What happened
Dannielle Attree, an autistic woman from Kent, was admitted to St Andrew’s Healthcare in Northampton after a period of poor mental health. She spent nineteen months there, including periods in seclusion. Another autistic patient, known in reporting as Bethany, was at the same hospital in the same months.
Attree was then moved to Littlebrook Hospital in Kent, run by Kent and Medway NHS and Social Care Partnership Trust. By November 2020 she had been in segregation there for nine months, and was sometimes locked in.
Her mother, Andrea Attree, said: “Dannielle doesn’t know how to be able to be anywhere but in seclusion now, because it’s been going on for so long.” She described her daughter’s mental health as having “declined to the lowest I’ve ever seen”.
The outcome
Nothing has been decided about her care. No court, coroner or regulator finding was established.
The trust said highly specialist services for people with autism nationally “are not where we all want them to be”. It said its role had been to support her while a suitable setting was found, in a placement that “was never set up as a long-term placement”. St Andrew’s said seclusion was only ever a last resort and that guidelines were followed.
A Commons statement on 18 April 2023 recorded that no charges were brought in any of the 42 police cases at Littlebrook.
What went wrong
According to the BBC, restraint was used just over 38,000 times in England in 2019, and prone restraint more than 4,000 times. Its figure for reported cases of seclusion was 3,225, 850 of them involving children.
The Care Quality Commission had reviewed restraint after Bethany’s case, and its findings, published the month before, were called “deeply concerning” by the health minister.
A second patient at the same hospital in the same period makes the practice systemic rather than one rogue decision. Two autistic women, one building, the same months.
What is missing is the ending. Nobody outside the ward appears to have been counting, and there is no record of anyone deciding that nineteen months was enough.
What it teaches
Seclusion is restraint. A locked room does to a person what a hold does, and it does it for months rather than minutes.
Duration needs an owner. Someone outside the ward has to hold the count and have the authority to move the person somewhere else. A placement described afterwards as never intended to be long-term is one nobody was reviewing.
The absence of a legal finding is not the absence of a problem. Some of the worst practice in this casebook has a court judgment. This one has a mother’s account and national figures.
Questions for the room
- Nineteen months in one hospital, nine in segregation in another. Who was counting, and what should have triggered a review?
- You are the nurse locking the door. What are you recording, and what would make you refuse?
- A placement is described as temporary for nine months. At what point does temporary become the plan?
Evidence and limits
Confidence: probable, and the limits are large.
There is one source: the BBC File on 4 report of 10 November 2020, which quotes the family and both providers. No statutory record of her care was found, and there is no inquest because she was alive.
Her durations are nineteen months at St Andrew’s and nine at Littlebrook. One caption in the same report describes more than two years in total, so they should not be added together.
The national figures are as the BBC reported them for 2019.
Our physical interventions training covers restraint and seclusion together, because the same people choose between them.
Sources
- BBC News (File on 4), “‘Inhuman’ use of restraint on disabled patients”, 10 November 2020
- Hansard, HC deb 18 April 2023, In-Patient Abuse: Autistic People and People with Learning Disabilities
Reviewed 20 October 2026.