Autism Community: Mental Health and Suicide

Sharon Hodgson Excerpts

Thursday 30th November 2017 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I congratulate the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) and others on securing this important debate and on her excellent opening speech. I thank Autistica, the National Autistic Society and Ambitious about Autism for the important work that they do and the support that they provide for people living with autism.

This is our second debate on autism since our return from the summer recess and it is good that it has been so constructive. I also thank all other hon. Members here for their excellent and passionate speeches. The hon. Members for Berwick-upon-Tweed (Mrs Trevelyan), for Bexhill and Battle (Huw Merriman) and for North Ayrshire and Arran (Patricia Gibson), and my hon. Friends the Members for Bristol West (Thangam Debbonaire), for Blaydon (Liz Twist) and for North Durham (Mr Jones), all spoke movingly, often from personal family experience or about constituents. This debate may have been short, but it has none the less been very powerful.

It is important to say that autism is not a mental health condition: it is possible to have both autism and good mental health, but that is not always the case, as we have heard. Between 70% and 80% of autistic people develop mental health problems such as anxiety and depression, and four out of 10 children with autism have at least two mental health problems.

Adults with autism who do not have a learning disability are nine times more likely to die by suicide than the general population; those with a learning disability are still twice as likely to take their own lives. Clearly, more needs to be done to support the mental health needs of people living with autism. Reducing the health inequalities experienced by people living with autism is a priority for the NHS mandate for 2017-18, and that is welcome. Mental ill health is a major contributory factor to health inequality for people with autism. Ensuring access to appropriate mental health care is important in the fight to tackle these disparities.

However, there are too often significant barriers to accessing the right treatment. In a debate in September, we talked about waiting times for autism diagnosis—it is a scandal that those can be as long as 125 weeks. Accessing a diagnosis is the first step towards securing the support that people living with autism need, and that is also true for mental health support. We are pleased that data on autism diagnosis waiting times is going to be collected and published from April 2018; hopefully, it will help to drive an improvement in this area.

Today, I want to focus on how mental health services can be improved for people living with autism. Last week, my hon. Friend the Member for Stockton South (Dr Williams) told the Health Committee about T, a young boy with autism. As we heard from the hon. Member for East Kilbride, Strathaven and Lesmahagow, T was rejected four times for treatment by child and adolescent mental health services, despite reporting suicidal thoughts and having a family history of suicide. He was rejected because he had not yet attempted to take his own life.

The Children’s Commissioner for England confirmed concerns about the issue when she stated to the Health Committee that this type of situation was now “the norm” within children’s mental health services. That is worrying generally for children’s wellbeing, but for those living with autism it is particularly so, for a number of reasons. Experiences of suicide are different in the autism community from those in the wider population; relying on certain behaviours and expectations of what someone in need of support will look like can be dangerous.

As the Children’s Commissioner put it, children with mental health problems will become adults with mental health problems very soon. We cannot continue to miss opportunities to intervene early. That means, sadly, that T’s experience is just one of many. The five year forward view for mental health recommended that NHS England develop autism-specific mental health care pathways, but there is currently no information on the timetable, the scope of the pathway or who will be leading the issue. The pathway should cover children, young people and adults on the autism spectrum. It should take into account the fact that mental health conditions can present themselves in different ways for people with autism and it should recognise that mental health treatment may need to be tailored for people with autism. I hope the Minister will reflect on that in her response. Will she tell the House when and how the pathways will be developed?

Early intervention and prevention should form the basis of our mental health services. However, too often specific issues make it difficult for people with autism to access that early support that is so vital. The first point of call for many people experiencing mental health problems is their GP; for many people with autism that can be difficult, as GP surgeries are often not autism-friendly. This is how one autistic adult described their experience:

“When anxiety is really bad I start to feel a panic attack at the prospect of just having to step out of my front door. So having to go to the GP is like having to climb Everest.”

It is important that GPs understand that every autistic person is different, and that each person may need some adjustments to be made before he or she can feel comfortable about attending the local GP’s surgery. For example, some autistic people may be hypersensitive to sound and light and may therefore need an appointment at a quieter time of day, while others may be hyposensitive and benefit from a more stimulating environment. GPs may also need to tailor the way in which they communicate with patients—for instance, using clear language, or finding ways of communicating with somebody who does not speak. To do that, GPs must be able to access detailed and accurate records about their patients’ needs. Currently GPs often do not record much information about their autistic patients, and may not even record that a person is autistic at all.

In August, the National Institute for Health and Care Excellence recommended that GPs keep a set of local autism registers similar to those kept for people with learning disabilities, asthma and diabetes. Will the Minister tell us when she expects the NICE recommendations on autism GP registers to be adopted, and whether NHS England will work to ensure that the data gathered is used to inform better commissioning of autism and mental health services?

We have heard powerful accounts today from Members on both sides of the House about what happens when we get mental health treatment wrong. It is all too easy for people with autism to receive inappropriate mental health treatment, or to be blocked altogether from access to treatment. As the Government review the Mental Health Act 1983, it is important that they consider everything that has been raised in today’s debate and ensure that autistic people are supported. The shocking suicide statistics and testimonies from Members today show starkly how crucial it is that more is done on the issue, and the power is in the Minister’s hands. I hope that she has listened and will act.