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One man, in his forties, was tied up, in his wheelchair, for up to 16 hours a day. The staff claimed they did this to prevent him from slapping himself in the face

One of my friends has a brother with severe learning difficulties. Brought up in institutions, Dave had been labelled as having "challenging behaviour"; unable to speak in sentences, he used to react to events that disturbed him by punching himself - in the face, aiming for his eyes.

His relatives were constantly worried: clearly, he would eventually cause himself permanent damage. People would try to calm him down, or try to restrain him physically, sometimes successfully, but often this only seemed to make things worse.

Eventually, through his self-harm, Dave lost the sight in both eyes, and has what his sister describes as "a boxer's nose".

He now lives in a group home with eight other people, which has a high staff ratio. Dave's present carers seem to have the time and motivation to observe, and to try to understand what upsets him and what gives him pleasure. They wonder if he has ambitions. He still hits himself when he's distressed, but it happens less often.

By comparison, the Commission for Social Care Inspection and the Health Care Commission has revealed that carers employed by Cornwall Partnership NHS Trust had been guilty of "institutional abuse" at Budock hospital, near Falmouth, and in small homes nearby. More than 200 people with learning difficulties had been subjected to physical and psychological abuse, including "hitting... kicking, withholding food, given cold showers, mocking (and) goading". One man, in his forties, was tied up in his wheelchair for up to 16 hours a day. The staff claimed they did this to prevent him from slapping himself in the face.


These people have been punished for having learning difficulties. This happens when the group culture of the staff is allowed to take a perversely moral stance - "this behaviour is bad and should be punished" - or one where inmates are seen as sub-human - "they are no more than animals, so it doesn't matter how we treat them".

If you, or your brother or sister had a learning difficulty, which kind of treatment would you prefer?