Number of autistic people in mental health hospitals: latest data

The latest monthly Assuring Transformation NHS Digital data shows that in September 2021: 

• In total 2,085 autistic people and people with learning disabilities are in inpatient mental health hospitals in England.  
• 1,220 (59%) of these people are autistic. 

This is the most up-to-date record of how many autistic people and people with learning disabilities, both adults and children, are currently in inpatient units in England. It also shows how long they have been in for when their care and treatment is checked and what kind of unit they are in. 

This data is important because it holds Government to account on its continued commitments to reduce the number of people in these institutions.  

Despite some progress moving people with a learning disability out of hospital and into the community, the number of autistic people in inpatients facilities has increased. In 2015, autistic people made up 38% of the number in hospital, now it is 59%. 

What needs to change

Alongside autistic people and families, we are continuing to campaign for better support and services. And we are also helping autistic people and families who are detained or at risk of detention directly, via our Autism Inpatient Mental Health Casework Service for England.

The Government recently confirmed important plans to reform the Mental Health Act, which could stop people being sectioned just because they’re autistic. This is a big step forward.

But the Government and NHS also need to first stop autistic people reaching crisis point in the first place. This means investing in better social care and mental health services that actually meet the needs of autistic children and adults.  

And if someone is admitted into hospital, it’s essential that this is for as short a time as possible and that they’re supported by people who understand autism, in an environment that reflects their needs. 

Do autistic people need to be in inpatient units and why do they get ‘stuck’ there?

It is widely recognised that for most autistic people, care in an inpatient unit is rarely helpful – and can be deeply damaging. 

Wards can be noisy, bright and unpredictable. Without reasonable adjustments to the environment and support from a professional who understanding autism and how to adapt their care, it can be completely overwhelming, particularly if you have an extreme sensitivity to sound, light or touch. It can actually increase someone’s level of distress, which can lead to further restrictions and make it even harder to move to support in the community. On top of this, there aren’t enough of the right type of mental health and social care services in the community for autistic people to move into.

The average length of stay is 5.5 years. And we continue to hear alarming cases of overmedication, seclusion and unnecessary restraint. 

A History of broken promises

In 2011 shocking abuse was uncovered at Winterbourne View Hospital, an inpatient unit for people with learning disabilities. This scandal led to the acknowledgement that there is a significant number of autistic people, those with a learning disability or both, stuck, inappropriately, in inpatient settings – largely because services to support them in the community simply do not exist. 

The Government’s response came in the form of the Transforming care programme which aimed to close up to half of the inpatient mental health beds and move people back to their local communities by 1 June 2014. This did not happen.

In 2015, NHS England published a 3-year closure programme and national plan called Building the right support. This set out how the NHS and local authorities in England propose to improve the lives of autistic people, those with a learning disability, or both in inpatient settings.

The key promises they aimed to achieve by the end of May 2019 included:

• Closing 35-50% of inpatient beds for autistic people with or without a learning disability. 
• The right support would be developed in communities to support these people.

Alongside this, NHS England published a ‘service model’ setting out all the local support that should be available in each area by March 2019.

But this is still not the case. There is simply not enough of the right type of community services, which is a key reason why autistic people are still being admitted to inpatient care and why it’s often so hard for them to move back to the community. 

Future

Alongside autistic people and families, we have been highlighting these injustices and campaigning for action from the Government and the NHS for years. NHS England’s Long-Term Plan reinstates its pledge to reduce the number of autistic people or people with a learning disability in mental health hospitals.

It has also pledged to:

• transform mental health care so more people can access treatment
• continue to develop services in the community and hospitals

Mental health law

The overwhelming majority (90%) of autistic people who are detained in hospital are put there using the Mental Health Act 1983. We and hundreds of thousands of campaigners have been calling for changes to mental health law for years, so it respects autistic people’s rights. In January 2021 the Government published promising proposals for change to mental health law in England and Wales which could result in fewer autistic people being wrongly sent to mental health hospitals. This is a huge step forward.  

They sought people’s views on these changes and the Government has now published their response which you can read our thoughts about here. You can also read more about the proposals in general and what they could mean for autistic people and the Government’s timeline for changing this law here.

It’s right that the Government has listened and is taking action. But it’s important to remember that these changes will take years to come into force and, crucially, won’t on their own end the scandal of autistic people being stuck in mental health hospitals. The Government and NHS need to stop autistic people reaching crisis in the first place, by investing in better social care and mental health services that work for autistic children and adults.

Further information

• Read our news story on the planned changes to the Mental Health Act.
• Read Alexis’ story about being “locked inside” various mental health hospitals for three years.
• Read our information, advice and guidance about autism and mental health.
• Find out about our specialist helplines/casework services and other help and support.
• Find out about our Autism Inpatient Mental Health Casework Service, which provides confidential advice and support autistic people at risk of going into inpatient units or stuck in them – or their families.