Learning Disability and Autism

Our charity fully supports the idea that Scotland’s mental health law needs to change for autistic people and people with learning disability and we welcome the work undertaken by the Review and the principles behind the proposals which have been made.

We support a number of the proposals brought forward, particular those around the monitoring of decisions and how the law should apply to autistic offenders. However, we also have a number of concerns with the Review’s suggestions and sought to make the views of our charity and autistic people in Scotland clear in a constructive manner during Stage 3 of the process.

We’ve summarised some of the key points we raised in our response below:

Autism and mental health

We support a move away from regarding autism and learning disability as ‘mental disorders’. However, we have some serious concerns over the terminology being proposed. Firstly, we find the proposed term ‘autistic impairment’ to be problematic and misleading - any impairments experienced by autistic people are not the result of their autism but of external factors in a world that is not yet autism-friendly. We are also concerned about the use of the word ‘impairment’, with a growing number of autistic people rejecting this term when used in relation to their autism in any way.

We find the suggestion that autism could be said to cause ‘temporary autistic disability’ also problematic. We are concerned that this appears to imply that it is a person’s autism which is the cause of any stress, distress or limitations when, again, it is the result of external factors. We also have concerns that this terminology would give the impression that autism can ‘flare up’ and could lead to a situation where professionals have an option to simply assume any mental health crises is the temporary result of autism.

We recommend a reconsideration of this terminology with greater emphasis placed on the external and societal factors that lead to so-called ‘temporary autistic disability’.

Decision making

We welcome the suggestion of an enhanced role for ‘decision makers’ and unpaid carers but believe the Review is required to provide further clarity on the safeguards which would be implemented to ensure that the best interests of the individual were central to the process. We also believe further clarity is needed on how the proposed statement of rights, will and preferences would be compiled and what the process would be in situations where an individual could not give such a statement and did not have an unpaid carer or independent advocate able to contribute.

We support the suggestion of a greater role for independent advocates in theory but fear that not enough consideration has been given to the lack of access to efficient independent advocates across Scotland, with both geography and funding not being taking properly into account in the Review.

Support, care and treatment

Our charity fully supports the good intentions of the Review but, again, we find the lack of clarity concerning, particularly the lack of recognition that those living in more isolated locations have less access to services. We contend the suggestion that women in particular need better access to diagnosis – we would argue all autistic people need better access to diagnosis – but, instead, believe the biggest barrier for autistic women is a lack of awareness in society in general, with the perception of autism as a ‘male condition’ still all too common.

We support the offer of Co-ordinated Support Plans to autistic children as proposed in the Review to but feel compelled to highlight that CSPs are not currently achieving a high success rate and proposals to improve this rate should be factored into the Review’s findings.

Our charity agrees with the suggestion of a legal right to services but believe it would be a step which is both minor and trivial without accessible services in the first place and we believe the Review should take this into account.

Where support, care and treatment happens

We are fully behind the Review’s proposals around community support and are encouraged by the good intentions behind the suggestion of ‘safe spaces’. However, we are left disappointed by the lack of further detail on what these would look like and how they could be made both accessible and sustainable. Similar concerns for us lie with the proposals around ‘secure support centres’ – an idea that, although welcomed in principle, remains without a lack of clarity and detail around how these would work in practice.

The National Autistic Society Scotland finds the Review’s proposal of a national autism service to provide support and advice to professionals to be somewhat misguided and we remain unconvinced that this is the correct way forward. We would support a far more effective and efficient approach, focussing in particular on accountability measures as well as advice and support, rather than the broad and potentially unsustainable approach being proposed.

Detention and compulsory treatment

The National Autistic Society Scotland is incredibly disappointed by the Review’s assertion that ‘Scotland is not yet ready to end all detention on the basis of disability, or all compulsory treatment, in a safe way’.

This point of view is in direct opposition to our charity’s stance on detention and compulsory treatment - no one should be detained on the basis of disability and we will continue to make this case loudly. We have urged the Review to seriously reconsider its stance on this point.

For more information on the Independent Review of Learning Disability and Autism in the Mental Health Act, please click here