People with Learning Difficulties and Autism: Detention in Secure Settings

Lord Touhig Excerpts

Thursday 28th October 2021 Grand Committee

[Lord Touhig (Lab)]

My Lords, I declare an interest as a vice-president of the National Autistic Society.

Autism is not a mental health condition, but many of Britain’s estimated 700,000 autistic people develop mental health problems and too many reach a crisis point that could be avoided. This is often because they cannot access the support in the community that they desperately need—a point well made in the opening remarks of the noble Baroness, Lady Hollins.

Due to way the Mental Health Act currently works, autistic people are at risk of being admitted to hospital and detained not because they have a separate mental health condition but because they are autistic. Not having enough services can be the reason for an autistic person’s detention or for preventing their discharge. Yet, as we know, the Mental Health Act code of practice clearly states that hospital is unlikely to be helpful in supporting autistic people.

More than 2,000 autistic people are currently in in-patient facilities, and more than one-third of them have been flagged as no longer needing care. Once detained, the average stay is almost five and a half years. This is an abuse of human rights, a point well made by the noble Baroness, Lady Bull, just now. As a former member of the Council of Europe, a body that Churchill helped to set up to protect human rights, Britain should be ashamed of its record in this respect.

I welcome NHS England’s long-term plan to reduce the numbers to below half the 2015 levels by March 2024. However, since the plan’s publication, there has been no significant reduction in the number of autistic people in mental health hospitals. Indeed, for much of the time, the number of autistic people in such hospitals was increasing. In 2015, autistic people made up 38% of the number; now, it is 59%. Autistic people should be able to live full lives in their communities with their families and friends. The Government must change the Mental Health Act to make sure that autistic people are not detained inappropriately in hospital.

Changing the definition of mental disorder to remove autism and learning disability in non-criminal justice-related matters is definitely the right step and to be welcomed, but we must provide the right community service support for autistic people with mental health needs. This must be underpinned by legal duties to have the right levels of support available in every part of the country—it cannot be some sort of pick-and-choose system. We must make sure that all mental health services have the right training fully to support autistic people, and there is a huge gap.

I welcome the rollout of the Oliver McGowan mandatory training in autism and learning disability, which is currently being piloted, but it must go further by promoting best practice, such as work recently done by the National Autistic Society in collaboration with Mind. More than that, we need to give talking therapists the guidance they need to make those vital early interventions work much better for autistic people. What steps have the Government taken to make sure that autistic people are not left behind in in-patient mental health hospitals when they should not be there in first place? How will the Government make sure that all mental health services have the right training to provide quality mental health support to autistic people because they do not have it now? In particular, will the Minister commit to funding the full rollout of the Oliver McGowan mandatory training? How will the Government guarantee that the right community services are available in every area for autistic people with mental health needs? Will the Minister commit urgently to review and improve the commissioning of support for autistic people and people with learning disabilities? Finally, will the Minister commit to develop clear guidance for commissioners in each area and provide commissioning support for those areas that need it most?

Locking up autistic people in the way we do now is a stain on British society. We should be ashamed of it, and we should put an end to it.