Out of sight and out of mind: explaining and challenging the re-institutionalisation of people with learning disabilities and/or autism

In the late twentieth century, many countries underwent processes of ‘de-institutionalisation’ – closing ‘asylums’ or long-stay hospitals for people with mental health problems, learning disabilities and dementia (Rogers and Pilgrim, 2001; Jack, 1998; Ramon, 1996; Bartlett and Wright, 1999). Despite this, the UK has witnessed a subsequent process of ‘re-institutionalisation’ with the creation of new public and private sector facilities providing ‘secure’/‘locked’ care to large numbers of people, who can be residents for many years with no sense of when they may leave. In 2023, 2,035 people with learning disabilities and/or autistic people were receiving inpatient hospital care in England, with 54% in hospital for over two years (NHS Digital, 2023). Not only are such people deprived of their liberty, but there is evidence of abusive, inhumane and degrading treatment (Jagger and Harris, 2024; see also Box 1). This is arguably one of the most fundamental, distressing, and scandalous human rights issues of the modern care system, but notwithstanding public and political attention, it seems an almost forgotten sociological problem. [...]