Government failure on mental health detentions ‘is scandalous’ 

The government has “fallen short” on its promise to halve the number of people with learning difficulties* and autistic people detained in mental health hospitals, a committee of MPs has warned. 

The number of autistic people in such settings is even increasing, according to a report by the Commons women and equalities committee. 

One leading disabled activist called the government’s failure an “absolute scandal”. 

The report by the committee** calls for the government to “learn from previous failings” and increase support for community-based alternatives to detention in mental health hospitals, and “do more to stop people reaching crisis” that can lead to detention. 

It calls on the government to explain why the number of autistic people detained in mental health hospitals is increasing. 

In 2019, the NHS Long Term Plan pledged to halve the number of people with a learning difficulty and autistic people in mental health inpatient care by March 2024 compared to 2015 levels. 

But the report says the latest figures show 2,045 people in such institutions at the end of March 2024, just a 30 per cent reduction since March 2015. 

It says that most of this limited reduction has been driven by a fall in the number of inpatients with a learning difficulty only. 

During the same period, the number of autistic people in mental health settings has increased from 1,115 to 1,380, including an increase in the number of women from 390 to about 500 over the last five years. 

Only last month, the UN’s committee on the rights of disabled people said in a report that it was “deeply concerned” at evidence of “increasing rates of institutionalisation of disabled people, including disabled people living in secure psychiatric facilities due to a lack of community-based support”, and of “abuse, mistreatment and the increasing use of restraints, restrictive practices and coercive measures” in institutions. 

Simone Aspis (pictured), campaigns manager for Inclusion London’s Free Our People Now campaign, said the government’s continuing failure was “scandalous”. 

She said: “This government still sees people with learning difficulties and autistic people as second-class citizens.” 

She also pointed to increasing numbers of young disabled people entering the psychiatric system due to a lack of support in the community. 

She said it was a “complete scandal” how much money was still being spent “locking people up in the psychiatric system” when it could instead be spent “moving people out of hospital and into the community”. 

She said: “If they really wanted to do it, they would bring in legislation to make it happen. 

“People with learning difficulties and autistic people have a right to be living in the community and not locked up in hospital.” 

The committee’s report also says that a National Learning Disability Board was established in 2013 to improve the health and wellbeing of people with learning difficulties, and its members included people with learning difficulties, but it was disbanded by the government in 2016. 

Now the committee wants the government to set up a replacement body. 

It says this new national board should be led by people with a learning difficulty, autistic people, people with parental and caring experience, and health and social care professionals.  

Caroline Nokes, the committee’s chair, said: “The government has fallen short on its commitment to halve the number of people with a learning disability and autistic people inappropriately detained in mental health hospitals.  

“It must learn from previous failings and increase support for community-based alternatives to detention and do more to stop people reaching crisis in the first instance.” 

The report is the third and final publication that has come from the committee’s inquiry into the government’s National Disability Strategy. 

The report also focuses on the barriers that people with learning difficulties and autistic people face in accessing healthcare. 

It reports that these groups face “significant health inequalities, leading to lower life expectancy and more avoidable deaths than the general population”, while 42 per cent of deaths of people with a learning difficulty (including autistic people with a learning difficulty) were avoidable, compared to 22 per cent of deaths in the general population. 

People with learning difficulties can request to be added to the learning disability register, which entitles them to reasonable adjustments, such as support with making decisions and access to an annual health check.  

But the report says that about three-quarters of people with a learning difficulty are not registered, and “many struggle to convince their GP and practice staff to add them to the register”. 

It also calls for action to address the lengthening waiting-list for an autism diagnosis, and improve the understanding of how autism is presented in women and girls “so that they can receive the support they need before they reach crisis and to prevent misdiagnosis and inappropriate care”. 

The report also points to the employment gap for people with a learning difficulty and autistic people, with just 30.8 per cent of people with “severe or specific learning difficulties” and 30.6 per cent of autistic people employed in 2022-23.  

It says the government should improve the way its much-criticised Access to Work and Disability Confident schemes support people with learning difficulties and autistic people. 

The committee says that people with learning difficulties and autistic people who do not have an education, health and care plan should be exempted from the maths and English skills requirement for apprenticeships. 

And it calls on the government to set an employment target for people with learning difficulties and autistic people. 

*Although the committee uses the term “learning disability”, Disability News Service continues to use “learning difficulty” as it is the preferred term of the self-advocacy movement 

**Inequalities in Healthcare and Employment for People with a Learning Disability and Autistic People 

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