‘Fear and harm’ for teens in adult wards

Fifteen teenagers have been admitted to a Christchurch inpatient unit for adults with intellectual disabilities in the past decade, with some experiencing ‘‘fear and harm’’ and ‘‘often being witness to violence’’.

The Assessment, Treatment and Rehabilitation (AT&R) unit provides compulsory care to adult patients with intellectual disabilities who have been charged with a criminal offence. It has been mired with safety problems, with more than a third of its 27 staff being assaulted by patients this year.

Teenagers aged between 15 and 17 were admitted to the unit over the last decade, for periods ranging from one day to over a year, according to Canterbury District Health Board (CDHB) figures.

The admissions breach the United Nations Convention on the Rights of the Child (UNCROC) and Ministry of Health (MOH) guidelines, which state children should only be treated alongside adults as a last resort and for the shortest period possible.

The CDHB raised concerns with the MOH repeatedly about the facility this year and complained the ministry failed to appreciate the seriousness of the situation and lacked urgency in its response.

Children’s Commissioner Judge Andrew Becroft said the issue was ‘‘highly concerning’’.

Intellectual disability units for children and young people were ‘‘overstretched’’ and under ‘‘huge pressure’’, an issue that ‘‘must be accorded urgent priority’’, he said.

‘‘We realise specialist health services do the best they can with the resources provided, but delivering treatment to children in adult facilities is wrong in principle.’’

Mixing children and young people with adults was a breach of international conventions, but was preferable to no treatment or treatment a long way from home, he said. ‘‘However, urgent improvements in resources and response are urgently needed, especially further investment in specialist services.’’

Becroft would discuss the issue with new Health Minister David Clark ‘‘at the earliest opportunity’’.

Correspondence obtained through the Official Information Act revealed the CDHB rang alarm bells with the MOH this year.

In an October email, head of mental health Toni Gutschlag wrote that a young person had been ‘‘living for many months in a secure facility for adults because of a lack of secure disability services for young people’’.

‘‘Both MOH and CDHB staff are well aware that [the young person] is frightened by the violence [they] witness in this service and [their] placement is in clear breach of UNCROC requirements’’.

In a March email, Gutschlag outlined serious safety issues in the unit and wrote: ‘‘I don’t see … any sense of urgency with responding to the issues we are raising.’’

In another email, she wrote: ‘‘I’m not getting a sense that MOH appreciates the seriousness of the issues we have here.’’

In April, a CDHB staff wrote that the unit could not accept any new patients as ‘‘we are really struggling to contain the risks currently, noting a long standing staff member was seriously assaulted‘‘.

CDHB head of psychiatry Peri Renison raised concerns about the underfunding of disability services along with other psychiatrists from around the country in a letter to the MOH in May.

She wrote ‘‘regular admissions of youth under 18 to the AT&R unit’’ was not consistent with UNCROC.

‘‘Young people have experienced fear and harm in the AT&R service, often being witness to violence,’’ she wrote.

There is one facility in New Zealand catering to young people with intellectual disabilities who have committed an imprisonable offence. Based in Porirua, it has 10 beds. Clark said it was ‘‘patently obvious’’ that the previous government had ‘‘failed to adequately resource and manage DHB funding’’.

‘‘The disability sector has clearly felt the same pressure … We will restore funding to the health system to allow access for all.’’

A MOH spokesman said the ministry was unaware of any person under the age of 18 being placed in a secure disability support service for adults.

‘‘They are admissions based upon clinical need, made at the CDHB’s discretion and will usually be made to manage an acute crisis.’’