Seni Lewis’ death exposed critical failings in our mental health services. It is vital we learn from them, writes Steve Reed
Seni Lewis was a 21-year-old young man living with his parents in Thornton Heath, South London. A recent university graduate, he had a bright future ahead of him. One Sunday morning his parents found him in a very agitated state and quickly recognised he was suffering an episode of mental ill health. Seni was physically healthy with no prior history of mental ill health. Deeply worried, Seni’s parents took their son to the local hospital and he was later transferred to a mental health hospital. After staying with Seni all day, his exhausted parents left him at 8pm to go home.
Seni became very anxious when he realised his parents had gone. He resisted attempts by hospital staff to restrain him and they called the police. Eleven police officers took Seni into a seclusion unit with his arms handcuffed behind his head, his legs in shackles, and pinned him face-down on the floor until he suffered a heart attack and became unconscious. Shortly afterwards Seni died.
Having gone through the trauma of losing their beloved son, Seni’s devastated parents were then left to fight the state for years to find out how it had happened. Serious failings by the Crown Prosecution Service and obstruction by the Metropolitan Police meant no inquest into Seni’s death was held for a further seven years. As the family’s member of parliament, I raised questions in parliament and took them to meet the then home secretary, Theresa May, to get an inquest opened. Having lost their son in the most appalling circumstances, the family were now denied the justice they deserved.
When the coroner’s verdict finally came in June 2017 it was damning. It found that Seni had been subject to ‘prolonged disproportionate and unreasonable’ restraint. Training for police and hospital staff was inadequate, responsibilities were unclear, medical staff failed to respond to the medical emergency, and the hospital was failing to follow its own policies on patient safety. The coroner warned that without change further deaths could occur.
More coverage on Seni’s Law:
Support for women in mental health services must be better
How can we rid our mental health services of racism?
Young people should not have to face the fear of excessive restraint
Race and restraint: it’s time we listened to the evidence
That change is the Mental Health Units (Use of Force) bill, known as Seni’s Law in memory of the young man whose tragic death inspired it. According to the mental health charity Mind there have been 13 face-down restraint-related deaths since 1998 and over 1000 physical injuries. Much of that suffering could have been avoided if lessons had been learnt from the many inquests going back decades, the conclusions of which have been ignored by the government.
Looking at the faces of those who died it is clear that young black men are disproportionately affected. This raises fears of unconscious racial bias, with anecdotal evidence linking their deaths to assumptions about young black men, drugs, psychosis and violence. No one should face discrimination, and yet there are widespread and justified fears in the black community about racial bias in the mental health services. The government’s own race disproportionality report, published last autumn, includes statistics on deaths in prison and police custody, but is notably silent on mental health custody because no statistics exist.
Seni’s Law will require every mental health hospital to keep a record every time restraint is used against a patient. For the first time, we will be able to compare hospitals, and see whether some groups – young black men, women, the disabled – are subject to disproportionate levels of force. Every hospital will have a policy on reducing force, and a named senior manager accountable for its implementation, including training on de-escalation. This will open the system up to scrutiny and accountability for the first time.
Moreover, if the bill as proposed is passed, police officers in mental health hospitals will have to wear body cameras. Every non-natural death will automatically trigger a fully independent investigation with legal aid for the deceased person’s family. And the government will publish an annual report summarising inquest findings and how those vital lessons are being learnt.
Seni’s Law is a major step towards ensuring mental health patients are treated with care and compassion not cruelty, and that the system learns when things go wrong. It is a first step towards transforming our mental health services and making them fair and equal for everyone. It enjoys the support of every professional body, patients’ group and trade union in the mental health sector. The bill is due for its third reading in the House of Commons on 15 June, and with cross-party support could be on the statute books by the end of the year. Seni’s parents’ profound hope is that that their son did not die in vain. Although nothing can bring Seni back, this new law will honour his memory by making sure no one else suffers the way he did.
Steve Reed is member of parliament for Croydon North. He tweets @SteveReedMP
Photo copyright: Justice for Seni website
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