In cases where autism has been formally diagnosed by recognised specialists, what protections exist to ensure that neurodivergent behaviours are not wrongly pathologised by carers or professionals unfamiliar with autism frameworks—and how does the law guard against such misinterpretations influencing Mental Health Act assessments or tribunal decisions?
I don’t know the answer to this but considering the long waiting lists for autism diagnosis at the moment, I’d like to know about those currently waiting for an autism assessment too.
Unfortunately you and others may not like my perspective. The law guards nothing! How dare I say that?! I dare and I do.
The law is a bunch of text. It sits there idly. It is for human beings to use the law in relation to their knowledge and experience. And the latter is where ‘everything’ tends to fall down.
I know you want to hear something about neurodivergent behaviours and autism. You know, someone will come along soon and give you a satisfying answer.
Reality is a hard place. There is too much lack of professional knowledge about all sorts of mental health problems: ADHD, Autism, barn door clinical depression, schizophrenia etc etc.
We have loads of laws around in domains of: Equality, Disability, Non-discrimination, Human Rights, Autism Act, Health & Social Care etc. Yet, every day I see breaches of the law for people will all kinds of diagnoses including those with neurodivergence and autism.
Ignorance is the big negative force that makes the law - that text on the page - appear so limp and ineffective.
Next consider, who are the most disadvantaged groups of people - the poor and those with lesser degrees of intellect. Some believe that Legal Aid is there to give those of lesser means good access to justice. Well it doesn’t. If I had to back that up with evidence I’d need 10,000 words which nobody would read. In short real access to justice in order to activate laws requires money. Somebody has to pay. The scale and evidence of cuts - all approved by law - to the very people who most need help is unbelievable even when one looks at the facts and figures.
So my tough ‘solution’ is 1) an ounce of law, 2) a stone of education, knowledge and experience, and 3) three stone of proper funding for justice. 2 & 3 ain’t happening any time soon with a £50 billion black hole to solve, a dementia debt bomb approaching in 2040, and untold sums of money haemorrhaging via back doors to the MOD. Fortunately, the analysis of Lord Darzi’s report - the parts on ‘mental health’, which I can’t share here, would be grim reading.
So laws ain’t gonna cut it however nice and voluminous they may be. Hard times - very hard times are ahead for the most disadvantaged. But nobody likes to hear that sort of thing. Someone else is gonna come along with better news, shortly.
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Not sure if you mean legal protections - that may include the MHA (obvs), the Autism Act, The Equalities Act; regulations and local policies and procedures about short and long term seclusions etc - but there is also lots of information about the Transforming Care programme initiative (link below) available which purportedly focused on improving community-based support for children, young people, and adults with a learning disability and/or autism - particularly those with behaviours that are said to challenge or mental health conditions. Its core aim was to reduce inappropriate hospital admissions and long-term segregation by (what they said) was investing in high-quality local support, ensuring people receive care in the community, in their own homes, or/and close to their homes and families, rather than in institutions. The aim was to prevent unnecessary admissions, and the development of suitable community housing and services. There are a range of opinions about how successful the Transforming Care Programme has been. But it does include guidelines and practical responses for local public services - including hospitals.
NHS England — South West » Learning disabilities.
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I imagine the waiting list is painfully long Louise —especially given how stretched services are right now. But even once a diagnosis is secured, the challenges don’t magically resolve. Autistic people often face ongoing barriers in care, housing, and understanding. The diagnosis might open some doors, but it doesn’t dismantle the systemic hurdles. That’s why we need more than just assessments—we need informed, respectful support that actually honours neurodivergence.
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Too true, I am diagnosed autistic. My husband is currently diagnosed with PTSD and Schizophrenia but is requesting an Autism Diagnosis, we have done the EQ and AQ as the local service requires before they will assess and he comes out as probably autistic on both. However, in the meantime he is on a CTO and recently had a recall for what he believes was an Autistic meltdown. The recall ended up being 8 days instead of 72 hours, when he probably shouldn’t have been taken in at all.
It’s difficult to know what to do about it but with no speeding up of assessments to stop autistic people being detained under the mental health act, we currently can’t see any way around this.
In parts of Berkshire it was 3 years on a waiting list for ADHD assessments on referral forms. In Northern Ireland 5 years. Similar or more for autism.
From your Lord Darzi report get the big picture:
Waiting Times (mental health servcies):
- Around 1 million people were waiting for mental health services as of April 2024 (p 32).
- 345,000 referrals were waiting over a year for first contact with mental health services (p 32).
- For children and young people under 18, 343,000 were waiting for mental health services, with 109,000 waiting over a year (p 33)
Increased Demand:
- Mental health referrals for adults have been increasing at a rate of 3.3% per year.
- For children and young people: referrals have increased by 11.7% per year from around 40,000 a month in 2016 to almost 120,000 a month in 2024.
- Perinatal mental health service referrals have risen by 23% per year since 2016.
- ADHD services:
- “The growth in demand for ADHD assessments has been so significant that it risks completely overwhelming the available resource.” (p34)
- “At current rates, it would take an average of 8 years to clear the backlog in adult ADHD assessments – and for many trusts, at current rates, the backlog would not be cleared for decades.” (p 34)
- “Implied clearance time for adult ADHD assessments based on activity and wait list size.” [Chart – (Figure II.6.10) on page 34]
- NHS England has established a taskforce on ADHD, which “will have important recommendations to make.” (p 35)
- While not specific to ADHD, the report notes that between 2004 and 2023, the number of patients on ADHD medication has been increasing by just over 10% each year. (p 19)
Funding:
- Funding disparity: Mental health accounts for more than 20 per cent of the disease burden but receives less than 10 per cent of NHS expenditure (p. 85). This indicates a significant mismatch between the need for mental health services and the resources allocated to them.
- Historical underfunding: The report notes that during the first half of the 2010s, mental health services experienced significant cuts. For example, the number of mental health nurses fell for each of the five years following 2011 (p. 76).
- Mental health investment standard: Since 2016, the NHS has applied the “mental health investment standard“. This intervention has helped by protecting mental health budgets and keeping its share of NHS spending constant at 9 per cent (p. 76).
- Slow recovery: Despite the introduction of the mental health investment standard, it took until 2023 for the number of mental health nurses to return to their 2009 levels (p. 76-77).
- Treatment gap: The combination of chronic underspending with low productivity results in a treatment gap that affects nearly every family and all communities across the country (p. 85).
- Impact on inpatient services: The report mentions difficulties in finding mental health beds, which contributes to long waits for patients with mental health issues in acute hospital emergency departments (p. 85).
- Capital investment: While not specific to mental health, the report highlights a significant overall shortfall in NHS capital investment compared to peer countries. This likely affects the infrastructure and facilities available for mental health services (p. 100-101).
[..truncated - there is a whole pile more]
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Despite the inclusive language embedded in national frameworks such as Building the Right Support, the promise of inclusion rings hollow.
Autistic individuals without a co-occurring learning disability are routinely excluded from meaningful support and placed in inappropriate settings. In some cases, their diagnostic identity is altered to align with service eligibility—without reference to the original diagnosis.
This is not care. It is distortion. When diagnostic integrity is sacrificed, the system ceases to honour neurodivergence. It trades truth for expediency, and in doing so, erases the very people it claims to support.
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…I know you want to hear something about neurodivergent behaviours and autism. You know, someone will come along soon and give you a satisfying answer.
I’m not searching for satisfying answers — I already hold them. I do what I can to educate others about how autism truly shapes the life it touches. All they need to do is listen, and engage with the reports written by those whose clinical insight runs deeper than mine.
…Reality is a hard place. There is too much lack of professional knowledge etc.
There is a widespread lack of professional understanding—yes, that’s true. But it’s not the whole story. I’ve encountered both ends of the spectrum: those whose knowledge falls painfully short, and others whose expertise and insight have been a genuine gift. I count myself fortunate to have met some of the latter.
…Yet, every day I see breaches of the law for people will all kinds of diagnoses including those with neurodivergence and autism.
These injustices must be challenged by everyone affected, with every tool, every ounce of knowledge, and every shred of resolve.
…Ignorance is the big negative force that makes the law - that text on the page - appear so limp and ineffective.
Absolutely, I agree, don’t just cite the law, read up, understand it, embody it, and ensure it’s used with integrity.
…Some believe that Legal Aid is there to give those of lesser means good access to justice.
That’s not a delusion I suffer from.
…So laws ain’t gonna cut it however nice and voluminous they may be. Hard times - very hard times are ahead for the most disadvantaged. But nobody likes to hear that sort of thing. Someone else is gonna come along with better news, shortly.
That has to be tongue-in-cheek—because if we didn’t believe someone might bring better news, we’d have to face the full weight of how bad things really are. But instead of waiting, shouldn’t we be challenging it? Making it harder for the system to ignore the truth?
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