In Our Best Interests

Steven Neary’s unlawful detention at the hands of the state is something we talk a lot about to students and social workers. When we have heard Mark recount what happened to Steven he often mentions that Steven serenaded the ATU manager with Queen’s ‘I Want To Break Free’. To his dad Mark, and with the benefit of hindsight to us in social work, there is no clearer evidence that Steven wanted to leave. The message is stark. And for those of us old enough to know the song and video, the image it immediately presents to your mind is that of Freddie pushing a vacuum and Roger Taylor applying make-up, to help him escape the grind of domesticity. Steven didn’t need to articulate any further, clearly and undoubtedly through using this medium, he wanted to break free.

“Sparkling lives” is a phrase we found in the case of C. C was a 50-year old woman, who, according to court reports, considered herself impulsive and self centred. In describing C the Judge said “C is a person to whom the epithet ‘conventional’ will never be applied … C has led a life characterised by impulsive and self-centred decision-making without guilt or regret. [She] has had four marriages and a number of affairs and has, it is said, spent the money of her husbands and lovers recklessly before moving on when things got difficult or the money ran out. She has, by their account, been an entirely reluctant and at times completely indifferent mother to her three caring daughters. Her consumption of alcohol has been excessive and, at times, out of control … In particular, it is clear that during her life C has placed a significant premium on youth and beauty and on living a life that, in C’s words, ‘sparkles’.”

The sparkle for C had gone. The things she had lived for previously were seemingly unobtainable due to her deteriorating health. As such she chose not to receive life saving treatment, feeling that the treatment was not life enhancing but was merely life prolonging and that being the case it would only go prolong a life she didn’t wish to experience. For the Judge, this, similar to how we feel about Steven, was a clear and unequivocal call to break free. C was deemed to have the capacity to make the decision and she lawfully rejected treatment. A seemingly unwise decision for most people perhaps but it was the most reasonable and rational decision for C. What is clear from C and Steven, is that the desire to lead fulfilling lives, where people are able to make a series decisions themselves and choose to colouring their lives in whatever way they want, is one of the most important elements of our very being.

So collectively this is where we find ourselves. Having lived in lockdown for 7 weeks and now eagerly awaiting updates of an easing of the situation, the red top press yesterday in the UK have vented its collective spleen in regards to how the British public feels about living in a world of restriction. We have tasted restriction and have come to the conclusion that we really don’t like them and within two months we want out. So collectively we are the 21A appeal or the person nervously sitting with their solicitor at a Mental Health Tribunal or the person 100 years earlier standing before the great and the good of the asylum and requesting their release. Restrictions, deprivations and indeed state interference are not for us according to the press, they are for the others. Whether it’s the increased traffic on the roads, the clamour to open up the shops or the need get out of the house for more than the state-sponsored one hour exercise each day, we are seemingly and collectively singing along with Freddie. We are appealing the decision. God knows, we want to break free.

The things we need to make our lives fulfilling or sparkling, whether that is seeing and hugging family and friends, watching football, singing in the choir, going for a drink after work, whatever, now appearing to be holding the sway as faced with such a particularly difficult decision, we try and complete our collective national best interest balance sheet. The emotional pull of freedom holding sway. More important it seems that anything else anyone can come up with. The consequences (cons) of enabling our sparking lives, starting to win out over the call to clap for carers on Thursday night because we’ve read in the papers that the premier league is back and by god we’ve missed football. If society in the UK was collectively assessed at that moment, when we were talking about our desire for freedom and to get on with our lives regardless of consequence, despite the warnings that this could be catastrophic for thousands of lives, in particular the lives of those who we know need social care, surely we would be judged to be making an unwise decision? May be our capacity would be questioned? Almost certainly we’d be judged to be lacking in the remarkable sixth sense that everybody who comes into contact with health and social care is expected to display in abundance, insight, or being able to predict the future, whichever term fits the form. Even with the gravity of the risk that just 8 weeks ago led us to collectively implement a lockdown by consent, will the weight of autonomy, the emotional wellbeing pull of needing to see family and friends and be able to do the things that bring meaning and sparkle to life for wider society now win out. Will the price of living with restrictions on our own lives lead us to a dark path for so many others?  It’s like we are trying to fill the balance sheet in with only half the information.

In social work we make decisions about restrictions every day.  Where someone lives, what they can do, who they can see, how long they see them for, what conversations are allowed and which are not acceptable, what food people can eat, what time people go to bed. We are trained to compete balance sheets, to create a defensible document that we can wave at others to say that we took all factors into account.  Social workers education teaches us to critically reflect, to ask questions of ourselves that are uncomfortable, but which leads us towards more honesty if we are open to doing it properly.  Our critical reflection is that it can be too easy to create a balance sheet which says that we are putting restrictions in place.  Too easy to forensically document the physical health and safety risks at the price of not documenting the emotional wellbeing impact on the person which might tip the balance the other way.  Too easy to dismiss the wishes, feelings and beliefs of the person as being “unwise” or “lacking in insight”.

The monotony of social care restrictions, the arbitrary way they may be used once legitimised by a “support plan”, the timescales it takes for someone’s desire for freedom to be broken, to accept their fate, stop rattling the door and succumb to the inevitable. When it came to us collectively, for society as a whole to be deprived of our freedoms and liberties, the restrictions we’ve been under, which are both by consent and are considerably minor in comparison the restrictions social care impose (you try reliving the last 8 weeks with 3 to 1 staff, 24/7), started to feel too much for some of us within just two months. The irritation of the forensic cotton wool that we often wrap others up in to justify our actions actually started to cause an itch that we couldn’t all live with.