Autism Your
Mental health supplement November 2014
www.autism.org.uk
mAGAZINe
ROADS TO RECOVERY People on the spectrum talk about finding healing through interests and lifestyle
AUTISM AND CRIMINAL JUSTICE
How can the system better support people with autism at risk of mental ill-health?
REAL-LIFE STORIES
People with autism bravely tell us about their experiences of mental health problems
PLUS
EXPERT ADVICE on anxiety disorders, OCD and depression Find out about the causes, symptoms and treatments
welcome ● contents
Welcome
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10 Contents
eople with autism can be vulnerable to developing mental health problems which can have an effect on their ability to lead a happy life. One example comes from the survey of adults with autism we did for our Careless campaign earlier this year, in which 66% of respondents said they have felt depressed because of loneliness. There are many different types of mental health problem. You can find information and advice on some common ones affecting people with autism on page 9. Take a look at page 14 to read stories from people who have struggled with mental health problems first-hand. Also, on page 20, three people with autism tell us how interests and alternative strategies have made a big difference to their mental health. It’s important that people do not feel that they are having to face the associated challenges of autism and mental health problems alone. I’d like to thank everyone who contributed their story to this supplement – as well as all the people who responded to our request for stories – for their willingness to share their experiences with our readers. If you’d like to share your story, please email yourautismag@nas.org.uk.
4 Introduction
I really hope you find this supplement interesting and helpful. Finally, I’d also like to thank our sponsors and contributors, South London and Maudsley NHS Foundation Trust.
20 Interviews: Criminal justice
5 Advice: Understanding Anxiety and OCD 10 Feature: My life 15 advice: Understanding depression 17 Feature: Wellbeing
23 Update: Children and young people in need
Eleanor Wheeler Editor, Your Autism Magazine Mental Health Supplement
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The National Autistic Society is a charity registered in England (269425) and in Scotland (SC039427) and a company limited by guarantee registered in England (No.1205298), registered office: 393 City Road, London EC1V 1NG
Disclaimer: In the interest of providing the widest possible range of information to readers, we may include details of some of the many approaches to autism now available. However, this does not imply NAS endorsement of any particular approach or product.
Copyright © The National Autistic Society 2014
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IntroductIon â—? AutIsm And mentAl heAlth
HOT TOPIC
Mental health and autism in the news AwAreness is growing around the importance of having adequate support services in place for mental health needs. But understanding the complexities of mental health problems when they occur in people with autism needs specialist understanding and support.
international medical journal showing that autism costs the UK more than heart disease, cancer and strokes combined. These costs include medical and social care and the associated costs of unmanaged mental health difficulties, such as lost productivity in employment and education. Our Research on the costs of autism for charity worked with the UK made headlines this summer the Government to At the moment, there is a shortage of achieve the Autism Act 2009 and the local mental health services for people 2010 and 2014 Autism Strategies. These with autism in the UK, particularly for recommend needs-led services for adults. There are even fewer mental people with autism in the UK, including health services specifically for people mental health services specifically for with autism. people on the spectrum. This summer, the London School *For a full reference, visit of Economics and Political Science www.ncbi.nlm.nih.gov/pubmed/24911948 (LSE) published research* in a leading
The role of GPs Autism wAs mAde a clinical priority by The Royal College of GPs this year, leading to a greater focus on education, training and resources about autism for GPs. It is hoped this will help GPs to enable people with autism to access the right mental health services for them. Your GP is the gatekeeper to getting help and support. If you or your family have concerns about your mental health but are not under the care of a local autism team, your GP is your first point of call. They can discuss your concerns with you and refer you to the most appropriate mental health team.
Contributors our thanks go out to everybody who contributed to the supplement, including the following professionals. Dr Juli Crocombe, St Andrews Healthcare (pages 20-22) Juli is a Consultant Forensic Psychiatrist in Neurodevelopmental Psychiatry and Clinical Director for Autism and Consultant Dr Dene Robertson, Dr Anastasios Galanopoulos, Psychiatrist. She Ms Debbie Spain and Dr Clodagh Murphy, is also Chair of the Maudsley Hospital Adult Autism and ADHD Advisory Board Service (pages 5-8 and 15-16) to the All Party The team of Psychiatrists at the South London and Parliamentary Maudsley Hospital Adult Autism and ADHD Service Group on work with people with autism, ADHD and mental Autism. health problems in London. 4 | mentAl heAlth suPPlement
Michael Beasley, CWP NHS Trust (page 22) Michael is a nurse working in the Forensic Support Service as part of the Cheshire and Wirral Partnership NHS Trust. He has a degree is psychotherapeutic interventions and a post-graduate certificate in the assessment and treatment of sex offenders.
FeatURe ● Real StORIeS
My life Living with mental illness
We asked four individuals – Thea*, Sophia, Paul and Tammy – to tell us about the difficulties they’ve had with mental health problems. We’d like to thank each of them for having the courage to share their experiences, in the hope that others may read them and feel they are not alone.
By Heidi AHo
Thea’s story I’m 19 years old and have Asperger syndrome, dyspraxia and OCD. In the past I have suffered from mental health problems and continue to suffer from depression, anxiety and obsessive behaviour. One of my biggest issues which constantly affects my life is the obsessions I have with people.
*The name of this individual has been changed to protect their identity.
“When I was in primary school, my teachers and parents thought I had Asperger syndrome because I didn’t make friends easily, was fairly emotionless and highly sensitive to noise. But it wasn’t until I was eight that I was diagnosed. “When I was 12 I started to have constant obsessive behaviour which has continued ever since then. My obsessive behaviour has affected pretty much everything in my life. It has ruined friendships, relationships and my general education; I was removed from two schools because of it. Not forgetting all the trouble it got me into along the way! I had CBT for a while but I didn’t really engage with it as I didn’t feel
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comfortable talking to the male psychologist, so in the end I had to stop. “I’ve also had depression on and off since I was 14. The depression has prevented me from carrying out day-to-day life; it makes me want to just sit at home and do nothing. In the past it has made me selfharm and consider suicide. When I was at secondary school, I saw a psychologist a few times. However, I was so obsessed and depressed that I didn’t want to engage with it. A couple of years later I saw a psychologist again and this went well for a while, but afterwards I started to get more obsessed and depressed. “In recent years my anxiety has really affected me. It causes problems for me as I will just sit and worry about something all day. It has also affected me at work and I have been signed off a couple of times for anxiety. “As an adult I have decided to take antidepressants for the first time which help with anxiety. I am also on the waiting list for adult mental health services. When I was younger I felt the help I received just made it all worse. But I’m in the process of trying again now.
FeatURe ● Real StORIeS
Sophia’s story I am an 18-year-old female with an autism spectrum disorder. I have also suffered from obsessive compulsive disorder (OCD) since the age of five, although I was not diagnosed until I was 15. “My issues with anxiety began when I was very young. I would obsessively ask my mum if she had remembered her keys, shut the windows and locked the doors. Instead of playing with my toys, I would line them up and order them. I was obsessed with puzzles and crosswords and had little interest in interacting with other children. “As I got older, my anxiety became allconsuming. I performed physical and mental rituals on a daily basis. I started to feel very low, and turned to self-harm as a way of coping. I was struggling through school and my panic attacks were becoming more frequent. A chance encounter with a teacher was the first time the possibility of being on the spectrum was mentioned. At that point, I couldn’t cope anymore and things were rapidly deteriorating. We made an appointment with our GP, who referred me to the Child and Adolescent Mental Health Services (CAMHS). “After our initial meeting, the people at CAMHS agreed that I had many symptoms of an autism spectrum disorder and so referred me for a diagnostic assessment. They also diagnosed me with anxiety, depression and OCD. I then began Cognitive Behavioural Therapy (CBT). Unfortunately, the therapy had very few positive benefits for me, so I was also prescribed medication. “An adverse reaction to this medication has left me with motor and vocal tics. After this, CAMHS did not feel that they could see me anymore. I was left to get on with it, with more problems than I had started with. “At the age of 16, I was diagnosed with an autism spectrum disorder. The diagnostic centre offered me more CBT, but unfortunately that did not work out either. I have had no professional help since then, although I was lucky that in my final years at school I met some incredible people who have supported me through the
en tried haven’t be treatments she’s e . th up ia, ve ph gi So to r t Fo rs no encourages othe helpful, but she
hardest of times. This has helped me to make the transition to university where I am now studying psychology. If you have
“I was lucky that in my final years at school I met some incredible people who have supported me” autism, navigating the world is hard enough, but mental health problems can cause extra challenges. Daily life with these conditions is tough but it is important to never give up. My experiences haven’t been great. However, I know that CBT and medication have changed many people’s lives and allowed them to manage their conditions effectively. If you can’t speak to your GP, write them a letter. They can refer you to services that could help. Don’t suffer alone.
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FeatURe ● Real StORIeS
Paul’s story I am a 56-year-old man, currently awaiting a full professional diagnosis for Asperger’s. I only recently realised that my struggles with mental health problems have been due to Asperger syndrome. “From a young age, I was told I was a different child: difficult, highly-strung, a loner. I remember getting very anxious if there were changes to my routines. “As a teenager, I would retreat into myself and my own thoughts. I frequently had physical symptoms such as migraines, dizziness, sudden panic and fear. After I left school, I had a massive panic incident. Doctors couldn’t find anything wrong and my parents said I was being ‘silly’.
“If I had one wish, it would be to rewind time, and have those close to me know the real reason why I was ‘different’” “After a period of increased anxiety and deep depression, my doctor referred me to a psychotherapist and I started group therapy sessions. I was diagnosed with a panic disorder and manic depression. I found therapy interesting: I could put on an act, as I had done in so many areas of my life, such as my work in the music business, marriage, and friendships. “By this time, I was unable to work due to my anxiety. Apart from the weekly therapy session, I would not venture out much at all. Home life was increasingly tense: my wife thought I was being deliberately difficult but I felt, as I always had, that there was something wrong inside my head that no one seemed able to explain to me. “When my marriage finally ended, I lived
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a diagnosis will be getting a formal at th s. s ue pe iss ho h ul alt Pa tal he proving his men step towards im
alone. Sometimes the ‘noise’ in my head was so bad I thought of ending it all. Thankfully, my daughters kept me going, even if as a dad I wasn’t much good at showing the love I really felt. My eldest daughter started working for an autism charity, and approached me with the possibility that my issues were associated with autism, in particular Asperger syndrome. “Having taken some tests, read books and discussed my feelings with my daughter, I recognised that many things associated with Asperger’s applied to me and my life. It was a rollercoaster of emotions, from relief, to some anger. Hopefully, if I can get the full diagnosis and talk to a professional, we could deal with my issues. “If I had one wish, it would be to rewind time, and have those close to me know the real reason why I was ‘different’. I am the same person and I managed to get here, despite the obstacles along the way.
FeatURe ● Real StORIeS
Tammy’s story I was diagnosed with Asperger syndrome very recently. I am 32 years old and have struggled all my life with difficulties I couldn’t understand or define as I had no understanding of autism before my diagnosis. “When I was a teenager I became depressed. I had no friends and cared for my parents. I didn’t seek help for the depression as I didn’t realise that I was ill. I considered suicide but didn’t tell anyone about my feelings because I was ashamed. I disliked myself because I thought I was a bad person for feeling the way I did; I believed this was why I had no friends. “Then I joined a church and my mental health improved as I met people who listened and cared about me. When my parents died a couple of years later, the depression returned and my anxiety worsened. This time I did seek counselling which helped me understand what I was going through. I also tried CBT which helped my anxiety but didn’t stop me feeling uncomfortable in groups of people. I was told I had low self-esteem and social anxiety disorder, so I continued to blame myself for my inability to function ‘normally’ in social situations, make friends and contribute in groups. “My mental health deteriorated again when I was at college and my family moved away. Although I was capable academically, I wasn’t doing well at college. I continued to struggle socially and couldn’t function in groups. “I was told I needed to build relationships and speak up more. The more I tried, the more I failed, and I became stressed, anxious and depressed. As it got worse, I saw a counsellor and learnt tools to cope with my anxiety difficulties. Again this helped a little, but the problems didn’t go away. “Eventually a lecturer, whose son is on the autism spectrum, spoke to me about autism as my son was starting the process for assessment. After talking to her I realised that many aspects of autism resonated with me. I still remember the moment I realised it wasn’t my fault; I wasn’t a failure. After my diagnosis I learnt that my difficulties won’t disappear, but I will not be so tough on myself. I will start accepting myself and continue to learn about my differentness.
Tammy’s diag nosis has he lped her feel her different more accept ness. ing of
Information and support It may be that these stories have resonated with you, and you’d like to learn more about some of the issues. • If you are having suicidal thoughts, the Samaritans can help you. Call 08457 90 90 90 or go to www.samaritans. org/how-we-can-help-you/what-speak-us-about/i-wantkill-myself. • If you have questions about your autism, call our Autism Helpline on 0808 800 4104 or visit www.autism.org.uk/ helpline. • To connect with more people with autism, join our community at www.autism.org.uk/community or subscribe free to Asperger United – written by and for people with autism or Asperger syndrome – at www.autism.org.uk/ AspergerUnited. • Mind offers information on a range of mental health issues and available support. Visit www.mind.org.uk.
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WELLBEING ● Feature
Finding a new way More and more people are recognising the importance of developing the right interests and personal lifestyle for them in order to protect against – or recover from – mental illness.We spoke to three people who’ve each found their own approach.
Girl in a Foreign Land by Rosemary Stephens
Art By rosemary Stephens I’ve had a lot of problems with my mental health in the past, mainly social anxiety and social phobias. These got so bad I ended up not going out at all without someone with me for ten years. Holding down a job has been very hard and I’ve found it difficult to deal with feelings of loneliness and abandonment, which led to depression. I decided I needed to get out in the world and that’s when I discovered how art could help me. I found a local art group and started going along to sessions. It was hard at first. I didn’t do much art at the sessions; I would go home and paint, and then show the group what I’d done every week. I kept going for a year in this way. Then I joined another group for people with mental health problems.
Rosemary’s art features on the cover.
There, I felt safe enough to start painting at the sessions themselves. Art has helped me feel better because I learned to paint or draw my emotions for the first time. I got them out on paper, then posted them on Facebook into a few art groups, where some other people saw and described the feelings I was expressing. I remember crying because, for the first time, people could actually see how I felt. After quite a lot of painful paintings, I was able to work
through them and come to terms with my feelings. I have tried so many therapies in the past and none have really helped. Neither have antidepressants. But as I started talking to people with autism in art groups on Facebook, their encouragement gave me the confidence to start venturing out of the house. I began to find it easier to talk to people – especially if it was about art and nature. I’ve even done some exhibitions at local art cafés. Art has been the major breakthrough for helping me shut off the world and go on a journey for myself. What I draw or paint is what I want to paint and how I want to paint it. It’s important to do it for yourself, not to please others. Art speaks in all languages. You don’t need words for someone to connect and you can have a voice without actually having to talk.
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FeatUre ● WELLBEING
Mindfulness By Chris Mitchell As a person with Asperger syndrome, I feel that mindfulness practice, including meditation and simple yoga stretches, has helped me to both notice and change the type of attention that I give to certain feelings and thoughts, including worrying, which can often induce anxiety leading to relapse into depression. My two favourite aspects of mindfulness practice are its simplicity and flexibility, in that practice techniques can be adapted to individual needs and circumstances. Those new to meditation may presume that it is largely done sitting cross-legged, which can discourage a person with Asperger syndrome if they experience difficulty sitting still for a
sustained period of time. However, it can also be practiced while walking. Family members and others who support a person with autism or Asperger syndrome can also be prone to stress and anxiety as well as the individual. Reducing stress in supporting family members and professionals can make a huge difference to all those involved. Managing stress through simple mindfulness techniques can help put across a more relaxed approach which will reflect positively on a person with the condition. The cost of attending mindfulness courses is prohibitive for many. But to access simple mindfulness exercises, you don’t need to go on an expensive course. There are many informative mindfulness practice instruction guides in the form of
horses By susan dunne As someone with Asperger syndrome, one of my biggest difficulties is being overwhelmed by too much human contact. Coping with people at work is about as much as I can deal with, and this means I tend to spend most of my time outside of work alone. It can get a bit lonely at times and lead to feelings of isolation and depression. That is where animals and, in particular, horses come in. I came to horses as an adult as a way of coping with post-traumatic stress following a very serious assault. They were tremendously helpful then, and went on to help me cope with autism in ways I could never have imagined. I now have my own herd of four horses and ponies and also run a therapeutic pony visiting service across West Yorkshire. There are so many advantages to being around horses. Firstly, it’s incredibly restful. I seem to enter their world, the separate time zone that
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Susan finds being around horses incredibly restful, and has four of her own.
they live in. Being around people can often feel overwhelming, draining and sometimes threatening – but with horses I feel naturally at home. All the stresses and pressures just melt away, my anxiety levels come down and I feel myself to be fully present in the moment.
online videos, books and CDs. Much of the stress experienced by people affected by autism often comes from feeling frustrated by looking for help without any success, or continually being turned down for support. Increasingly, mindfulness practice is being recognised within mainstream settings and support services. It is most effective when those seeking it avoid having initial expectations, as the benefits are more likely to arise over time through continual practice.
Through riding I’ve learned a lot of skills which are directly beneficial to autism. When I’m riding my horse, Misty, we are a team and we work through cooperation. I have to tune in and listen to him which also means thinking about things from his perspective – the ‘theory of mind’ that people with autism can find so difficult. Riding teaches you body awareness like nothing else, because your body has a direct effect on the horse. Also, the rhythmic pace of riding is supposed to stimulate the feel-good hormone, oxytocin. I’m not a scientist but I do know that when I’m riding I always feel great.
• To see more of Rosemary Stephens’ art, go to the-art-of-autism.com/rosemary-stephens-self-discovery-through-art • Mindful living with Asperger syndrome by Chris Mitchell is available from www.autism.org.uk/amazon. • Find local art, horse riding and mindfulness groups and services at www.autism.org.uk/directory.
InteRVIeW ● CRIMINAL JUSTICE
t ’ n o D erstand me
misund
For many people with autism involved in the criminal justice system (CJS), the stress of dealing with the police, the law courts and being in prison can have a particularly damaging effect on their mental health. This is made worse by a lack of awareness about autism in the system, and a failure to differentiate between behaviour caused by mental health and that relating to autism – and manage it accordingly. We spoke to two health professionals to find out more about the issues.
Dr Juli Crocombe is the Clinical Director for Autism and Consultant Psychiatrist at St Andrew’s, the UK’s leading charity providing specialist NHS care. Day-to-day, she works with people with autism who have complex mental health needs and offending behaviour. She also does research in the area.
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“One of the major challenges facing people with autism in the CJS is lack of recognition. A lot of people with autism don’t have a diagnosis – which by definition means they don’t get the right support and interventions they need to help them live in the best possible way. The other challenge, even for those with a diagnosis, is a lack of support. This means that people can get themselves into situations such as breaking the law, or being the victim of someone else breaking the law – because there just isn’t the support in place to help them. “This lack of support makes people with autism more prone to developing mental health problems. In particular, they can have extremely high levels of anxiety that can go on to cause depression – or even psychosis. Some people might become very withdrawn. Other people can behave in ways that cause concern, and this might then be interpreted as anything from challenging behaviour to offending behaviour.”
CRIMINAL JUSTICE ● InteRVIeW
o Prison may not be the best environment “Some people with autism (whether the autism is recognised or not) can struggle if they end up in prison. For some people there’s a high risk of developing mental health problems and even contemplating ending their life. It’s important to recognise these people and look at whether they would be more appropriately dealt with through a secure hospital system. It’s not unusual in my clinical work to have people admitted who were struggling in the community, committed some sort of offence, were put into prison and had a complete breakdown to the point that they have become extremely anxious, very depressed or even psychotic. If appropriate, getting such people moved to a secure hospital can help them to regain their normal functioning. However, not everybody benefits from the hospital route. For some people with autism, prison is actually quite appropriate because it’s structured, routine-bound and clear. It’s about finding the best environment for the individual.”
Lack of awareness can mean injustice “The big issue is awareness raising, from the first point of contact with police officers on the beat, to judges, prisons and right up to the Ministry of Justice itself. In addition, we need training programmes. There are lots of examples which show that, even if someone’s autism is recognised, during that first contact with the police they aren’t treated any differently to other members of the public. Lack of awareness leads to all sorts of issues – from miscarriages of justice to people getting overly heavy sentences because they are perceived as uncooperative or arrogant by people who don’t understand their communication and interaction difficulties. “These issues put people under
“If someone does have mental health problems it’s crucial to think about both the autism and the mental health issue when deciding on the best way to help them after they’ve offended.” Juli Crocombe
a great deal of stress, especially if they have high levels of anxiety anyway. In addition, being put into an unfamiliar situation quite often away from home where people don’t understand their needs can lead to further stress and a breakdown in mental health.”
Understanding the difference between autism and mental health problems “Criminal justice is an area where
We produced an awareness booklet for professionals in the CJS.
it’s so important to have an awareness of the difference between autism and mental health problems so that responses can be appropriate. Further to this, we need to be clear about when it’s a mental health issue in need of psychiatric treatment, as opposed to a behaviour related to their autism which will respond to other forms of intervention. People with autism need to be supported by those who understand their needs, and appropriate interventions might relate to their environment, sensory or communication needs. “There’s a danger that professionals sometimes incorrectly think people with autism have severe mental illness and prescribe medication. But something as simple as adapting the environment can be what’s needed, and means you may only need medication for a short period of time to see out the crisis, or not at all. It’s about everyone in the service having that awareness about autism and how to help the individual.”
The importance of diagnosis and disclosure “As a parent or carer, you may be worried that the person you care for engages in behaviours that might draw attention to themselves or potentially cause conflict with other people in a way that can get misinterpreted. If this is the case, see if there is any system operating locally with the police force or local authority that would make it clear that they have autism. Some police authorities and other agencies have alert cards. Some have a system of logging people’s needs and points of contact on their computer systems. Carrying an autism passport means that, if the police come into contact with them, they can easily find out more about them. “I know a lot of people get upset about the idea of ‘labelling’ people. It’s an emotive issue. But I think it’s
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InteRVIeW ● CRIMINAL JUSTICE
“The behaviour of people with autism is often viewed as being obstructive or dismissive and despite attempts at explanation, this can be ignored” Michael Beasley
unfortunate that we talk about it in these terms. I’d view it as giving someone the correct diagnosis to make sure that they get the recognition and support they need. If you don’t diagnose someone with diabetes, you can’t give them the right treatment and their health will suffer. If you don’t diagnose someone with autism, they’re not going to stand even a small chance of getting the right support and interventions, so you are potentially disadvantaging them. In this world of discrimination and inequality, part of the issue is making sure people with autism are understood and awareness is raised. Certainly when it comes to the CJS, if someone has autism but it’s not recognised that this is the case, the police just aren’t going to treat them appropriately.”
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Michael Beasley is a nurse in the Forensic Support Service in the Cheshire and Wirral Partnership NHS Trust. He works with adults with learning disabilities who are in contact with the CJS, or are in danger of doing so, because of their behaviour. “Where possible, our aim is to divert people away from being taken into custody or into a secure hospital while also considering their safety and that of the general public. I would suggest about 40% of the people I work with have both autism and mental health problems, particularly depression, anxiety and phobias. “A significant component of our work is raising awareness about autism in the CJS. We’ve given awareness training to custody sergeants, probation service staff, and the police force. Despite significant investment by our team, we still find there is not enough understanding of autism in the system. “The behaviour of people with autism is often viewed as being obstructive or dismissive and despite attempts at explanation, this can be ignored. This can be very traumatic for people with autism who are then more at risk of developing mental health problems. But I don’t think there is necessarily the funding for enough clinical staff with the appropriate skills to provide the right kind of support in the CJS. “The particular challenge of my job is balancing risk against the team ethos of keeping people in the least restrictive environment possible. I am very aware that in some instances there is no alternative other than custody. But this can be particularly hard when you are aware that this will mean it is very unlikely a person with autism will receive the treatment that they need. This means they are at risk of getting anxious and depressed and means they are likely to face similar difficulties when they’re released. “Despite the problems, we’re making progress. Its very rewarding when, working with colleagues within the CJS, we get a positive outcome for someone. Small steps can be significant.”
• Order our free guide for criminal justice professionals at www.autism.org.uk/shop/books-andresources-from-the-nas. • Order our autism alert cards at www.autism. org.uk/shop/books-and-resources-from-thenas/autism awareness. • My Hospital Passport is a resource designed to help people with autism to communicate their needs to doctors, nurses and other healthcare professionals. Download it for free at www.autism.org.uk/ hospital-passport.
UPDATE â—? CHILDREN AND YOUNG PEOPLE
Children and young
people in need
For many adults with autism, the mental health problems having a profound effect on their lives will have begun in childhood or adolescence. Our Policy and Parliamentary Officer explains how children with autism suffering from mental health problems are more vulnerable than ever to missing out on the right support, and what changes are afoot to address this. BY EmmA SHEPHERD Half of all lifetime cases of diagnosable mental illness begin by age 14, so mental health support received in childhood can have a significant impact of mental health in adulthood. One in 10 children who access Child and Adolescent Mental Health Services (CAMHS) have autism, but CAMHS professionals often do not have the expertise to support children with autism who are experiencing mental illness. At a time when CAMHS are struggling to meet the needs of the children and young people they support, there is a greater risk than ever that children with autism will fall through the gaps. A report recently released by NHS England found that there is currently a shortage of inpatient beds in parts of the country for children experiencing mental health problems. As a result unwell children are being placed a long way from home and their family support networks. The report also found that some children and young people are being inappropriately placed in inpatient units because community mental health services cannot offer them the support they need. Mental health charities and psychiatrists have also raised concerns about the ability of CAMHS to support children with mental health problems, because of a lack of both funding and expertise. As a result of the concerns raised, Norman Lamb, the Care Minister, has announced that a national taskforce will be set up to look at how to improve CAMHS services. The taskforce will include representatives from NHS England, the Department for
Education local councils and the charity sector as well as young people with mental health issues. Our charity is working with local communities to improve local mental health services. A recent survey by NAS Furness branch found that 70% of families in Cumbria have not been able to access support when their child was experiencing a mental health crisis. In addition, 70% of families said that their child had not received support from a mental health worker specialising in autism, and over half said that lack of appropriate mental health support had had an impact on their child’s mental health. Furness branch has passed the results of this survey to Healthwatch, and over the next few months will be working with the NHS and local authorities, as well as local MPs, to try and improve the support vulnerable children and young people receive from CAMHS. The media and political attention children’s mental health has received over the last few months can only be positive. The national taskforce will conduct a thorough review of CAMHS, and its conclusions should help to improve the support given to children and young people experiencing mental illness.
Luke* is a 10-year-old boy with Asperger syndrome. He was referred to CAMHS because he was experiencing severe anxiety and suicidal thoughts. After waiting for an appointment for four months his parents contacted CAMHS again because they were concerned for his safety. They were told that the reason he had not yet received an appointment was lack of staff. Luke attended one appointment, and then the second appointment was cancelled. He was then allocated another worker without the family being told. The family feels that the staff were not adequately trained, and failed to communicate with Luke or his family. *The name of this individual has been changed to protect his identity.
Buy our guide to mental health and autism for child and adolescent mental health practitioners at www.autism.org.uk/shop. n Young minds offers advice on mental health for young people at www.youngminds.org.uk. n For information around mental health during a transition, visit www.autism.org.uk/ mental-health-in-transition. n
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