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TX: 25.01.05 - Rocky Bennett

PRESENTER: LIZ BARCLAY
Downloaded from www.bbc.co.uk/radio4
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BARCLAY
David 'Rocky' Bennett died on a psychiatric ward in October 1998, after being restrained, pinioned, face down by at least four nursing staff for over 25 minutes. It's a story we've covered many times. His death eventually led to an official report, which was published a year ago and which concluded that there was institutional racism within the UK mental health service.

Collette Hume can tell us more about Rocky Bennett's story. Collette.

HUME
Well Rocky developed severe mental illness in his late teens and he spent the last 15 years of his life in and out of psychiatric units. He ended up at the Norvic Clinic in Norwich, that's a secure unit for severely ill psychiatric patients. Now on the night he died he was racially abused by another patient but it was Rocky who was moved out of the ward and not the patient. Rocky got angry and lashed out at a nurse. Now he was restrained face down on the floor and then pinioned for 25 minutes. At the end of that time he stopped breathing and an inquest eventually returned a verdict of accidental death caused by neglect.

BARCLAY
That was the inquest verdict, how did the wider inquiry - the government backed one - come about?

HUME
Well that was basically down to his sister - Dr Joanna Bennett - and it came up with 22 recommendations. It included setting a time limit of three minutes for any patient to be restrained, as Rocky was, face down on the floor. But although there were widespread concerns about the restraint of psychiatric patients the Department for Health, in its official response to the report two weeks ago, rejected the three minute rule. Instead it reaffirmed its current advice that any restraint should be used only for as long as is absolutely necessary and also denied the charge of institutional racism.

BARCLAY
Collette thank you.

Dr Joanna Bennett spoke for the first time about the government's response to the report to us, I asked what she thought about the Department of Health's rejection of those two central conclusions.

BENNETT
Those recommendations really form the crux of the inquiry. One in relationship to institutional racism and the second one was in relationship to the length of time that people should be restrained face down. And I really don't believe that the government has responded adequately to either of those two recommendations.

BARCLAY
But they rejected them, did they not?

BENNETT
In fact they have both been rejected yes.

BARCLAY
So there has been no progress then, as far as you're concerned?

BENNETT
I wouldn't want to be seen to be all doom and gloom. Yes those two recommendations have been rejected, but on the other hand I would say we've come a long way since the 1960s and '70s, when racism in mental health services, for example, was seen as a ghetto issue and only a handful of radicals would talk about racism in mental health services. It's now mainstream - racism in mental health services has been accepted as an issue and an issue that impacts on the quality of care that black people receive. The whole area of control and restraint - I believe there's a huge amount of work going on and I believe that that work needs to be further developed. I think there's an extensive amount of evidence pointing to the dangers of prone restraint and the government needs to take note. I would suggest that in fact we should no longer be restraining people who are vulnerable, who are mentally ill, face down on the floor in an acute psychiatric ward. I think it's a barbaric approach to what we call therapeutic care and it's about time that we look at alternatives to that type of approach.

BARCLAY
What do you think about the commitment to document deaths on psychiatric wards?

BENNETT
Well I think in relationship to documentation of deaths on psychiatric wards it has to happen. The only way that mental health services can be seen to be publicly accountable is if we provide those statistics for the public. If people are dying in mental health services then the public should know how many people are dying.

BARCLAY
Doesn't that seem incredible that that doesn't happen?

BENNETT
Well it's absolutely incredible because that obviously was the first question I asked when my brother died and that question was asked time and time again, we were being told that in fact that data's not been collected.

BARCLAY
If you look back over your six campaign how much progress do you feel has been made?

BENNETT
It's difficult sometimes, there are times when I feel why did I bother because in fact six years on, yes I know all the horrors of how my brother died but nobody's been held accountable for that death. I've exposed myself and my family to a lot of psychological trauma, going through the processes over and over again. And in that respect sometimes it feels like no progress has been made. However, on the other hand everyday I speak to taxi drivers, even the chap who dropped me off today, and they for the first time are hearing about the issues related to black people's experience in mental health services, they are hearing about the excessive use of force, they're hearing about the excessive use of medication, they're hearing about the plans for change. So in that respect I would say huge progress has been made, as I said before, to actually mainstream the issues around black people's negative experiences over the years in mental health services.

BARCLAY
Then given that where will you take your campaign?

BENNETT
The government has set out a five year plan. There's very little in terms of structures to make that plan happen. My intention now, although I need to take some space for myself, but I believe that campaign needs to continue. Maybe with me not in the same role but the role of that campaign will be to hold the government accountable for this five year plan. If they're proposing that they are going to reduce the number of people who die in mental health services, as a result of restraint, if they're proposing they're going to reduce the number of people who are admitted through the use of the Mental Health Act then in fact we need to see that happen.

BARCLAY
Where do you think we'll be in five years time?

BENNETT
I would suggest that not a huge amount will have changed in five years. But we have to believe that change is a process and that we're at the beginning of that process of change.

BARCLAY
Dr Joanna Bennett.

Professor David Sallah is director of the National Institute for Mental Health in England's black and minority ethnic mental health programme and will be responsible for implementing the government's new five year plan. Professor Sallah you heard Dr Joanna Bennett saying there that she doesn't believe that a huge amount will have changed in five years, can you reassure her and others that things will change?

SALLAH
Well my view is that a lot has happened since the death of David and my aim, as it is when I decided to apply for the position and got it, was to make sure that things do change. I think in five years time I hope a lot will have changed. We've got structures now in place and what is required now is to ensure that individuals, services, deliver the action points in delivering race equality and I hope in five years time we'll come back and we'll be able to say what we've done to make things better.

BARCLAY
But let's look at the specifics. On the question of a time limit of three minutes on people being held face down, why did the government reject the - that recommendation in favour of a much less precise and open to interpretation phrase - "as long as is absolutely necessary"?

SALLAH
In my view the challenge to the mental health services is this - is to make real changes that ensure the safety of patients and to minimise the need for physical intervention by finding better ways to prevent and manage aggression. Already the National Institute for Mental Health in England have begun working with the National Patients Safety Agency on a programme of work which Joanna has referred to, including new guidance on the management of aggression for trainers and for service providers to follow. Soon the National Institute for Clinical Excellence guidance on restraint will be published and we hope would take that issue on board to develop real action to reduce the need for restraint.

BARCLAY
On the question of the registrar of deaths on psychiatric wards why have those figures never been collated before?

SALLAH
Well I wish I know the answer for that but what is absolutely essential now is the commitment of the Department of Health to make sure that things are right. Now as your listeners may be aware there is a confidential inquiry into homicides and suicides that publishes every five years, the next one is due in 2006. Now that inquiry has been extended to cover all sudden unexplained deaths in psychiatric units. It also, we hope, we expect it to collate information on recent use of restraint. In addition to that we want to see regular full reports of tables that are published each year showing deaths and by ethnicity and by gender. And we will do our damnedest best to make sure that we provide this information.

BARCLAY
Professor David Sallah, director of the ethnic minority programme within the English National Institute of Mental Health.

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