The right to ‘home’: human rights and sensory needs on psychiatric wards
As part of our Designing Homes for Sensory Differences Summit, Charli Clement (NdC Associate) examines the challenging sensory environments that psychiatric wards can present to Autistic inpatients through the lens of Article 8 of the Human Rights Act.
Article 8 of the Human Rights Act in the UK—the Right to Private and Family Life, Home, and Correspondence—is chronically under-discussed and often misunderstood. The aspects of life that come under it are things that are often seen as just ‘nice to have’, not prioritised particularly when other rights are at play - including autonomy, community, wellbeing and relationships.
The ‘home’ element of Article 8 focuses on the enjoyment of your current home—whether that be your family home, a hospital ward, a residential setting or any other housing situation. You have a right to feeling safe and supported in your current home, and this has broad applications. You have a right to enjoy your home peacefully without this being intruded on by public authorities.
In the psychiatric system, it is often not recognised that an inpatient ward is your home during your time there. Living there under the existing power structures (as well as in the sensory and social environment) is not often conducive to ‘enjoyment of current home’. This fact is often brushed aside when focus is elsewhere: on 'risk', ward management, or hospital policy. But inpatients deserve better. This is particularly true for Autistic inpatients, who are more likely than their allistic counterparts to experience segregation, restraint and over-medicalisation as part of their experience on inpatient wards.
The average length of stay for Autistic inpatients remains at 4.9 years. 1,380 Autistic inpatients are currently stuck in mental health hospitals, despite NHS England having committed to reduce the levels of Autistic inpatients to less than half of what they were in 2015 by March 2024 (1). This target has now been spectacularly missed: the number of Autistic people without a learning disability detained has actually increased by 109% since 2015. Another key issue is that those who are being released from hospitals are often being released into similarly lacking or difficult environments, with community care still extremely limited and often problematic.
The sensory environment and sensory demand of psychiatric units is often not just a violation of (or, at the very least, a push against) Article 8, but also of several other rights:
For many Neurodivergent inpatient ward residents, possessions that help them regulate are restricted (contravening Article 1 Protocol 1 [Peaceful Enjoyment of Possessions]), and access to regulatory outside spaces or places is limited through lack of ability to leave (restricting Article 5 [Liberty]). These environments are not like homes: they are loud, lit by fluorescent lighting, horribly sterile in design. Alarms, heavy-duty cleaning products, and rapid staff turnaround are just a few of the many aspects of a ward that create a highly stressful environment for Neurodivergent residents.
Restraint (physical, chemical or otherwise) and seclusion often violate Article 3 (Right to be Free from Inhumane and Degrading Treatment). As an absolute right, this should never be restricted, and what is inhumane and degrading varies from person to person due to a variety of factors - including but not limited to gender, disabilities or trauma. For Autistic people, these events are not only more likely, but can impact them more heavily.
The new draft of the Mental Health Act proposes that Autistic people should not be detained without co-occurring mental health need, but this will not be introduced before the next General Election at minimum, and will be unlikely to prevent the detaining of those with co-occurring diagnosis or misdiagnosis, as many Autistic people experience. There is far more that must be done to change the psychiatric system and how we treat those in crisis.
When we discuss housing for sensory needs, we must centre human rights by considering all possible definitions of what constitutes ‘home’ under Article 8 of the Human Rights Act. Public bodies have a duty to uphold these rights across society, in spaces such as (but not limited to) psychiatric inpatient wards that constitute housing and the ‘current home’ of many individuals. These spaces need to be designed in ways that consider sensory requirements (so that they are calm, inclusive, and more conducive to recovery) and staff in these spaces need to be empowered to realistically be able to uphold and care for the human rights of their residents.
