would … They took me straight to the floor, before I had a chance to do it myself. Someone put a knee in my back, which did hurt a lot. They took my shirt off completely, then my trousers, boxers and shoes. They chucked a jumper on me to cover my bum.’”
- “Dangerous examples” of restraint being used on children with medical or other conditions. Inspectors report that, “In general, staff were unfamiliar with the content of [individual restraint] plans; this was a serious oversight that could have led to significant injuries.”
- Girls being restrained in a way which evokes past abuse. For example, one girl reported, “‘One member of staff grabbed my neck and then others pushed me to the ground and held me there telling me to calm down. While I was on the floor a male member of staff was holding my head almost between his knees. I have been sexually abused in the past so you can imagine how that made me feel. I was terrified.’”
- Inspectors watched CCTV footage of children being kept in a head hold whilst being walked up and down flights of stairs and across long distances. Painful techniques were used even after children had calmed down. Children’s accounts in the report include, “‘I had my wrist bent back; all the while I was walking up the stairs. It was really painful. I went up three landings with my neck and wrist in flexion.’” and “‘My wrists were behind my back and my head was pushed down and I was taken all the way to the seg like that. I wasn’t kicking or going mad but I was trying to struggle because I wanted to get some control back.’”
Many more examples of abusive treatment are contained in the inspectorate’s detailed report. Its 10 recommendations include the cessation of restraint techniques which deliberately inflict pain on children, no more strip-searching under restraint and Local Safeguarding Children Boards and local authorities ensuring they are equipped to maintain effective independent oversight of restraint.