People with a learning disability or a mental health label are not treated in a respectful manner, says Terry Bryan
Does anyone ever look at the lofty principles organisations use to describe themselves? Do we think any of these actually make the transition to operational levels?
I have worked alongside vulnerable people, such as those with learning disabilities or mental health problems, for more than 30 years. There have been some changes in that time. Currently, we like to think we are “person centred”, where the fundamental idea is that the vulnerable person holds the power, not the nurse or carer. Many of our brightest minds have elaborated on this, and we now stand at a glorious crossroads where vulnerable people write their risk and support plans and live their lives as they wish. Actually, no.
In my current work, I lead teams that transfer vulnerable people between services in the UK and abroad, attend court hearings, funerals and so on.
We rely on the expertise, patience and experience of the teams who deal with the person at the centre of each transfer. We ensure that the person is given as much information as possible before the move, is involved in how it happens and is treated respectfully, to complete the transfer with a minimum of anxiety or distress. In a person-centred way, if you will.
That’s where things tend to change. For example, I have arrived at services having spent the entire journey gently talking and listening to an extremely angry person, using every skill I know to keep the peace, only to be met with a wall of silence or grunts from the staff. That’s if they even answer. The other day, an entire hospital wing just wasn’t answering. Our passenger shrugged as I pressed every door bell I could find. Eventually, we were discovered accidentally by staff going off shift. Sometimes staff do not even say hello to us. Sometimes we are ignored - left in the middle of a building, not knowing who to talk to. Staff mumble under their breath, whisper in corridors and ignore our passenger when they ask for a bathroom or a cigarette after the long journey.
So, once again: how many lofty principles actually make the transition to operational levels?
It happens abroad too. I was recently in the Far East to bring a man back to the UK. The service there blatantly ignored him when he asked a simple question, yet immediately answered me when I asked it on his behalf. The man shrugged and loudly whispered that it “happened all the time”. I was indignant on his behalf, but he persuaded me not to pursue it. He called it cultural.
We generally have a good idea of a person’s level of risk before we meet them, but I always ask for more information, such as favourite topics of conversation or trigger words to avoid. I would estimate that 90% of the staff I ask tell me nothing. Staff will point to individual care plans and risk assessments, all written by staff and kept in the office. Individualised yes, person centred, no.
Our passengers invariably accept this level of rudeness. As a professional nurse, responsible for the safe and least-problematic transfer I can provide for each person we ride with, this is unacceptable to me.
I’ve worked as a Care Quality Commission bank compliance inspector this year too. At 20 unannounced visits around the country, I was treated with utmost respect and offered all the courtesies expected. So why aren’t I greeted in the same way when I arrive with a passenger with a learning disability or mental health label? Why isn’t the person I’m with accorded the same courtesies I was offered as a CQC inspector?
In a former life, I worked at Winterbourne View. After what I saw there, I wanted change and I still do. I’m really not convinced things are changing fast enough.
Terry Bryan was the nurse whistleblower at Winterbourne View