The latest monthly Assuring Transformation NHS Digital data shows that in September 2023: 

• In total 2,045 autistic people and people with learning disabilities are in inpatient mental health hospitals in England
• 1,335 (65%) of these people are autistic
• There are 205 under 18s in inpatient units that are autistic or have a learning disability. Of these, 93% 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. 

Collecting this information is important because it holds the Government to account on its commitment 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 inpatient facilities has increased. In 2015, autistic people made up 38% of the number in hospital, now it is 65%.

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 – in fact, it can be deeply damaging. 

Wards can be noisy, bright and unpredictable. Without reasonable adjustments to the environment, and support from a professional who understands autism and how to adapt care, it can be completely overwhelming and increase someone’s level of distress. This 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 around five and a half years. And we continue to hear alarming cases of overmedication, seclusion and unnecessary restraint.

The overwhelming majority (92%) of autistic people and people with a learning disability 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 June 2022 the Government published a draft bill to reform the Mental Health Act which could stop people being sectioned just because they’re autistic and make it easier for autistic people in hospitals to leave. This was a big step forward. However, the Government has yet to respond to pre-legislative scrutiny, meaning the Bill cannot progress through Parliament.

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.

Several targets have been set since which have not been met. The 2019 NHS Long-Term Plan committed to halving the number of autistic people and people with learning disabilities in inpatient care from 2015 levels by March 2024. In 2022, this target was reaffirmed by the Government in its ‘Building the Right Support Action Plan’. However, the number of autistic inpatients has only increased, and it is likely this target will also be missed.

The fact is, despite pledges to transform mental health care and develop better services for autistic people, there is simply not enough of the right type of community support available. This 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. 

This month, the Care Quality Commission, regulator of health and social care in England, published its latest report on the state of care in the country. This report highlights the dire situation in social care, with record staff vacancies and pressure from the cost of living crisis meaning the gap in support for autistic people is only widening. To protect the human rights of autistic people and end the scandal of unnecessary detentions in inpatient care, this worsening lack of social care provision for autistic people must be confronted by the Government.

What is the National Autistic Society doing?

Alongside autistic people and families, we have been highlighting these injustices and campaigning for better support and services from the Government and the NHS for years. 

In 2022 we presented oral and written evidence to the Joint Committee on the Government’s Draft Mental Health Bill, emphasising how important it is to reform mental health and social care services in the community. Our contributions have been reflected in the Committee’s report and impacted the recommendations they have given to the Government.  

Most recently we launched our Time to Act campaign in collaboration with Mencap. Together we are calling on Prime Minister Rishi Sunak to reform outdated mental health law to stop autistic people and people with learning disabilities from being stuck in mental health hospitals. Whilst the campaign action is now closed, you can sign up to our campaign updates if you would like to hear about the outcome.

It’s important to remember that, if the Mental Health Bill is passed, these changes may take years to come into force. The Government needs to do more to stop autistic people reaching a crisis point. This means investing in better social care and mental health services that meet the needs of autistic children and adults. Without a fully funded social care system that provides the support autistic really people need, the scandal of autistic people being wrongfully held in mental health hospitals won’t change.  

Further information

Read our news story on the Joint Committee’s report on the Government’s Draft Mental Health Bill

Read Alexis’ story about being “locked inside” various mental health hospitals for three years.

Read our news story on the Government’s Building the Right Support Action Plan

Read our information, advice and guidance about autism and mental health.