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 THE BIG ISSUE IN SCOTLAND AUGUST 22-28,2002

Forgotten patients

Carstairs spotlights a major gap in services

ByLiam McDougall

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This story has been passed on to me by Lucille Crichton:

Is this what lay ahead for mental health patients in England through reduction of funding?

When David and Lucille Crichton look out over the Dundee landscape which now defines their horizons, they find it hard to believe it took almost three years to get their son back to the place they call home. . .

In the beginning it was all for the best. Their son Darren, then 17, would be transferred temporarily to the State Hospital at Carstairs for his own safety after his schizophrenia

worsened and a lack of resources meant that doctors could no longer treat his mental illness in Tayside. .

Although it was supposed to be a short-term measure to deal with his newly-diagnosed condition, little did they know this move would be the start of a battle for freedom that would spark widespread media attention and furious political debate.

He would become one of more than 30 'forgotten patients', trapped in the high-security unit despite doctors' recommendations that he should be returned to the community.

"We could not understand why it was happening," says David. "It was frustrating. Everyone agreed that he should not be there, but he was forced to stay because there

were no beds outside of Carstairs.

Then, when there were beds available, there was no staff." The frustrations endured by the family began to mirror their experiences when Darren was in his early teens and they first suspected that something was not quite right. After a relatively normal early

Child-hood, Darren began using alcohol and drugs at the age of 14.

His personality became more erratic until, says his mother, it began to feel like she was losing her son. A few weeks later she almost did when Darren was rushed to hospital

and lay for three days on a life support machine after taking Ecstacy tablets.

The sight of her son lying motionless surrounded by drips and bleeping monitors terrified her. Both David and Lucille began questioning why Darren had ended up like this. Were they bad parents? Could they have done more to stop him from turning to drugs and alcohol? Was it all their fault?

Later, as Darren's schizophrenia developed, it became clear their son was ill. "We tried to help him any way we could, but he began saying things like he could see the

devil in our eyes and that we wanted to harm him. At that stage we knew he was ill and that he needed to see a psychiatrist."

Darren was diagnosed as suffering from manic depression and schizophrenia. After electric shock treatment he assaulted a nurse and was sent to Carstairs for his own

safety in January 1999. Within six month’s, with his condition improving significantly, doctors were in agreement that he should not be there. However, there were no places available for him in Tayside, or elsewhere, for the scores of other "delayed discharge"

patients who walked the same corridors in Carstairs.

Incensed by the situation, the Crichtons began to air the thorny issue in public, hoping to make the government face up to its failings on mental health provision, an area

it pledged to make a key priority when elected.

It appeared that people with mental health problems were caught in an impossible position. Although nothing further could be done medically to treat their illnesses, they were unable to leave the high-security unit. In fact, it was acknowledged that the conditions of many, who would be better served in their local community, were actually deteriorating because of the distress & frustration caused by being held there against their will.

An unrelenting campaign of letter-writing to welfare groups and MSP’s followed as did formal complaints to the local health board and the Scottish Executive. Both David and Lucille began to talk of their son's human rights being abused. He was a person with mental health problems, after all, not a convicted criminal who might be a danger to society.

However, nothing appeared to change. For months they were told that the Murray Royal, the nearest suitable facility for Darren, had no bed spaces. Later, when they were informed there were spaces available, staffing levels were insufficient to take him on.

Earlier this year, with his family fearing Darren could still be held in Carstairs when he turns 21, the severity of the situation was revealed. As the Scottish Executive was

reeling from pressure being applied by the Crichtons and those in the medical profession, the Scottish Health Advisory Service found that at anyone time as many as 40 patients at Carstairs were in a similar position.

Such patients are easily forgotten, partly because of public misconception that Carstairs houses dangerous, mentally ill criminals. In fact only a third of patients arrive at the hospital via the courts. Another third are transferred from prison due to a mental health condition, while the final third have committed no crime.  In January Darren's case was taken to the public petitions committee at the Scottish parliament.

David Crichton told the committee:

"My son is one of the patients entrapped in the hospital. By entrapment I mean people who are ready to move to their local hospital or community, but who have nowhere to go. "I believe that keeping people like my son incarcerated in Carstairs breaches their human rights. If they had been through the judicial system they would have received a sentence they could serve and eventually would have been released. But the fact that

they are mentally ill means there was no time limit placed on it." He added that he feared his son may become institutionalized and that Darren's condition could deteriorate if he

remained at Carstairs.

Just days later, Darren himself spoke to journalists about his situation from Carstairs. In what is believed to be the first press conference held by a patient in the secure hospital, he said it was "ludicrous" that he had been forced to stay there for years because his local health board could not find a bed for him at a lower-security

unit nearer his home. "A lot of guys in here are waiting for a transfer like me. I think it's

ludicrous, " he said. "I am trapped, that's really what I am. I want to be nearer my family and to get on with my life.

"The only way things will change is if more money is spent on hospital places so people like me can be transferred. Carstairs is good: the staff are nice and there are lots of things to do, but I want to go home now."

Darren added: "I feel let down but I am still fighting on. There have been odd days when I have wondered if I will ever get out but my family keeps me going. If I give up now I will end up staying even longer."

It took another three months of intense pressure before Darren was found a bed in the forensic psychiatric ward at the Murray Royal. Six weeks later, doctors said his condition had improved and he was allowed home to Dundee. "It just seems ridiculous that he spent so much time in Carstairs and that it took so little time for him to be allowed to come home," says David. "I feel bitter that my son has lost such a large part of his life. He missed his teenage years because of his mental illness and the last three

all because of a lack of money.

 He went in there a boy and came out a young man. It was like he was a prisoner and the blame must rest with the Scottish Executive." Both David and Lucille say that at least they now feel they have their son back. Even the day that he was released, the family were determined not to get their hopes up. "It was such a relief for all of us when

he was let out," says Lucille. "We would not allow ourselves to believe it was happening until it actually did. We had our hopes dashed so many times." David adds: "He just wants to get on with his life and put it all behind him. It was a terrible situation to be in. Now is the time to look forward."

In recent months the Scottish Executive has given the green light for a number of 'entrapped patients' to be moved into the community as their inaction came under the spotlight. Publicly, the Executive says that the position at the State Hospital will only ease when the right local facilities were in place. But, as Darren was released, an investigation by The Big Issue in Scotland revealed that more than 100 mentally disordered offenders are languishing in the locked wards of hospitals across Scotland because there are no alternatives currently available for them.

The situation, say campaigners, is being hampered by protests from local communities opposed to any specialist psychiatric unit being built in their areas. They are keen

to stress that such facilities do not present a public risk. However, although many are still waiting for freedom from Carstairs, the long-running campaign by David and Lucille Crichton has paid off. 

This week,Darren Crichton will spend his 21st birthday at home with his parents..