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Family’s anguish over son’s five years locked up in ‘deeply inappropriate’ mental health unit

© Supplied by Paul CaswellRyan Caswell with his dad, Paul. Image: Supplied
Ryan Caswell with his dad, Paul. Image: Supplied

When Ryan Caswell was first admitted to Carseview mental health unit in Dundee, his parents were told that he would spend three months in a temporary assessment unit.

Despite concerns their son could “fall down the rabbit hole” of Scotland’s creaking care services, Paul and Irene were talked into the step after doctors warned that without leaving home, Ryan could end up on strong psychotropic medication.

This week marks five years since Ryan first entered Carseview and – despite his case being raised with three first ministers and three separate NHS Tayside chief executives – his parents are still fighting to have him released.

They allege he has at times been sedated and restrained, including with the strong psychotropics they had hoped to avoid, instead of being given proper medical treatment.

Ryan’s time at Carseview was described by one local politician as “extremely concerning” after he was left to endure months of unnecessary chronic pain.

Devastating toll on family

Ryan, 22, has been diagnosed with Autism Spectrum Disorder as well as a learning disability, and has significant communication issues.

He is currently classed as a delayed discharge so cannot leave Carseview until an appropriate community placement is found for him.

Speaking last night, Paul Caswell revealed the devastating toll the time inside has had on both Ryan and his family.

He said: “Ryan had difficulties managing life but what I see now is just a shell of what was there before.

© Gareth Jennings/DCT Media
Paul and Irene Caswell. Image: DC Thomson

“I think they’ve stripped away so much of him and what he was able to do that I don’t know if we’ll ever get back to where we were before with Ryan.

“As a parent, you always hope that your kids will thrive and grow, and all I see is the reverse with Ryan. He is withering in that place.”

Two years ago, Nicola Sturgeon – when she was first minister – told MSPs that details of Ryan’s case sounded “unacceptable”.

Paul is concerned that patients like Ryan are spending too much time locked up in hospitals rather than in more appropriate settings and, as a result, are losing vital skills such as being able to feed and look after themselves.

Missing funding

A new report this week reveals the majority of a £20 million fund created to get people with learning disabilities out of institutional care has not been spent.

The Scottish Human Rights Commission said it could only trace £14m of the money – of which £12.5m was still unspent.

It does not know what happened to the remaining £6m. The commission believes much of the funding has been misspent.

Ministers pledged in 2022 that the majority of people with learning disabilities and autism would be moved out of hospitals by March 2024.

That did not happen and hundreds remain stuck on wards – with 55 locked up for more than 10 years each.

Paul knows all too well the strain the situation can have on families.

He said: “It becomes all consuming. You are so worried about your child that you do everything you can to move them out of the system.

“Your focus changes entirely. Instead of having a normal family relationship, that’s all gone, you’re just trying to mitigate the system’s effect on your son.

“For some families, the system is so inflexible and so unwilling to change, they decide that they can’t take that suffering any more.

“They can’t stand to see it and have to insulate themselves from it. They give up.

“What you find is that sometimes people in these settings end up with no one at all to support them and that makes things even worse.”

Deeply frustrating

Scottish Labour MSP Michael Marra has repeatedly raised Ryan’s case at parliament.

He said the testimony given by the Caswell family is heartbreaking and tells a wider story of service failures.

Marra said: “First ministers and ministers wring their hands and say it is unacceptable, but they actually do nothing.

“I am deeply frustrated and angry at the lack of progress but that is nothing compared to the anguish of the Caswell family.”

Dundee Health and Social Care Partnership said: “Due to patient confidentiality we are unable to comment on matters relating to individual patients.

“We are in direct contact with Ryan’s family to identify an appropriate care provider.”