Joint Committee on Human Rights
Oral evidence: Youth detention: Solitary confinement and restraint, HC 994
Wednesday 4 July 2018
Members present: Baroness Hamwee (Chair); Ms Karen Buck; Joanna Cherry; Baroness Lawrence of Clarendon; Jeremy Lefroy; Lord Trimble.
Questions [1–15]
Witness
Witness B (accompanied by Alice Victor, Youth Engagement Co-ordinator, Young Minds).
USE OF THE TRANSCRIPT
Witness B (accompanied by Alice Victor).
Q1 Chair: Thank you very much for coming. We are the Joint Committee on Human Rights, consisting of Members of the House of Commons and Members of the House of Lords. I should say, just in case it happens, that there might be a vote in the Commons, in which case bells will ring. That does not mean that you have to rush out; it is not a fire alarm.
Ms Karen Buck: Unless it is a fire alarm, of course.
Chair: One of my friends, who is an MP, thought on their first day that it was a fire alarm and ran up many flights of stairs from the underground car park. If the bell rings, we will have to stop for 10 minutes or so.
As we have explained, Karen is going to ask the questions.
Q2 Ms Karen Buck: Thank you so much for doing this. As you know, we are just starting to look at detention, so it is incredibly helpful for us to hear about first-hand experience. You have given us a bit of a statement that has given us the outline of this. If it is okay with you—and stop any time you do not want to talk about anything—I will run through what happened, your experiences and how you felt about them. I will prompt you with some questions if I feel that I need to, because I would like to draw out from you a fuller picture of everything you went through.
You said in your statement that you were admitted as an inpatient. Can you start off by telling us a little bit about what happened there, how you came to be admitted and what your feelings and experiences were about going into hospital in that way?
Witness B: I had tried to access services at the beginning of the year, maybe in March, and it did not result in anything, just referrals, which got cancelled eventually. Things got progressively worse. I tried to access them again in October, and again there was no response until December, and that was through my GP. Then I was referred to CAMHS, because I had just turned 16 at this point. The appointment was not until January, so things just got worse. I got admitted four days before my appointment with the services. I had to go to A&E as I had overdosed, and I was in the hospital for three days, waiting to hear anything. They admitted me straightaway from there, informally, to a hospital.
Q3 Ms Karen Buck: When they started to admit you, how did you feel about the process of being admitted? Did you—you can use your own words—feel that this time it was almost a relief, or was it something you did not want? Did you feel that this was a crisis that had come about because you had not been able to access the services that you had wanted to earlier?
Witness B: In the back of my head I was relieved that something was going to happen and that I was going to get that sort of help, because that had not happened the previous year. Between the time I spent waiting to be admitted to A&E to being told that I was going into an inpatient psychiatric unit, there was a lot of waiting and not knowing what was going to happen. There was never any discussion that that could be a possibility. I knew that it was a possibility, but it was mostly just waiting. Then suddenly that happened, so there was not really much time to think. When I first went into the hospital I was relieved and thought, “Okay. Things are going to look up from here”. But I was not really prepared for how it panned out.
Q4 Ms Karen Buck: In the time that led up to that admission, you said that your GP was trying to get services for you, but what was around you giving you advice, help or guidance? How much did you engage with the GP? Did you have family working with you to try to get some sort of satisfactory conclusion?
Witness B: My relationship with my family was not very good at that point, because my mental health had got worse and I was very isolated. I went to my GP, because my friends had noticed that things were deteriorating, so they pushed me to go there. I was in such a difficult and dark place that I was not actively accessing help, like through charities or helplines. When I went to the GP it was with the expectation that that would help, so it was a big disappointment when on multiple occasions that did not amount to anything. My parents did not know much about what was going on. When I went to the GP they knew that I had gone because of my mental health. When I was so ill in that way I was very withdrawn, so it would be hard for other people to notice it and realise how bad things were.
Ms Karen Buck: Sometimes the more you need to explain things, the less likely you are to feel that you want to.
Witness B: Yes.
Ms Karen Buck: So you went in, and I think you said in your note that you were in two different hospitals and four separate units. Could you tell us a bit about how that worked out? How long were you in each place and why did you move around so much? Did you feel that you were being told why you were moving around to different places?
Witness B: When I got admitted in January, things were going well for maybe a month or two, but then they started to deteriorate because I was not getting the psychological help that I needed through therapy and things like that. There are a lot of delays in getting back on medication and things like that, which I felt I needed. So I ended up on 24-hour observations for six and a half months straight. There was someone with me in my room at all times, and I was on ward restriction, which meant that I was not allowed off the ward to the dinner hall or anything like that.
Ms Karen Buck: I am going to ask you a bit more about that in a minute, because obviously we want to hear about that.
Witness B: After about seven months of being in that hospital, they transferred me to a psychiatric intensive unit. I was on one of the units there for coming up to nine months, and then they moved me to the other intensive unit in the same hospital.
Ms Karen Buck: Did they explain what was happening when they were moving you? Did you feel part of that process, or that it was something that was happening to you?
Witness B: When I moved from the open unit in the separate hospital, it was spoken about with me in clinical meetings and ward rounds, and things like that. My family and I did not want it to happen, because we felt there were other ways in which the progress of my recovery could have been addressed, such as through the therapy I was asking for. I was with a certain therapist and it was not working. I tried six weeks of sessions, but I did not feel as if it was helping, so I wanted to try something else. That was not offered to me, so I was given nothing. The people around me—my family and even the support workers who worked there—did not feel that it was necessary. I was told that I was going to be moved, and the next day I was moved, so it was very sudden. That did not give me a lot of time to process it, which made settling into the new unit even more difficult.
The second move that I experienced was within the same hospital, but the two units were run very differently, with different members of staff. Change is something that I struggle a lot with, and when that move happened I was there one day and within an hour they had moved me. I was so unaware that that would happen, so that was difficult. Everything felt as if I was being treated just like a space for a bed, and that was it, rather than people looking at my actual needs and progress or at me as a person.
Q5 Ms Karen Buck: You may not have been aware of it in these terms, but did you feel that there was a plan for the way you were being cared for and treated that was then up for review and that you were a part of discussing, or did you feel that it was all a little jerky and changing without a proper pattern to the support?
Witness B: There were regular CPAs with all the team members of the hospital, which my family were involved in, so things were briefly discussed when I was in the first hospital. We knew that it was a possibility but did not know the details of where I would be going and so on. But the second move was very abrupt due to reasons other than my mental health. So, yes, it felt very jerky and as if I was not being looked at as a person who needed help but more as a figure among the patients at the hospital. It was very difficult to process that, and it made it very difficult to move on from there. It set me back quite a lot, because the change was so drastic and sudden.
Ms Karen Buck: Did you have any consistent people? Were you able to build relationships with people in that process? If so, did you feel that they were people you could complain to if the way you were being supported and looked after was not what you expected?
Witness B: I had just started therapy with the psychologist on the unit that I got moved to within the same hospital. Things were going well and I had built up relationships with key workers on that unit. When I moved to the second unit, it was all completely different. There was no chance of me getting into contact with social workers, therapists or key workers—anyone. I could not leave that unit to go and find them, and I could not talk to anyone who could get hold of them because I was no longer associated with the other unit, and there was a completely different set of staff that I had never met before and had never had any interaction with. For about three weeks I had no contact with anyone I was familiar with or who I felt I could talk to. All my time there was spent calling my parents, who would then be able to call the unit. It was a sort of three-way communication, so initially I was never fully able to speak about how I felt and how much I was struggling with that change.
Q6 Ms Karen Buck: You mentioned in your statement, and you referred to it again, the time you were kept in your room, were watched and had people with you. Can you describe how that happened and what the experience was like? How did you feel about that happening?
Witness B: It happened after an incident—a suicide attempt—while I was in hospital. It was very procedural. They would have someone stay with me due to the risk, and I understood that. But initially there were very few attempts to find other ways to manage my risk and to help me get better and prevent those things happening. It felt really careless on the part of the doctors, because they were not listening to what I was saying I needed. I feel as if they gave me a diagnosis and said, “These are the behaviours and incidents that are happening. Therefore you need this”, rather than looking at my individual case.
There was a lack of that humanistic approach of seeing me as an individual with very different needs from somebody else with my diagnosis. That was not there, so it got worse and worse, to the point where I would not have been able to come off the 24-hour observations even if I had wanted to, because I was so unused to being on my own. They tried it once with my door locked. I had to be in communal areas for the whole day, which I struggled with because of my anxiety around people, and it was always very chaotic on the unit.
Eventually they got to a point where they did not have the option to take me off that, because it had taken so long even to try to think of other ways to manage my risk and my mental health. It was very dehumanising. It felt like I was in a cage, especially with the ward restriction.
Q7 Ms Karen Buck: Describe the ward restriction a little more. So there were times when you were not allowed into your room, and presumably there were other times when you were in the room and not permitted to come and go as you would have liked to. How often did that happen and for how long?
Witness B: I was ward-restricted from February to July, and during that time I was not allowed outside at all. At no time was I anywhere else but in my room and the small corridors on that ward. Obviously it became very mundane. There is no real reason to carry on and even try when all you are experiencing is four walls and a very chaotic and sad environment. A lot of people, including the staff and the other patients—
Ms Karen Buck: This was the same period when you were being watched.
Witness B: Yes. I had someone with me 24 hours a day, who obviously was only allowed in that small space. It was so difficult to find a reason to carry on and even recover, and as I said it felt so dehumanising because I could not do anything without someone there with me. I could not go to the bathroom without someone coming with me, and I was not even allowed outside. You forget what the weather is like. I could see outside, but I did not remember what rain felt like.
Q8 Ms Karen Buck: What was the argument for you not being able to go outside if you were being supervised and under constant watch?
Witness B: It was due to the risk of suicide. They said that the risk of absconsion from the unit was high and they did not want to take the risk of me running away and something happening. The structure of the hospital was not very suited to the needs of patients there. It was all or nothing. You had to be okay in the community even to go outside, and if you were not okay to be walking outside, on roads and so on, you were not even allowed in the garden. It was enclosed.
Ms Karen Buck: What did you do all day? What was the structure of your day? Did they provide you with any education? How did they occupy you?
Witness B: Their provision of education was very much, “Do what you want. Do general key stage 3 maths and English”. I had already got my GCSEs, and there was no teaching or education that catered to people above GCSE level, so either you did not do education or you did your own stuff. Teaching yourself an A-level takes a lot of dedication, especially when you are struggling with mental health problems, and even getting the resources and access to teaching materials was very difficult.
Eventually I felt that there was no point trying to teach myself all these things and feeling disappointed that I did not understand anything when I had no guidance from anyone. Most of my day was spent doing puzzles, crosswords and things like that, mindfulness colouring, having conversations with the member of staff I was with the whole time. If it was someone unfamiliar, such as agency staff, some days that would mean that I did not talk to anybody.
Q9 Ms Karen Buck: How often did the staff change? You would have one person with you, but they would change.
Witness B: There were permanent staff, so depending on the needs of the ward on that day my observation staff would change every hour and move on to different roles. Sometimes, when there was a shortage of staff, which happened a lot, they would be with me for maybe six hours straight, which is almost half their shift. That caused a lot of problems in itself because of professional guidelines and things like that, and safeguarding, so a lot of the time when there were so few staff that people could not change that much, it became very mundane and routine.
On days when there were enough staff, they would change every hour and the organisation would be quite smooth, but on other days there might be a nurse and a support worker. So that support worker would have to be with me and the other people had to go to the nurse if they needed anything, but the nurse was also busy talking to doctors and doing medication, so there was a lot of stress on the ward. That meant that I would have to go with my member of staff to help other people to do things, such as going to the kitchen if they needed anything or taking them to education so they could be in education. If there were no members of staff there—
Ms Karen Buck: So you were effectively required to go with a member of staff for them to fulfil other duties.
Witness B: Yes. That was in my first hospital. In the second hospital I went to, the situation was a lot worse. Because it was an intensive unit, all the bathrooms and the kitchen were locked, so if you needed water you needed a member of staff to go with you. When I and other patients were on 24-hour observations, it was up to another patient to listen to what the other patients needed, to go with them when they left their room, to open the bathroom door and wait outside while someone went to the bathroom and had a shower.
I have been on the other end of it when I have had to say to some of my friends in hospital, “I really need the toilet and there’s no one there to open it for me, so could you come with me?” There have been times where there has been no one to open the toilet for any of us, so we have to get staff from other units to come and help us, or get the staff member for someone who is on one-to-one observations to come with us. A lot of responsibility was put on patients because of the shortage of staff, if that makes sense.
Ms Karen Buck: At this point you interacted with other patients. Was that was controlled?
Witness B: No, because my risk was primarily to myself rather than to other people, so that was never really a concern. In the first hospital I was in there were two wards. It was never really isolated in that sense. People could go between the two, unless you were on ward restriction. There was an isolation section. There were a lot of opportunities on ward rounds and clinical meetings for me to go into those rooms, which are completely isolated a lot of the time. When people are in them they are not allowed out of there, and there is no interaction with anyone else.
Ms Karen Buck: How much did that happen to you?
Witness B: I never got moved into those rooms, mostly due to staffing problems. I needed someone with me 24 hours a day, and if I was in those rooms I would need two members of staff because it is so isolated. Because you need those two members of staff to be in those rooms, the observation and isolation is very intense. Because of the lack of staff, not just with me but with other people, if they needed to go there there would need to be two members of staff, so often it would not happen and those doors would have to stay open. For me that never happened. It was more a case of being isolated in my room, and there were times when I was not allowed outside my room due to risk.
Q10 Ms Karen Buck: For how much time in those different episodes in hospital were you conscious of feeling isolated, on your own and not able to interact?
Witness B: In the first hospital I was in I felt very isolated for the entire seven months. There was very little contact. I had a couple of friends, but obviously they would go on leave with their family and be getting on with their own recovery, and the other friends I had would be struggling in their own ways, so I could not really interact with them either. If I interacted with the people who were struggling, it would have an impact on me and on them, and the other people were moving on with their recovery, so I would not see them much because they would be going out with their parents and their friends, or they would be outside in the summer months. The weather was consistently hot, so for most of the day all the other patients would go out and I would be the only one left on the ward.
Ms Karen Buck: This question may not be possible for you to answer, but how much of that sense of forced isolation did you feel was because there were not the staff to support you and engage with you to get you out, and how much of it was because of decisions that had been taken about your care that prevented you from being treated as some of the other patients were being treated?
Witness B: I can understand why they would not want to take the risk of taking me outside, but at the end of the day there was always discussion that I could outside if there were enough staff available. There would be times when they said, “Okay, maybe we can go outside today with you”, which was a massive deal for me, because obviously I had not been out for four or five months straight. There was always a glimmer of hope that I would be let outside, but a lot of the time those plans would fail because they did not have enough staff. They wanted to have three members of staff with me, but there were never enough staff to be able to do that. So even with those requirements, I still could not go out.
Ms Karen Buck: Sometimes they might talk the evening before or in the morning about what they were going to do in the day, and you would think, “Maybe I’ll be able to have a change of routine or get out”, but when it came to it that did not happen. Did that happen with some regularity?
Witness B: Yes. In the last two or three months, with a push from my parents and the members of staff who would be with me, they managed to convince the doctors—“We can try it if there are enough staff”. They would tell me, “Yes, you can probably go outside today”. So I would wait for an hour and say, “Can I go outside this hour?” They would say, “No, maybe later”. It would be an hourly thing of me asking and being met with disappointment because they did not have enough staff.
There were maybe two times when it did happen, and even then it was not the staff who should have been taking me out; one of the doctors offered an hour of her time to come out with me, along with two other members of staff. It always made me feel so guilty that in order to go outside I was taking up other people’s time, especially the doctors, who are so busy.
Ms Karen Buck: You were aware that it was a kind of burden.
Witness B: I felt like a burden the whole time I was there, because a member of staff had to be with me the whole time, and a lot of that was because it meant that the other patients would not have a member of staff who was free to help them to do anything, to go outside with them or even just to talk to them. I felt so much guilt that I was taking that away from other people. It was a mixture of feeling guilty, feeling like a burden, feeling isolated and not being able to get out of that cycle. There were a million reasons why I was not being offered the care that the people around me thought I needed. It was really difficult to manage all that, and eventually I just shut down. I did not want to go outside, because I did not want to be feeling that guilt of being a burden on time and resources and so on.
Ms Karen Buck: As you understand, was this always because of risk to yourself? There was no element of risk to others?
Witness B: That is right.
Q11 Ms Karen Buck: Were you ever physically restrained?
Witness B: Yes. When I had certain incidents, restraints would happen, obviously to prevent those incidents from happening. But, again, because of the lack of staff on the units it was usually one person witnessing it, realising that something had happened and calling the alarm. No one would come for five or 10 minutes, so that person would have to restrain me by themselves, which obviously was not allowed as it was never the safest restraint.
For me personally, if someone realised that I was doing something and eventually stopped it happening, I would usually comply because of my own feelings of guilt over a member of staff feeling that responsibility for me. With other patients, though, I witnessed situations where there were not enough staff to safely restrain someone and people would come out of their rooms eventually with bruises and things like that. Other patients witnessed that, too.
Ms Karen Buck: Roughly how often did that happen?
Witness B: To me personally? Maybe a couple of times a week.
Ms Karen Buck: A couple of times a week?
Witness B: Not every week, but during bad periods maybe a couple of times a week. It was very sporadic, depending on the time I was going through.
Ms Karen Buck: Do stop if at any point you find this difficult. Was the process of being restrained frightening? Was it painful? Were you aware of what needed to be done to stop you hurting yourself?
Witness B: When it has happened to me, I have been so caught up in my own distress that I have never really paid much attention, so there are only a couple of times that I can really remember. It is really painful, especially when it is not done properly, not due to that member of staff not being trained but because there are not enough people to do it safely. It has always been very rushed and quite harsh, because they are in a panic to stop the self-harm, but that causes more harm—pulling my arms back, sometimes sitting on my legs and things like that. Sometimes I remember it being painful, but for me personally never for an extended period of time, because for me the idea of further restraint was just so uncomfortable and distressing that I would just stop and comply with whatever from there.
Q12 Ms Karen Buck: As with keeping you isolated, did the people who were doing the restraining, your doctors or anyone else talk through how those situations had arisen and why they acted as they did? Was there a sense of trying to help you to understand the process better?
Witness B: There was never much talk about the restraints, because there was only so much that they could say. Depending on which member of staff had carried out the restraint, they would apologise if they had hurt me. But a lot of the time it was brushed over. The ward manager would come and speak to me and say, “This is why that happened”, and people had to do incident reports. I heard a couple of times that people did not know what to write on the incident reports. If they said that they had carried it out by themselves, they would be in trouble, but what else could they have done? Something even worse, even fatal, could happen to the patient they did not restrain. So there was never much talk about it with me.
Obviously I never really heard from the doctors about it. They would just say that there had been an incident. A lot of the time, how do you respond to the question, “Why did it happen?” It happened because you were feeling so bad that you felt like you needed to make an attempt on your life. Everything was brushed over, because it was so normal in those environments. Even if it is not normal for those patients in the grand scheme of their lives, it is normal within that environment, so it is not seen as an abnormal event that needs to be discussed.
Q13 Ms Karen Buck: Were your family involved in that at any stage? If this was happening sometimes a couple of times a week, was that reviewed with your family? Would people talk that pattern through with them so that they could try to understand it and work with you on it?
Witness B: Every time there was an incident they would have to ring my family and let them know. Again, though, because it was so normalised, my parents just came to expect those phone calls. Eventually, once I had been discharged, they told me that it never really shocked them and that as long as I was okay and they were actually receiving the phone call to say that there had been incident, they thought, “Okay”. It became the norm, and they were never really debriefed about why it had happened. So they were aware of it happening, but they were not surprised.
During my time in hospital I did not have a very good relationship with my parents, so it was hard for them to have any input because I did not want them to be involved and to know the ins and outs of what was going on for me, because I just did not feel that they needed that amount of pressure, and feelings like that.
Q14 Ms Karen Buck: Do you think that any of this could have been done differently? Obviously, as you say, there should be more staff. That is clearly key to what you are saying. Is there anything apart from that—the way they treated you, listened to you, responded to you—that you feel could have been done differently?
Witness B: It varies from doctor to doctor based on how they are trained, and everything like that, but a big thing for me that could have prevented the transfers from units and things like that, especially at the beginning, was if they had listened to me when I said that this therapy was not working for me and that I would like to try something else, and if they had offered me the things that I said I needed. If they had done that, I feel like a lot of it could have been prevented.
Ms Karen Buck: Is there an example of something in particular that might have worked for you?
Witness B: For me, it was the therapist I was working with. She was a very structured CBT therapist. I had tried that in the past with outpatient health services. It was very structured. The therapy I needed was more humanistic interaction rather than focusing on thoughts, behaviours and things like that.
I was very articulate in expressing what I needed, but even being able to talk about that and being aware of different therapies available, I just was not listened to. I could not tell you why. My parents would say, “Maybe she needs that instead”, and the support workers would say, “Yes, why don’t we try that?”, but it just never came about. By the time they appointed me a new therapist I got transferred maybe a month later, so there was no chance of that actually working.
Ms Karen Buck: So they did not say to you, “We strongly recommend that you stick with a form of CBT”, for example, “because in our professional experience that would be the best”. It was just, “There might be another option”, but it just did not come about.
Witness B: Yes. It just never happened. I think one of their reasons was that if I wanted to change my therapist it would mean that other patients would want to change theirs and they could not keep doing all that. So I got stuck at a point where my case was compared with all the other patients and if I needed something different for my care, a lot of the time I could not get it because that was not how they did things and it was not the generic care plan.
There was no individualised care for each person. I could not tell you of a single person in my time in hospital who had the same problems as another. Even though people had the same diagnosis, they have always presented differently and felt differently, and I do not feel that that is focused on enough. If people had been seen as individuals, maybe things would be different, but it is not the case. I do not know if that is because of the pressure of getting people in and out of hospital because of the shortage of beds and things like that, but I just feel that you cannot not treat people as individuals. There is no other way to get people better. No one has had the same experiences and the same thoughts going through their head, and things like that, so being so structured and strict with rules on therapy and medication just does not work, and I do not think it ever will.
Q15 Ms Karen Buck: We are almost at the end of the meeting. You have done brilliantly. What was the journey out at the end? How did that manage itself?
Witness B: My discharge, again, was very complicated. I got transferred from the first hospital and then I got transferred again. Eventually I got transferred to the open unit in that hospital, because I was doing well.
But I turned 18 that year, so I was not meant to be there. I was meant to be discharged into a supported living placement, because I could not live at home due to risk and things like that. They just could not find me a place.
As I said, I was not meant to be there past my 18th birthday, because obviously it was a CAMHS hospital, but they could not find me anywhere to go. They could not really treat me as a patient there because I was 18, but they could not discharge me with nowhere to go. That brought a lot of other issues, because I just felt so uncared about. They needed to find me anywhere, even if it was not suited to me, because I just needed to leave the hospital.
Ms Karen Buck: So 1 minute to midnight you are a child and 1 minute after you are an adult. Would you ideally like to see that changed as well?
Witness B: Yes. The transfer from CAMHS into adult mental health services is so bad and has been so bad for almost everybody I know. You cannot be referred to adult services when you are still a child. There needs to be a really strong case for that to happen. Again, with waiting times, there cannot be preparation in advance for your care when you turn 18, so a lot of the time it is very disorganised and you do not get the help that you need, because the responsibility is passed on from one group to another and from doctors to other doctors. A lot of the time, things get lost in the process.
I moved into a supported living place. I had been on section while I was in hospital. That meant that I was discharged under Section 117, which is about entitlement to care after discharge.
Ms Karen Buck: You were not sectioned all the way through, were you?
Witness B: No. I think I was sectioned from… I cannot quite remember.
Ms Karen Buck: For a while, but not the whole period.
Witness B: No. Under that entitlement I was required to have follow-up with psychiatrists and psychologists and have therapy and medication reviews. None of that happened. I was discharged in November and I did not see any psychiatrists or mental health workers, even in the service where I was until March.
Ms Karen Buck: So there was a discharge plan that set all that out—
Witness B: Yes.
Ms Karen Buck: —but it was not implemented.
Witness B: No. It was meant to happen. It was very clear from the consultant psychiatrist who was in charge of my care when I was in hospital that all this needed to happen in order for it to be a successful discharge, and it did not happen. Even now I am still waiting on those referrals to be involved with a mental health team. I have seen a psychiatrist once.
It is a cycle of not getting what you need. When people say that you are going to get what you need and that there will be a strict plan and requirement, it still does not happen because there is so much transferring from one team to another team that things get lost, and there is so much to deal with that unless you are such a high risk that you need to sectioned or you are at risk of harming yourself seriously, you are not focused on or prioritised, because there are not enough people to deal with your case when there is another person who is in serious need. But then that just results in people like me, who can present quite well, deteriorating to the point where we need to be the priority. It is just that cycle.
Ms Karen Buck: Thank you very much for explaining this. Your insight is extraordinary and has been incredibly helpful. Is there anything that we have not covered that you feel you would like to say to us?
Witness B: No. That is everything, really.
Ms Karen Buck: Thank you very much.
Chair: That was really very helpful. We can read words on paper, but hearing it in your words and what you choose to emphasise is really important to us. You have contributed a lot to our inquiry. Feel proud of that.
Witness B: Thank you for having me.
Oral evidence: Youth detention: solitary confinement and restraint 4