Learning Disability Practice conference 2018: mother of man with autism recalls his traumatic transition to adult care

Jill Nasralla described the distress caused by her son's medication regimen and police arrest

A mother has described how her son, who has autism, was restrained for several hours, and experienced broken teeth and ultimately, police arrest following his transition to adult services.

Speaking at the RCNi Learning Disability Practice conference 2018 in Manchester this week, Jill Nasralla wept at times as she recalled Adam’s story and the post-traumatic stress disorder he now experiences.

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‘Adam is 24, is severely autistic, and had until last year been in hospital from 18,’ Ms Nasralla told the audience. ‘He likes Thomas the Tank Engine, chocolate labradors, trains, aeroplanes and egg cups.’

Ms Nasralla gave her account to an audience of learning disability nurses and students to show the lessons that can be learned from a failure of care.

'Medication left Adam in a ‘chemical straitjacket’

At the age of 18, Adam was detained under the Mental Health Act 1983 and taken to a learning disabilities inpatient unit, Greenways Assessment and Treatment Unit in Macclesfield.

The difference between the care he had received in children's services compared with that in adult services was ‘staggering’, Ms Nasralla said.

Adam was subject to regular restraint and, when transferred to Wast Hills Hospital in Birmingham, his medication tripled within eight months, leaving him in a ‘chemical straitjacket’.

‘How do you cope with seeing black and purple bruises, nail marks dug into his arms and broken teeth?’ Ms Nasralla said. ‘How do you deal with having to witness your once-articulate son lose his speech, and his wonderful signwriter handwriting disappear through the side-effects of haloperidol – and have no one care.’

Removal of autism diagnosis

Staff at the independent hospital restrained Adam for up to 11 hours, removed his autism diagnosis, told the police he was culpable for his actions and he was arrested.

Ms Nasralla said the situation still haunts her son and ‘he needs constant reassurance that the ambulance won’t take him away to the nasty hospital and that his bathroom door won’t be locked’.

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When Adam was transferred to Recovery First in Widnes, Cheshire, Ms Nasralla said his care improved considerably.

She added: ‘There was no special formula – the ward staff just showed kindness and understanding of his autism and trauma, as well as patience, consistency, and a commitment to help him and listen to the family.'

The staff reinstated his diagnosis of autism and realised he responded better to being outside the confines of the hospital.

Enjoying happier times

Five years on from being admitted, he was discharged and now enjoys walks, swimming, sport and family holidays.

In 2016, Worcestershire County Council published a serious case review into the care Adam received, referring to him as TT.

It found: 'A very vulnerable young man suffered a sequence of traumatic experiences which may adversely affect him for many years. This was a wholly undesirable outcome of the decision to place TT in a specialist autism hospital.

'Undue reliance on restraint'

'TT’s placement at Wast Hills completely failed. There appeared to be unduly heavy reliance on restraint to manage his presenting behaviour before it was decided that because he did not respond positively to their approach, TT’s diagnosis of autism and learning disability should be removed.'

Private legal action against Wast Hills and West Mercia Police ended in an out-of-court settlement.

Both Wast Hills and West Mercia Police were invited to comment. The West Mercia force referred to a statement it made in relation to the case in 2014, when it said officers had to make quick decisions in difficult circumstances to protect the public every day.

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