Introduction: The day unit

Summary

“… the child outside of family reflects on what family truly is, more than what it promotes itself to be.”

Lemn Sissay

“… perhaps, Emily Dickinson, my love, hope was never a thing with feathers.”

Claudia Rankine

Drummond Hall stands at the top of a hill in one of the most affluent boroughs of the city. Many of the houses here cost millions of pounds and are inhabited (if they’re inhabited at all) by lawyers, doctors, academics, television personalities and politicians. It's an incongruous setting for an NHS school, of which there are a few in the UK, designed as a provision for children with special educational and behavioural needs, and I wonder, sometimes, what the locals make of the service, the swear-words and screams floating over the playground wall.

The building is old and not quite fit for purpose, with a heavy oak door, a wood-panelled foyer, a large wooden staircase in the entry hall, and tall, draughty windows (all protected by thick sheets of plastic). The walls and cornicing are constantly being repainted but always somehow scuffed and covered in crayon. Paper displays on the walls last less than a week. Homophobic, racist and sexist graffiti is common, but quickly cleaned off by a dedicated team of domestic workers.

The provision, officially an NHS day unit, provides care to children aged between five and fourteen referred by local authorities. Some of these children have been excluded from mainstream education, others have never attended. Many have diagnoses of ADHD or autism. Most have extensive and complex histories of trauma, which can manifest as extreme behaviours, including verbal, physical and sexual abuse. Sometimes the students abscond. Local curtain-twitchers watch them storm down the hill, kicking cars and brandishing sticks, followed (at a safe distance) by staff members, of which I am one.

In addition to the usual academic roster of teachers, the school employs nurses and therapists (psychotherapists, occupational therapists, and others) as well as a psychiatrist. As a support worker, my job is to help structure the children's day and regulate behaviour. Regulation sometimes involves physical “holding”. Staff are trained in a restraint system that prioritizes harmless physical intervention and preserves the child's dignity.