Physical Control in Care - A Manual of Child Abuse

A deeply disturbing story in the UK's Observer newspaper caught my eye this morning.

“Revealed: brutal guide to punishing jailed youths”
a picture of Carol Paounder. Her expression is grave and her cheeks look sunken with worry - she gazes into the distance
Carol Pounder from Burnley, whose 14-year-old son Adam Rickwood was found dead at Hassockfield secure training centre in County Durham in August 2004. Photograph: Christopher Thomond. © The Observer.
In the UK, children between the ages of 12 and 17 years old remanded to custody awaiting trial or sentenced to custodial sentences are despatched to one of four privately run "Childrens' Prisons" - Oakfield, Hassockfield, Rainsbrook and Medway. These are euphemistically described as Secure Training Centres (STC's).

The Children's Rights Alliance for England (CRAE) have been campaigning for some time to publicise the conditions within these institutions

"CRAE first became involved in challanging the use of very painful and humiliating restraint in STC's in 2005, when our national co-ordinator was part of... [an] independent enquiry into the use of physical restraint, solitary confinement and forcible strip searching in custody."

They say in the (pdf download) Campaign report just released

"Grave concerns about the treatment of children in these centres first emerged following the restraint‐related deaths of 15 year‐old Gareth Myatt and 14 year‐old Adam Rickwood in April and August 2004 respectively.

The bereaved families have spent years seeking justice and accountability for what happened to Gareth and Adam, working closely with INQUEST and the law firm Bhatt Murphy. Most of the information about the mistreatment of children in STCs has only become available through the inquests into the deaths of Gareth and Adam, and subsequent legal action brought by Carol Pounder, Adam's mother."

The case of the late Gareth Myatt is particularly shocking as the Guardian reported three years ago

"Gareth Myatt was just three days into a six-month sentence at Rainsbrook Secure Training Centre in Northamptonshire when he was restrained by three members of staff after refusing to clean the sandwich toaster.

He tried to tell them he couldn't breathe, but they did not release him. As they held him down, Gareth choked on his own vomit and died. He was 15 (and four feet, eleven inches tall)."

During the restraint that killed him, he both vomited and defected. It was revealed at his inquest that other children had been seriously injured after the same techniques had been applied.

"Distraction techniques", i.e. repeatedly punching the child in the face, used routinely at one centre, have already been found to be unlawful by the Court of Appeal.

The Physical Control in Care manual itself makes equally engaging reading

‘The member of staff drives straight fingers into the young person’s face, and then quickly drives the straightened fingers of the same hand downwards into the young person’s groin area. The member of staff’s other arm will extend fully, with their palm uppermost, and their elbow will be driven back whilst moving their hips laterally into the young person’s rib cage. The member of staff will continue to carry alternate elbow strikes to the young person’s ribs until a release is achieved’.

‘The member of staff will rake their shoes down the young person’s shins and drive their foot into the young person’s instep’.

‘The member of staff will move their hips forward allowing them to strike with extended fingers into the young person’s groin area. The member of staff (sic) buttocks are then driven rearwards into the young person’s groin whilst simultaneously driving forward with both of their arms to achieve a release’.

‘The member of staff will rake their shoes down the young person’s shins and drive their foot onto the young person’s instep. Should the young person persist then the member of staff can drive with extended knuckles of both hands into the young person’s rib cage area. The member of staff can also break the young person’s grip by pressing an inverted knuckle into the base of the young person’s thumb and applying of (sic) downward pressure’.

The manual also helpfully specifies the approved form of handcuffs suitable for the 12 - 17 age range. Only the Hiatt Handcuff Model 2015 may be used - and thoughtfully they come in a variety of colours

Just the ticket for a stroppy 12 year old

Christopher Gillberg, the well-known Swedish Autism researcher, has looked at the prevalence of Autistic Spectrum Conditions amongst children in forensic detention. The study found

1) the prevalence of ASD in these institutions (at least 13%),
2) the distribution of diagnostic criteria in this special population (mostly social interaction and communication problems, few or atypical flexibility problems),
3) the degree of comorbidity (the rule rather than the exception),
4) neuropsychological test profiles (lowered IQ with uneven profiles),
5) types of crimes and offences (very heterogeneous, often stress-related with dissociated features),
6) mental health care needs (high),
7) special clinical features (especially expressions of flexibility deficits in non-classical areas and proneness to dissociation).

The first of many notable findings is the prevalence of ASC's in this group is 13 times greater than that of the general population.

Another pertinent study that may indicate why so many Autistic children find themselves in these institutions was authored by Pinto-Martin et al. in 2005. They found that

Caregivers reported that 18.5% of children with autism had been physically abused and 16.6% had been sexually abused. Physically abused children more likely had engaged in sexual acting out or abusive behavior, had made a suicide attempt, or had conduct-related or academic problems.

Sexually abused children more likely had engaged in sexual acting out or abusive behavior, suicidal or other self-injurious behavior, had run away from home, or had a psychiatric hospitalization.

We are naturally lead to assume that the nearly 1 in 5 Autistic children that suffer abuse go on to develop the kind of behavioural issues that leads them into the forensic estate and the dumping grounds of the STC's.

My own experience is little different to that outlined in the two papers above. As you can imagine I don't particularly want to besmirch the sanctity of this Sunday afternoon by publicly recounting my own particular tale - but  more from fear of a visit from the Police demanding names, than religious conviction.

My first reaction on reading the Observer this morning was an instant recollection of one of the many foul institutions that are the seamarks of my childhood -- Braithwaite Hall, and of Sophie who's face I could see before me as I read.

Braithwaite Hall was an "Assessment Centre", a place where disturbed and usually criminal children were placed by the courts while it was decided where they should be permanently housed. The options ranged from foster-care, children's homes, detention centres and Borstals. I was 13 years old when I was sent there by a Magistrate's Order.

I was already by this point, an eight-year veteran of the care-system and I'd heard all about "The Hall" as the kids used to call it. Being sent there/back-there was regularly used as a threat to non-compliant kids.

Later on when I was 15 and refusing to return to the most violent institution I ever encountered -- a loathsome residential 'school' set in the English countryside -- I was similarly threatened. I resolved to kill myself rather than return. At the moment of this decision, I was overcome by a wave of happiness and a feeling of peace, the like of which I had never experienced before... ... But, I digress, as is often my way.

Induction to The Hall began with a medical with Dr Patel, where the children had to strip naked and were examined and it invariably including a detailed genital inspection. I knew what was coming. and refused to take of my underpants for Dr Patel. He was not keen on taking 'no' for an answer and I was equally keen to avoid what he had in mind.

He quickly called for help which served as an introduction to the institution's kommandant, Alex. He  was a spectacularly repulsive, full-bearded man, well over 6 foot tall. Morbidly obese with perpetual rings of sweat staining his nylon shirts. He bear-hugged me ramming my face into his stinking arm-pit and gave me his 'this is a community, with community rules and we all abide by the same rules' speech.

Anyway, this story is about Sophie, not me. Sophie was inducted at the same time as me. She was 14, eye-watering beautiful, already sexually active, and utterly unattainable... ... I didn't really know her although I'd seen her around in different homes, and schools and spoken to her a few times. She equally clued-up to the Hall, though. She kicked-off worse than me. Much, much worse. She ended up being dragged off to the secure unit where Dr Patel injected her with the adult dose of Largactil.

I've no idea if he helpfully removed her clothes before dumping her on the bed -- perhaps he took the opportunity to complete his 'medical'. Perhaps he raped her. Perhaps Alex joined in. I don't know.

All I know for certain that is in the morning, she was dead.

There was a terrible hoo-har the next day. Even in the antediluvian 1970's, dead children were difficult to sweep under the carpet. It ended up in all the (local) papers. Dr Patel was suspended. Eventually, he was even struck-off, although he was never prosecuted.

Anyway, for those of you who are inclined, it won't be difficult to find Sophie, Dr Patel and even me, in some recently digitized local newspaper archive. You can compare and contrast the two stories.

Then ask yourself what has changed over the last 31 years. The answer is both very little and very much.

For Autistics, the issues of their vulnerability in the care, medical and prison systems are being addressed most forcefully, not by attacking and destroying that that ails them - but by attacking and destroying the victims' very existence.

I'd like to leave you with a video by Roderick Cobley from the London Autistic Rights Movement. It has to be said, the Autistic status of some of the more famous people featured is a little dubious to say the least, but it is a point well made. The sub-titles are very important to the story, so please turn them on.

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