Autism, motherhood and detention under the Mental Health Act

The Mental Health Act 2025¹ received Royal Assent in December 2025 to modernise the law governing the assessment, treatment, and rights of people experiencing mental distress in England and Wales. Key changes included people not being able to be detained for treatment in a hospital just because they’re autistic or have a learning disability, except for those who have been charged with or convicted of a criminal offence.

Other changes included ending the use of police and prison cells as places of safety, shortening detention times, and increasing involvement from patients, families, and carers.

Alexis Quinn is a psychotherapist and a manager at the Restraint Reduction Network. She has also worked as a schoolteacher for 12 years. In 2012, she experienced sensory dysregulation following the birth of her daughter and the death of her brother, which ultimately led to her being detained under the Mental Health Act in an inpatient unit. She has since written two books, including her groundbreaking memoir, Unbroken and Autistic and Expecting.

Her story is one of resilience and determination. In this interview, she discusses her experiences in the inpatient unit and what the new Mental Health Act could mean for autistic people and people with learning disabilities.

You have spoken at length about your experience in the inpatient unit, sometimes referred to as an assessment and treatment unit (ATU). Would you mind telling us what happened?

As an autistic person, I often need routine, structure, predictability and familiarity in my life. All of this was lost when two major life events occurred within a few months of each other. I became a mother, and not long after, my brother died. My sensory system responded strongly to this. Everything felt loud and bright, and I needed to run all the time. I didn’t have the understanding at the time, or even the words to frame what was happening, so I was quite fearful.

It led to a lot of repetitive thoughts and to the kinds of experiences we know autistic people have when things aren’t right for them. I sought help from mental health services, but I didn’t receive the right support. Since then, I’ve been working to raise awareness so that more people can get what they need at the right time.

Originally, your stay at the hospital was supposed to be a 72-hour break, but it turned into quite a long stint. Why was that?

What was striking was that I entered the ATU as a schoolteacher, a new mother, and the sister of a brother who had just died. As soon as those doors closed, I wasn’t those things any more. I was this patient, this risk, this illness that needed to be fixed. It was deeply dehumanising, objectifying, and quite shocking.

This led you to escape and go to Africa. How did that all come about?

I was detained in the system for nearly four years. Because I was dehumanised, I was misunderstood. I wasn’t Alexis. I was the ADHD manifestation, the autistic manifestation, the obsessive-compulsive behaviour. This kind of language was used to describe me.

The staff would respond to that with some form of restriction or by administering medication. Subsequently, a sensory overload would occur, prompting the staff to respond again by restraining me, which would increase my distress. Consequently, their response would escalate. Ultimately, I was subjected to physical and chemical restraint, as well as long-term segregation, commonly known as solitary confinement. This sequence of events was repeated over a period of three and a half years.

In the end, I was in a community placement and began reconnecting with the community. They began speaking to me and engaging with me on a very human level. When I was sectioned for another year, I decided to escape to Calais across the Channel, and from there I lived in several countries overseas.

The key point for people to understand about this was that within two weeks, I was functioning as I had before. This was because I had agency, control, and self-determination, and I was away from that unpredictable environment.

So, when you were back in a non-hospital setting, things returned to normal. Was that when you were also reunited with your daughter?

That’s right. She came just a few weeks after I landed, and we were a family again. You say things returned to normal. That was actually my human right. I always had a right to a home, to family life, and to physical integrity. After I left, I was able to regain that control and exercise familiarity and all the things we know autistic people need, which are sometimes stripped away in hospitals, especially during crises.

When I was hospitalised, I noticed that everybody had a specific incident or circumstance that had led them there. It wasn’t a spontaneous event associated with their disorder. It was something that had happened in their home life, and they hadn’t had the right support, nor had they had the understanding within the teams around them to provide it.

That’s the crucial part of this. It’s often called a meltdown, and it can occur during transitional periods. When you’re experiencing something new and don’t receive the right support at the right time, everything can spiral.

When you were in Africa, you returned to work as a teacher and obviously started a new life there. How long were you in Africa?

I stayed for five years and lived in two countries. It was about rebuilding my sense of self, figuring out who I am. Am I this disorder, this dysregulation? I needed to reconnect with myself as a person, as a mother, and as a teacher. I also needed to create stability in my home environment. It’s my house, these are my rooms, and I can go into them whenever I want. Before, I didn’t have that freedom or flexibility. Simple things were taken away from me. For example, I wasn’t allowed to boil a kettle or have a porcelain mug. Normal things. I really enjoyed teaching, and it was important to me. So it was about un-medicalising normal things in my life, and it takes a long time. What happened doesn’t leave you, as it is very traumatic.

Can you tell us more about your experiences of motherhood? How did your two pregnancies compare?

In my first pregnancy, it almost felt as if things were just happening to me. I don’t think you can ever be prepared for that kind of role change. You can plan all you like, but the real plan is to prepare for your plan not going as expected.

During my first pregnancy, I was well-read, but when I was giving birth to my daughter, I didn’t have any control over what was happening, so things kind of spiralled. I had to react rather than be proactive. It was a 30-hour labour, and I was exhausted and overwhelmed, but I had this beautiful baby on my chest, so it was also wonderful.

There were so many aspects I hadn’t expected, and I now know I didn’t have the relationships with professionals I needed. That’s not all their fault, but it’s not all mine either. It’s about that mutual coming together. I was consenting to things, but I had no idea what I was consenting to. I just needed it done because I was getting so overwhelmed.

For my second pregnancy, I opted for a caesarean. I’m not suggesting that anybody should do this unless it’s right for them. But for me, it meant I knew I was having him on the ninth of December at nine o’clock in the morning, and that I would be the first in, so there would be no delays or unknowns. It gave me a successful start, and I was able to breastfeed for three years. It was a very different experience, really born out of the relationships I had developed with professionals. I knew what I needed. I had the language to describe it, and ultimately, that’s why I wrote the book Expecting: A Guide for autistic parents, to give people that head start.

Until you wrote the book, there was little information available for autistic mothers. Why is it so important as a practical resource?

Everyone who is autistic has their own experiences, so it’s hard to speak to the whole group, but I thought it would be useful to share my experience and how it might be relevant to others.

It’s also for professionals reading that book to understand the profound powerlessness autistic people have experienced throughout their lives. You know, being labelled and treated differently, with a lifetime of being cast as a deficit or compared unfavourably to others. This breeds distrust of services, and if a person feels stuck or believes they have no agency to change things, that’s very triggering.

You have the right to make decisions about your body, and I didn’t realise I had that right during my first pregnancy. I was encouraged to mask all the time, and I consented to things I didn’t understand, which could trigger panic. Under the Equality Act and the Autism Act, consent isn’t really consent unless it’s informed. Professionals can’t examine you, investigate, or provide care and treatment unless you say yes, and it’s okay to say no. I think starting the book from that perspective makes it empowering and hopeful. Things can be different.

Did the healthcare professionals with whom you developed these relationships over time have a good understanding of autism?

I think they had an idea. You don’t need to be the biggest autism expert. Instead, you need a professional who’s willing to listen to you and build a relationship and trust with you. When you find someone like that, you can work together to make the reasonable adjustments you need. Making reasonable adjustments isn’t a nice thing to do. It’s the law.

Continuity of care was essential. Someone who provides appropriate care and warmth can make the biggest difference. People with learning disabilities have dedicated Learning Disability Liaison nurses, or they’re supposed to, but that doesn’t seem to apply in the same way to autistic people. This is quite shocking to me, considering that autistic people also face significant health disparities, and there are no dedicated nurses who specialise in autism.

Would you like to see more nurses specialising in autism?

I think it’s a problem that we haven’t got that expertise and that it isn’t available. But it is also basic core training for healthcare professionals to listen to patients, genuinely hear what they’re saying, and act on that in line with the Equality Act. That is doing a great job. If I had got the right support during my first pregnancy, I could have potentially avoided the hospital admission and saved years of trauma.

The new Mental Health Act introduces rules that allow autistic people and people with learning disabilities to be detained for up to 28 days only if they do not have a co-occurring mental health condition. Do you think this will help?

I have mixed feelings about the changes to the Mental Health Act. A few years ago, I campaigned with the National Autistic Society to remove learning disability and autism as criteria for detention. However, I didn’t know what I know now. I thought that removing these criteria would allow us to invest more in the community, build more homes, and enable autistic people to flourish. This is what everybody wants. But I didn’t realise that the appalling rates of suicide and criminalisation among autistic people are symptoms of poor community provision.

We have been trying to get community provision right since the Winterbourne View scandal, through the Transforming Care and Building the Right Support programmes. To be honest, probably long before that, and we’ve done a pretty appalling job of it. We’ve not succeeded in getting it right. Therefore, I don’t think the Mental Health Act will magically sort it out.

What are your biggest concerns about the Mental Health Act?

I worry that some autistic people will be given a co-occurring mental health diagnosis to justify their detention. I also worry that people with learning disabilities could be detained under the Deprivation of Liberty Safeguards (DoLS) framework, which offers fewer safeguards than the Mental Health Act. Another concern is that people like me, who are deemed articulate and ‘high-functioning’ autistic people, even though I can’t fold my clothes or tie my shoelaces, will be criminalised, made homeless, or made susceptible to suicide due to the changes.

For example, at the moment, instead of holding people in prison facilities, they’ll be held in healthcare facilities. But everyone knows the NHS is completely overrun. They don’t really have the space for extra beds, so there are huge holes in the plan. When I was very dysregulated after the birth of my daughter and the death of my brother, I was doing things that people were really worried about, and I was worried about them too. If the police don’t have the ability to support somebody like me when I’m in a meltdown, what is the option? I can’t go into the police cell unless I’ve committed a crime. So that could lead to an unmanaged, unnecessary escalation of risk in the community without effective intervention and support.

My concern is that the police will be forced to act and will view distress not through a medical lens but through a criminal one. In my case, I am a school teacher, and if I’ve got a criminal conviction, I can’t teach children. That’s very unfair and has huge implications for people’s lives. Many people say this gives us an opportunity to get better community support, but we’ve been trying for decades and have failed. Instead, we are removing a safety net.

Another point is that autistic people and people with learning disabilities who are currently detained under the Mental Health Act have access to Section 117, which provides aftercare. What will happen now? Will this create further discrimination against this already massively discriminated-against population? There also needs to be clarity on how long autistic people and people with learning disabilities must be discharged for before they can technically re-enter the system.

In an ideal world, what we need is the right community support. It’s that simple. But it doesn’t start when you’re my age; it should start when you’re 18 months old, when people notice that you’ve got a learning disability and aren’t meeting milestones.

There is an opportunity under the Mental Health Act to improve community support settings, but a significant shift in funding, attitudes, and investment is essential.

1, https://www.legislation.gov.uk/ukpga/2025/33/contents/enacted

Interview by Lauren Nicolle for the Spring In Focus 2026 edition, which focuses on legal issues.

To hear more about this topic, join Alexis for our free webinar, How to end inappropriate detentions, on April 29th at 1 pm

Lauren Nicolle

Lauren is a qualified journalist who writes primarily across the health and social care sectors. She is passionate about exposing the injustices faced by people with a learning disability, with a particular focus on equal access to healthcare.

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