Screaming child

Addressing chemical restraint in Western Cape schools

13 September 2021 | Advocacy

Some schools in the Western Cape are allegedly coercing parents into drugging their disabled children.

Chemical restraint happens in schools in several countries. It is often perpetrated against disabled children by people in authority at SEN schools. Parents are coerced into complying with the school’s demand that they drug their children.

What is chemical restraint?

In simple terms, “chemical restraint” means giving someone a drug to make them behave how you want, without the person wanting that drug.

The difference between chemical restraint and regular medical treatment is that the restraint is done for the convenience of the people in authority, rather than to address the medical needs of the person being restrained. Basically, you’re medicating a person because you have a problem with them.

In psychiatry, chemical restraint in “behavioural emergencies” is considered controversial. But when a school tells a parent or other caregiver that they must give their child certain medicines as a prerequisite for that child being allowed to come to school, it isn’t just “controversial”—it’s illegal.

Which schools require chemical restraint for children?

The reports we’ve received over several years have been from parents of autistic children in SEN (Special Educational Needs) schools in several provinces. We suspect that this may also be happening to children with other developmental disabilities, and that some mainstream schools may also be involved.

How do schools practice chemical restraint?

Chemical restraint as a prerequisite for school attendance follows a similar pattern in several countries. Reports from the Western Cape correlate with this pattern. Typically, a school has a relationship with a prescribing clinician, such as a certain psychiatrist in the town. This clinician has a specific cocktail (such as Risperdal + Ritalin) which they prescribe to all the children referred by the school. If the child’s own doctor advises against this cocktail, the school simply repeats its ultimatum to the parents: your child takes this medication, otherwise they can’t come to school. Schools may even have arrangements with officials in government to support what they are doing.

How do parents respond to the schools’ demands?

Some parents feel obliged to force their children to take the drugs required by the school, because they know that no other schools will take their child. Other parents keep their children out of school rather than subjecting them to the school’s requirements.

Wherever we’ve encountered these practices, we’ve found parents afraid to speak out publicly. Some parents fear that their child will be victimised if they speak out. They are also afraid that school leaders will talk about them to others and brand them as “difficult people to deal with”, making it hard to apply to other schools as well.

What makes chemical restraint in schools illegal?

The pharmaceuticals being used are highly scheduled, powerful medicines, not illegal street drugs. Doctors are permitted to prescribe them to children. However, certain children may suffer considerable harm from them, so parents may be reluctant to have their children take them.

In 2013, the makers of Risperdal were fined $2.2 billion for incentivising clinicans to prescribe this drug for children and elderly people. They have subsequently been fined several billion more for failing to warn people of adverse effects, as well as for the harm caused to specific individuals.

Press release by the US Department of Justice

Education is a human right, enshrined in the Constitution as well as in Article 24 of the UN Convention on the Rights of People With Disabilities. Although the medicines are approved by SAHPRA, schools may not legally require that children take them to be allowed to go to school. In South Africa, children also have the legal right to refuse medical treatment, but are seldom informed of this right.

What happens to the children who take these medicines?

We’ve had reports of schools not allowing children to go off medication even when they reported adverse effects. We are not specifying the reported symptoms here, because we are concerned that those in authority at the schools will recognise these reports and target the families who raised the concerns. Generally speaking, though, potential adverse effects of the pharmaceuticals reportedly in use in the Western Cape include headaches, seizures, aggression, irregular heartbeat, vomiting, dizziness, and weight loss or weight gain. Some boys develop extremely large breasts. A small number of people have died from the use of these pharmaceuticals.

Some children who come to school unmedicated are allegedly told to not come into the classroom. They remain on the school grounds without tuition.

Our campaign to stop chemical restraint

The immediate goal of our campaign is to stop chemical restraint in schools in the Western Cape. We hope that our efforts will inspire people in other provinces to address this practice throughout the country. We’ve chosen the #StopChemicalRestraints hashtag (note the plural), because it is already in use on social media by related campaigns in other countries. In this way, we can support each other’s work.

We’re not trying to prevent parents from giving their children medicine. We’re only working to stop schools from coercing parents to do so.

Why we’re getting involved

Parents talk to us.

South Africa—and Africa in general—has a dire shortage of schools equipped and willing to accommodate disabled children. To change this situation, we shouldn’t just multiply the schools we already have, along with all their problems. We should improve the schools we already have, so that they truly meet children’s needs, and create new schools that don’t have these problems.

The Autistic Strategies Network exists to promote strategies that autistic people say work for them. Coercive drugging doesn’t work for us. We can help schools work towards ways that do work for autistic children.

Our approach

Chemical abuse is one of many institutionalised abuses perpetrated against autistic children. Because ableism is so entrenched in our culture, it is difficult for many people to recognise such practices as wrong.

We want to understand the struggles that teachers experience, that contribute to schools turning to such practices.

We hope to educate people responsible for autistic children (including parents) about ableism, and to show what an anti-ableist education looks like in practice. We’d like to support schools that struggle to meet the needs of autistic children by helping them discover autistic strategies—approaches that autistic people say work for them.

Some children subjected to chemical restraint in the province may be nonspeaking, and have no reliable alternative means of communication. We confer regularly with nonspeaking autistic activists who shape our understanding of their challenges, and inform our recommendations.

As part of the process of understanding the extent of the problem, we support the creation of structures that would make it easy for parents to report abuse and coercion by schools.

We recommend starting with a moratorium on prosecutions, in the hope that people involved in this illegal practice will come forward and enter into discussions about better ways of dealing with disabled children who don’t fit their current model of support. We hope to reach not only schools, but also clinicians and other parties involved in the restraint pipeline.

Getting involved

We’re working with a task team convened by the Western Cape Network on Disability to bring together people (including representatives of government) who can address the problem of chemical restraint in schools.

We’ll soon will be holding a virtual meeting to start the process of change. If you’d like to join the meeting, contact Natalie Johnson (Coordinator of the Western Cape Network on Disability) at +27 (0)61-602-7256 or info@wcdisability.org, and mention the #StopChemicalRestraints campaign.

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