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The National Autistic Society (NAS) is calling on the government to reform mental health law after a Channel 4 documentary revealed serious failings in care and abuse in mental health hospitals across the UK.
In the documentary, Locked Away: Our Autism Scandal, Dispatches investigated why autistic people are still being locked away in hospitals when it is well-known that hospitals are not the right place for the vast majority of autistic people.
“If autistic people have a mental health crisis, inpatient treatment on a psychiatric ward in unlikely to help. The noisy, chaotic environment often makes us worse, and once you’re in that system, you can end up trapped, sometimes for years,” said Richard Butchins, who led the investigation.
This means that when autistic people are going through a mental health crisis, they often avoid getting support from healthcare professionals due to fears they will be sectioned under the Mental Health Act and detained in hospital.
They can then be stuck without any mental health support, which is particularly concerning considering autistic people are six times more likely to experience a mental health crisis compared to the general population and nine times more likely to take their own lives.
Mr Butchins, who is autistic, got in touch with four autistic patients who are currently or have recently been an inpatient in psychiatric hospitals. Amy, Dannielle, Lauren and Shaun all sent in videos explaining what affect living in a hospital has had on them.
22-year-old Amy was diagnosed as autistic at 11 years old, and has been treated for OCD and eating disorders over the last nine years. She is currently detained at the Breightmet Centre for Autism in Bolton.
The Breightmet Centre is meant to provide care tailored to the needs of autistic people which isn’t available on a general psychiatric ward, but Amy says “it’s all about punishment.”
She says her eating disorder has gotten worse since being in hospital, and there isn’t a day that staff members do not use restraint. Sometimes, staff will threaten patients with restraint to get them to conform, Amy says.
“They’ve chucked me about … they will nip you, they have pulled my hair out, they will push your wrists down,” she said.
In March, the CQC found that Breightmet was not safe, caring or effective, rating it inadequate overall. The review found that staff laughed at people and used “disproportionate” levels of restraint. But the centre is still open, operating under ‘special measures’.
Dr Salim Razak, a consultant psychiatrist, says people should never be threatened with restraint. “Holding someone in forced flexion, inducing pain, using punishment, or using threat – all of those I would term abuse,” he said.
After Breightmet were told Amy had taken part in the documentary, her situation worsened. They took her phone, but when she got it back, she sent photos of bruises covering her arms.
The CQC are now inspecting Breightmet again, and Amy has been moved to a new hospital in light of the documentary’s findings.
Lauren was just 21 when she took her own life inside a psychiatric intensive care unit. She had anxiety and OCD, and while Lauren’s mum Lindsey knew she was autistic, she had not received an autism diagnosis.
She was told she would be fast-tracked for therapy if she voluntarily admitted herself to a psychiatric hospital, but Lauren’s mother Lindsey says she didn’t receive any therapy while she was in hospital. She tried to discharge herself after just a few weeks in hospital, and then she was sectioned.
Lindsey says the fact that Lauren didn’t have an autism diagnosis meant she was receiving the wrong treatment. She then paid for Lauren to have a private autism assessment, which confirmed that she was indeed autistic. But by this point, Lauren had spent years in and out of psychiatric institutions, and she had begun self-harming.
She was transferred to an adult ward when she was 18, but at this point, Lindsey was told that Lauren had ‘childhood autism’, and the hospital tried to remove her autism diagnosis. She was then moved to a psychiatric intensive care unit, where her condition deteriorated even further.
“I begged the doctor not to move her, I told the commissioning group it would end up in the worst case scenario, which tragically, I was right, and it did,” Lindsey said. “She was an autistic person that was cemented in a mental health system that simply isn’t equipped for autistics.”
“I regret the day I ever asked for help, they took away my child and I believe if we were listened to right at the very beginning, then Lauren would still be here,” Lindsey said. “She wasn’t listened to, nobody took her seriously, nobody took me seriously, and our cries for help went unheard.”
In a video Lauren made before she died, she said: “If you’re struggling please ask for help before it gets too late. I feel like if I’d had the right support then maybe this wouldn’t have happened.”
Shaun had a mental health crisis last year and was sectioned and admitted to a general psychiatric ward. While he was in hospital, he sent a video to Mr Butchins, saying: “I’d rather be dead than be in here, because it’s hell.”
During his time in hospital Shaun lost his home, so by the time his mental health had improved, he had nowhere to live and couldn’t be discharged.
He was forced to spend three months longer than necessary in hospital, until the council found him somewhere to live. Although Shaun has been given a care plan, none of the objectives in the care plan have been met, and Shaun does not have a mental health team to lean on for support. He is now living completely unsupported in a one-bedroom flat on his own.
25-year-old Danielle was diagnosed with an eating disorder at 12 years old and was diagnosed as autistic at 19. She is currently sectioned in a psychiatric hospital 320 miles away from home.
Danielle was first admitted to hospital 13 years ago, meaning she has spent half of her life locked away, with no freedom.
There are very few facilities in the UK specifically for autistic people – only 237 are for autistic people out of the 18,000 mental health inpatient beds.
Danielle is currently at the Mitford Unit, a specialist adult inpatient unit located on the Northgate Hospital site. Danielle said she had high hopes for change and help when she came to the hospital, but sadly, this has not happened.
“In the 18 months that Danielle has been at Mitford, she’s just deteriorated, in almost every possible way,” said her mother, Andrea.
Now, Danielle has been taken to a ward at a nearby general hospital, as she’s refusing to eat. She is currently being surgically fed through a tube.
“After 13 years of trauma and neglect, she can’t see an end to it, so she’s been starving herself. She just wants this to stop,” Andrea said. “She’s so tiny, she’s so frail, she looks like an old lady, her hair is falling out. She’s just skin and bone.”
Before Danielle was at the Mitford unit, she was an inpatient at the Littlebrook hospital. She was kept in long-term segregation for the entirety of her stay – a total of 551 days.
“She was heavily drugged, and because she was so overwhelmed, she would seriously self-harm,” Andrea said.
Andrea also revealed to Dispatches that during her stay at the Littlebrook hospital, Danielle was taken to areas where there weren’t cameras, and was molested and raped by members of staff. And this was not an isolated incident, Dispatches found that 18 sexual assaults and 24 rapes at Littlebrook hospital were reported to the police between 2020 and 2023.
One agency nurse was reported to the police and their employer, but no charges have been bought in any of these cases, including Danielle’s.
“Being in hospital has terribly affected her mental health, the trauma and abuse she suffered caused irreparable damage,” Andrea said.
Tim Nicholls, Head of Influencing and Research at NAS, says the findings of the documentary are “unbelievably distressing” and “harrowing”.
“It is the latest in too many examples of autistic people being locked away in seclusion and subjected to abuse in mental health hospitals. This scandal must end,” he said.
NHS data has revealed that there are currently 1,290 autistic people in mental health hospitals in England. This is an increase from 2015 when autistic people made up 38% of the number in hospital – now it is 63%.
NHS England says it is “committed to transforming the care received by autistic people” and reducing the need for hospital admission with £120 million of new funding., as well as additional support to discharge patients promptly when they are medically fit to leave hospital. They have also commissioned reviews to ensure local services are operating safely.
However, Mr Nicholls says NHS England and the government must do more: “Government must reform mental health law as soon as possible, and provide urgent and meaningful funding for the social care system, so that autistic people get the support they need to avoid hospital in the first place. But for anyone in hospital, anything other than compassionate and highly skilled care is completely unacceptable.”