This September it will be five years since Aidan left Skye House, the adolescent mental health ward in Glasgow where he spent nine months.
Now 21 years old, Aidan – who has a diagnosis of autistic spectrum disorder (ASD) – and his family are convinced it was not beneficial for him to spend so long in hospital.
Those who work with people who are severely mentally unwell are clear that psychiatric hospitals are life saving, and stress they are an essential aspect of treatment services. But campaigners have called for more investment in community services, arguing they are key to more successful hospital discharges, and allow people to rebuild their lives more quickly and sustain a recovery.
Aidan and his family believe wider availability of community treatment, suitable for someone with ADS, would have made a huge difference and avoided the trauma they say was caused by a long stay at Skye House. Aidan - though using only his first name - is speaking out in the hope his experience can help inform positive changes to the system for others.
Though previously high levels of distress have dissipated now, Aidan’s obsessive compulsive order has returned and he is isolated from others his age and unsure of what the future holds. “I just feel sort of numb,” says Aidan, who loves music and is interested in politics.
He and his aunt trace back the start of his mental health struggles to 2015, when his grandparents died just a year apart. By December that year the severity of Aidan’s depression – along with OCD and anxiety – saw him admitted to Skye House – Scotland’s only adolescent mental health unit – on a voluntary basis.
But his stay was fraught from the start, as he struggled to adapt to what he describes as a “pretty draconian regime” with his ASD leading to regular periods of high distress – described by autism specialists as emotional dysregulation.
He’d had no past contact with the criminal justice system but by mid January 2016 police were called due to behaviour staff considered to be verbally abusive. He and his aunt claim staff did not understand how to deal with his ASD.
After six weeks Aidan’s family supported his decision to return home and believe more treatment at this stage could have helped him recover. But without sufficient community support in place the situation soon deteriorated with Aidan becoming suicidal and having to be stopped from running into traffic on the road near his home.
He was readmitted to Skye House in February, this time under a short-term detention order for 28 days, but due to his autism, struggled to cope. Staff responded to challenging behaviour by regularly calling police throughout March and April.
In one incident he broke a table and claims he was threatened by police with being taken into custody. “The reason they were called was because I had destroyed property and because I used abusive language,” says Aidan. “I would get very highly agitated. But I felt staff just didn’t understand my condition.”
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His aunt stressed her complaint is with the system, not individuals. But she maintains this should not have been necessary. “If you listen, reassure him, de-escalate as much as you can and let [the “melt-downs”] run their course,” she says. He has never been violent with anyone inside or outside the family and the people who now work with him in the community now have never expressed any concern.”
His father told a mental health tribunal in May that the environment at Skye House was contributing to his son’s distress and “challenging behaviour”. But it decided “on balance” to grant a compulsory treatment order.
Following this speech, occupational and psychological therapy sessions, only available to him on site, were put in place. De-escalation techniques were agreed so police would no longer be called.
“This started off well,” says McGurk. “But then Aidan’s OCD became very bad, he couldn’t get out of the shower because of all the rituals he had to carry out.” She says staff did little to resolve this and he started missing sessions and even meals.
The resident medical officer finally admitted that they lacked expertise in ASD and suggested a referral to a specialist psychiatric unit at St Andrew Heathcare, Northampton, which has attracted controversy in recent years, causing the family great concern.
Meanwhile, it was confirmed the treatment order was due for review in October. McGurk claims community social work said that even if it was lifted it would be a further 12 weeks before Aidan could leave, to allow support and benefits to be put in place.
But on the 7 September the family received a phone call out of the blue, letting them know Aidan could go home for good two days later. Funding for St Andrews had not been granted. It left them feeling previous decisions to keep in hospital were arbitrary.
“We feel Aidan would have progressed better at home with a robust, documented community support plan and some provision for short overnight stays once a month to provide respite support for the family,” says McGurk. If that had happened she believes he would have stayed more in touch with his friends would have better self esteem.
Aidan too struggles to feel positive about the experience. “When I was there [in Skye House] I was just thinking that I wanted to get home and get support there. It just felt like a very dark road that I was on.”
A spokesperson for NHS Greater Glasgow and Clyde said: We are very sorry to hear that this young man and his family are unhappy with aspects of his stay and for them they remain unresolved.”
They said they could not discuss his case due to patient confidentiality but claimed the safety of both patients and staff was a priority.
“The team at Skye House pride themselves on the care and treatment they offer young people,” they added. “Each patient has a care manager allocated to them, who meets with family and supports family throughout the young person’s time with us.
“Our mental health teams work hard to protect the needs and wellbeing of our patients with those of our staff. While there will be instances where the police will be called, this will be as a last resort, when the use of therapeutic support has not been able to deescalate a situation and there is a risk to a young person, other young people, or our staff or where a staff member feels they’ve experienced violence and aggression.
“We recognise that when a young person requires inpatient psychiatric care it’s a significant event for both them and their loved ones. We aim to work collaboratively with all families whilst within Skye House. We are happy to meet this young man and his family to discuss their concerns.”
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