Challenges and concerns
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The ACDT process - a process of documentation, supervision and risk management - is not a clinical response and does not involve therapeutic invention. It has been criticised by Medical Justice for being run by custodial staff, not healthcare professionals and so is therapeutically inadequate. The Brook House Inquiry also highlighted that it does not address the underlying causes that result in self-harm or suicidal thoughts.
Rather, the process of constant observation can be distressing especially when combined with a culture of Disbelief. This was the case for Marcin Gwoździński whose distress was not taken seriously and for whom ACDT monitoring was closed before he took his life in 2017. written by friends of Marcin's in detention stated:
“For a long time he asked officers, psychologists and doctors for help. He was ignored. Many times he asked for help. Therefore myself and other detainees are very anxious and depressed about the situation. It is a disgrace that nobody has been [made] accountable for such poor care. We are human beings not animals.”
Despite the stating that the use of segregation should be exceptional, there has been an overuse of segregation powers for people distressed and at risk of self-harm and suicide in detention. This was echoed in evidence heard during the Brook House Inquiry of people under ACDT being inappropriately placed in segregation conditions which in turn increased distress and the risk of suicidal thoughts.
Nonsensically, the process of information gathering and assessment of risk of suicide and self-harm for the individuals under ACDT is not required to engage with safeguarding mechanisms for reviewing detention such as Rule 35 process or the Adults at Risk policy. Therefore, people in detention might be placed on ACDT but not have a Rule 35 (2) report completed on their behalf.
