When Susan was 15, social services obtained an interim supervision order but left her with her mother

Susan's story

Despite being known to social services from the age of one, Susan endured a childhood of violence and neglect from her mentally ill mother, who suffered from schizophrenia. She witnessed her mother attempting to kill herself and attacking her father and others. She physically abused Susan and her siblings, pulling their hair out and smacking them in the mouth. She damaged the house and garden during episodes of disturbed behaviour. Social services staff noted that the children were in mouldy and torn clothing. The children spent months in the care of a family friend as well as periods in the care of the local authority while their mother was sectioned. They were repeatedly returned to her care. As teenagers, Susan and her siblings were kept away from school for years by their mother who imprisoned them in the house, despite frequent visits from education welfare officers and social services staff. The children witnessed their mother self-harming, assaulting her boyfriend and having violent hallucinations. Susan learned to self-harm from the age of 11 or 12. She was kept isolated and did not attain a basic level of educational achievement. She was exposed for years to her mother’s paranoid and violent behaviour.

When Susan was 15, social services obtained an interim supervision order but left with her mother. After a couple of months, the interim supervision order lapsed. A few days later, Susan’s mother threw her out. Susan went to social services and demanded that they take her into care, saying that she was tired of being the butt of her mother’s anger.

At a time when Susan urgently needed stability and structure, social services were unable to provide her with a stable placement. She had at least twenty different placements over the next two months, despite having mostly good relationships with her foster carers and often expressing a desire to stay. Eventually Susan was placed in accommodation exclusively for her, where she was looked after by two members of staff at all times. Over the next seven months, Susan had the longest experience she would ever have of intensive support and stability. Seven years later, the carers from this home still remain in contact with Susan and visit her in hospital.

Susan was not easy to manage and would frequently abscond, self-harm, overdose and engage in low-level offending behaviour. But her carers noticed that she started to respond to the boundaries that they put in place. Susan was soon made aware that because she had turned 16, the placement would not be funded for much longer and she would have to move on again, even though social services could have kept her there until she was 18. As the prospect of leaving the home got closer, Susan became increasingly distressed and disturbed and her self-harm escalated. When she eventually had to leave, no alternative placement had been found for her and she was placed in an emergency bed. She then had a further period of instability, including attempts to return to her mother, insecure bed and breakfast accommodation and a short stay with a friend’s father.

After several weeks of instability, Susan was given an independent flat in a ‘sink estate’ housing many young and vulnerable care leavers and known for high levels of crime and drug dealing. Isolated, fearful and without any emotional resources, Susan was unable to cope alone and without structure in a volatile environment. She misused drugs on a daily basis. Several weeks after moving into the flat, she committed an offence of aggravated burglary and false imprisonment and was remanded to custody at the age of 16.

Despite all of this, two further opportunities presented themselves to avoid the suffering and wasted potential that has characterised Susan’s life for the last six years. She was remanded to a secure children’s home, where she felt relatively settled. Susan was difficult but not impossible to manage and was generally co-operative. She continued to have a tendency to self-harm, particularly after upsetting telephone conversations with her mother. Unfortunately, on returning to the children’s home after a court appearance, Susan was informed that she could not come back because she was too difficult. She was then driven up and down the motorway for several hours while attempts were made to find another placement for her.

After a week in a secure training centre, where she witnessed horrifying levels of violence against very young children, Susan was moved again to another secure children’s home, where the last of several opportunities was missed to give her a chance to recover from her childhood and rebuild her life. Susan felt safe in this small home, where she was able to choose activities she enjoyed. She started to enjoy art and design. Her records describe how relaxed she was during art classes. The principal of the children’s home felt that Susan could be managed there and praised her behaviour.

This last missed opportunity ended nearly two months later when Susan turned 17 and was moved to a prison. This was the beginning of a spiral of isolation, boredom, pain and anger which nearly led to Susan’s death through self-harm two years later. Prison could not provide her with the level of support, stimulation and structured activity she needed in order to recover from her traumatic childhood and which had been recommended a year before by a psychiatrist who had assessed Susan during the care proceedings. Furthermore, the prison’s response to Susan’s distressed behaviour was to punish and isolate her and to label her manipulative. Prison staff were ill-equipped and unmotivated to engage with Susan as a human being. Many of the comments in her prison records are both tragic and ridiculous, for instance: “20 min am and pm to be offered to allow the individual an opportunity to ventilate her thoughts and feelings;” “Susan hangs around staff all the time, talking and swearing. She needs to find her own friends.” Over 500 staff had dealings with Susan during her time in custody.

Susan spent frequent periods in segregation or ‘safe cells’ stripped of all her possessions and with nothing to distract her from her emotional distress. Her self-harm spiralled out of control until she was losing pints of blood. She sought transfer to a secure psychiatric hospital under the Mental Health Act, but medical opinion was divided. She was hospitalised over 20 times. The prison was simply unable to respond appropriately and resorted to transferring her to another prison “to give the staff a break”. On one occasion the prison put Susan in a body belt to stop her self-harming, but she was so thin that she slipped out. Amid the futile attempts to deprive Susan of the means to self-harm, no-one seems to have thought about how to stop her wanting to self-harm.

Finally, as doctors began to fear for Susan’s life, she managed to obtain an injunction during one hospital visit preventing her return to prison. All of a sudden, medical opinion miraculously concurred that she was suitable for a transfer to a secure psychiatric hospital. In hospital, Susan started to recover. Her hair grew back, she put on weight and her levels of self-harming dropped to the point where she can now go for months without self-harming. She is taking A-level Art and has won a Koestler prize for one of her paintings. She designs and sells greetings cards through the Howard League website. She is a tough, witty and loveable young woman who struggles on a daily basis to overcome her problems and to do what is required of her. Despite the huge improvements in her condition in hospital, it is questionable whether a secure psychiatric hospital can provide her with what she really needs. Seven years ago, a top psychiatrist concluded that Susan required a programme of social, educational and psychological interventions organised around her needs. She is still waiting for this, and if she gets it, it may not be too late, even now, to realise her potential to live a more or less normal life.