The Health and Social Care Committee has published the Government Response to
its report on the treatment of autistic people and people with
learning disabilities. The Committee’s report made a number
of recommendations against the background of Government plans to
reform mental health legislation. The Government said it had
taken the Committee’s recommendations into account in developing
its Building the Right Support action plan to strengthen
community support for autistic people and people with a learning
disability, and reduce reliance on mental health inpatient care.
Health and Social Care Committee Chair said:
“We welcome action taken by the government in response to our
Committee’s report to improve community support for autistic
people and those with a learning disability.
“Ministers accept that there must be credible alternatives to
inpatient facilities, allowing people to live independent and
fulfilled lives in their community.
“The government has agreed with us that there are too many
instances where restrictive practices such as restraint are used.
It has promised action to ensure that care for inpatients is the
least restrictive possible.
“We will look to the draft Mental Health Bill to bring about
reforms to further protect individuals’ rights and freedoms.”
ENDS
Restrictive practices: The Committee had called
for further reforms to deal with concerns that the use of
restrictive practices were commonplace in many inpatient
facilities, presenting a risk to autistic people and those with
learning disabilities. The Government agreed with the
recommendations in principle and agreed there were too many
instances of restrictive practices. It said “Where needed,
inpatient care must provide a therapeutic benefit and be the
least restrictive possible. We are taking action to ensure this.”
On inpatient care: the Government agreed with
the Committee that services should be ‘person-centred’ however
rejected calls for all mental health inpatient units used by
people with a learning disability and autistic people to be
closed within two years. It further rejected a call to implement
the Trieste model of care and did not agree that admissions to
mental health inpatient settings should be banned altogether.
However it agreed with the Committee that admissions into mental
health inpatient settings for people with a learning disability
and autistic people should be for the shortest time possible,
with reforms to the Mental Health Act seeking to prevent
non-therapeutic, long term admissions.
The Government partially accepted the Committee’s recommendation
that autistic people and people with learning disabilities should
never be admitted to inpatient facilities that had received an
“inadequate” rating from the CQC, however said that there may be
“exceptional occasions when a person is admitted to a unit rated
inadequate.” The Government said that in this situation
“additional mitigations and safeguards will be put in place to
monitor their safety, wellbeing, and treatment.”
On community-based care: The Committee
recommended that the Department of Health and Social Care offer a
credible alternative to inpatient facilities and provide
additional support so that autistic people and people with
learning disabilities can live independent and fulfilled lives in
the community. The Government accepted this recommendation
in full, stating “We agree that there must be credible
alternatives so that people live independent, free, and fulfilled
lives in their community, and there must not be any financial
incentives or disincentives which prevent this from happening.”
Independent review of
deaths: The Government did not accept the
Committee’s recommendation that they mandate an independent
review of the deaths of all autistic people and people with
learning disabilities in inpatient and community settings, saying
that there would be practical challenges with mandating this in
every case. However they “agreed with the importance of learning
from and improving quality of care to ensure that the deaths of
people with a learning disability and autistic people in hospital
are not medically avoidable.”
Detention: The Government proposes to limit the
scope to detain people with a learning disability or autistic
people for treatment under section 3 of the Mental Health Act
unless they have a clear mental health need.” A person with a
learning disability or an autistic person would only be able to
be detained for treatment under section 3 of the Act if they had
a co-occurring mental health condition that required treatment in
hospital.
The Committee’s report on the treatment of autistic
people and individuals with learning disabilities was
published in July 2021.
