Concerns over the use of psychotropic medication and restraint, and ‘very long delays’ in discharging people with autism from hospital are being highlighted in a report from the Mental Welfare Commission published today.

Across the country, the Commission says it found individuals with autism who also have a learning disability or mental illness are often treated in general learning disability centres, mental health wards or care settings which are not designed around their particular needs.

In the first report of its kind in this area, the Commission concludes people with autism and complex needs require more support in a number of ways.

As part of their focus on the care of individuals with autism and learning disability or other complex care needs who have been subject to orders under mental health or incapacity legislation, Commission visitors spent time with 54 people living in hospital or in the community across Scotland, and spoke to medical and care staff, family members and carers.

The Commission found wide variation in assessment and post-diagnostic support, noting that ‘sometimes having another diagnosis, such as a learning disability, was seen as a barrier to proper assessment of autism’.

Mental Welfare Commission chief executive Colin McKay says the support and care on offer is not consistent across Scotland:

“The people we met had a range of complex, individual needs, and there was wide variation in the extent to which services were able to meet those needs.

“Getting it right takes time and can be expensive. But we found that getting it wrong, and failing to design services around the individual, could be even more expensive.

“Equally important, getting it wrong fails the individual and leaves professionals unable to give the high-quality care and support we know they want to give.”

Among the report’s ten recommendations is a call for action to reduce the use of psychotropic medication and restraint.

For those ready to leave hospital, thirteen of 28 individuals were waiting in hospital for suitable accommodation.

Of the 54 people met by the Commission, 45 were prescribed psychotropic medication on a regular basis, with 40 of those being prescribed regular antipsychotic medication.

Mr Mackay says the Commission is unhappy at the extent of use of some interventions:

“On the use of psychotropic medication and restraint to manage behaviours, while we cannot say that in individual cases it was unjustified, we are nevertheless very concerned by the scale of its use, and we are asking the Scottish Patient Safety Programme to work with the NHS to reduce this.

“We are also disappointed that we have again found very long delays in discharging people from hospital to community settings. This has been reported several times – we now need a clear plan to solve the problem.”