Autism Community: Mental Health and Suicide
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The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)
I have greatly enjoyed listening to the debate, because I have heard so much good common sense and so much passion and care expressed about this important issue. It has been a pleasure. I am glad that we reached it in the end, although it was slightly truncated.
I congratulate the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) on securing the debate, and I congratulate all the other Members who have participated in it. Everyone was absolutely right to say that we need to understand more about mental health, autism and suicide, and to understand more about what constitutes appropriate mental health treatment and treatment for people with autism. The existence of the suicide statistics, unpleasant as they are, demonstrates that we really must do better in this regard.
As I have said, I enjoyed all the speeches today, but I pay particular tribute to the hon. Member for East Kilbride, Strathaven and Lesmahagow for the expertise and the personal passion that characterised her arguments. She has given me a lot to think about, but let me reaffirm to her that my door is always open so that I can hear more. I particularly want to hear what the strategy in Scotland has delivered, because she is absolutely right: when we see good practice, we should all share it and ensure that it becomes the norm for everyone.
We can never debate autism without considering the issue of waiting times, and, as Members have pointed out, in some areas they are very poor indeed. As we have confirmed, we will be publishing more data from April which will provide us with the tools with which to “give challenge”. However, it is clear that waiting times are not good enough, especially in the north-east, and we are failing people when we do not give them an early diagnosis.
The hon. Member for Cardiff West (Kevin Brennan) mentioned the criminal justice system, which is where people with autism and mental health issues often end up. As he said, we need to improve the sensitivity with which the criminal justice agencies deal with such conditions. I can tell him that the Ministry of Justice is working with the Home Office and the Crown Prosecution Service to develop new guidelines to help officers to support people. I think I need to do more with the MOJ to ensure that we do not put people in a setting that will damage them further, but I am pleased that there are now liaison and diversion services covering 80% of the country to achieve exactly that.
The hon. Member for East Kilbride, Strathaven and Lesmahagow also described very well, as did the hon. Member for Washington and Sunderland West (Mrs Hodgson), how for some people with autism accessing support from GPs can cause distress in itself. This is where debates such as this can be so useful, because sometimes the most simple, practical things can make the biggest impact. It surely cannot be beyond the wit of any of us to make sure that GPs receive appropriate advice about things like lighting, and even having a quiet area. We often now have multi-service GP and health centres, and there must be space in them to have a quiet area.
Mrs Moon
One of the risks is that, rather than going to their GP, people will look on the internet, where, sadly, they will find far too much information about how to take their own life and what methods to use. Also, if they go into chatrooms to share, they find encouragement to take their own life. This is an area that we must tackle.
Jackie Doyle-Price
I thank the hon. Lady for that intervention and the work she does in this area; I know she cares about it a great deal. She is absolutely right that there is a serious vulnerability among people who feel uncomfortable about accessing medical care. We must consider the proximity of the internet where it is possible to buy drugs and where nobody really understands what they are buying. We can do a lot more to enable people to protect themselves. The internet is a great source of information, but it can be less than benign when people want to use it for these purposes.
I have limited time and know I will not be able to do justice to all the contributions to the debate, but I will do my best. If I do not cover them all, it is not because I have ignored any of the points raised; rather, it is because there were too many good speeches to address in a short space of time.
The hon. Member for Bristol West (Thangam Debbonaire) made some extremely good points. She rightly highlighted the issue of unemployment, and I, too, am particularly concerned about that. We have just published the work and health strategy, and this is an area where we need to do better. The reality is that there is a great skillset here for particular disciplines, and enlightened employers recognise that. We can do a lot more to spread good practice here, as with GP surgeries, such as about what would be sympathetic interview styles for people with autism, so that we can enable them to become integrated. The hon. Lady is right that work is probably the best tool with which to protect our mental health, and we will look at that.
I was also intrigued by the hon. Lady’s autism surgeries, and wonder whether she might consider making that a toolkit that all of us with an interest in the issue could roll out in our own surgeries. Again, a lot of this is about raising awareness of the challenges people with autism face. We are in the public eye and have the ability to do that, so I ask the hon. Lady to tell me how she organised those surgeries.
My hon. Friend the Member for Bexhill and Battle (Huw Merriman) rightly mentioned schools. There is a problem with provision, and whether we always get it right—whether it should be mainstream or alternative provision, and whether we have enough places for alternative provision if that is the appropriate setting. That is particularly challenging in my local area, but it is not fair to fail individuals by excluding them because maintaining them in mainstream schools is either challenging or not appropriate for them. The state needs to ensure they get appropriate schooling.
My hon. Friend the Member for Berwick-upon-Tweed (Mrs Trevelyan) spoke at length about her own experience and set me a number of challenges. I will be happy to report to her on them. I can also give her every guarantee that the data she asked for will be made public next year.
I shall now turn to some of the things we are doing to develop the autism pathway and autism strategy. We have set an expectation in the NHS mandate that the NHS will reduce the health gap between people with mental health problems, learning disabilities and autism and the population as a whole, and support them to live full, healthy and independent lives. We acknowledge, however, that the complexity of autism and the multifaceted nature of the needs of those on the spectrum poses particular challenges to professionals and commissioners. I am keen that mental health should be considered by the new task and finish groups that are being established to implement the autism strategy, and I will ensure that progress is made in implementing the strategy in line with the Autism Act 2009.
It is important that the NHS accommodates the requirements of vulnerable groups such as autistic people through staff training, awareness raising and reasonable adjustments to services, as we have heard. Autistic people should be able to access mental health services like everyone else if they are supported to engage with services and helped to explain their problems so that they can receive treatment. They should not fall between two stools—between autism or learning disabilities services on the one hand and mental health services on the other. We need to ensure that we are giving bespoke treatment and care to people with both issues.
A lot of the treatments that we are developing in mental health will not be suitable for people with autism. We are therefore looking at what we can do to alter the psychological therapies that are available to make them more user-friendly and sympathetic to people with autism. I was horrified to hear what was said about group therapy. I am a lay person, but it is pretty obvious to me that group therapy is not appropriate for people with autism. Clearly, the fact that that is happening is an indication of how much more we have to do to ensure that society is more sensitive to the needs of those people.
I am running out of time, and I really want to hear from the hon. Member for East Kilbride, Strathaven and Lesmahagow, but I just want to emphasise that research will play an important role. We are looking at many projects at the moment. There is a research theme on neurodevelopmental disorders, and a project at Avon and Wiltshire Mental Health Partnership NHS Trust looking into guided self-help for depression in adults with autism, as well as work at Leeds and York Partnership NHS Foundation Trust. In the East of England, a project is being led by Professor Simon Baron Cohen focusing on suicide, autism and autistic traits, which will obviously be of interest to everyone who has participated in the debate today. I am grateful, too, for the research undertaken by Autistica, which has really highlighted this issue and brought us to where we are today. I am pleased to say that Autistica has met the national suicide prevention strategy advisory group, which advises the Government on the national suicide prevention strategy, to talk about its research. We will be reflecting on the advice that it has given us.
I thank everyone once again for participating in the debate. As I have said, I am always interested to hear about good practice and what more we can do. Rest assured, we still need to do much more to support people with autism, and particularly to ensure that they can access appropriate mental health services.