Recently there has been much activity on social media here in he UK around the use of ATUs (assessment and treatment centres) to detain autistic children and adults often for long periods of time. Adults and children with a PDA profile are particularly vulnerable to ending up in one due to them being often misdiagnosed, misunderstood and needing very specific support strategies.
I found this description of ATU’s and their flaws on the VoiceAbility website;
The reality of them is often grim especially when they are used for long term ‘care’. You may of already read the distressing account by Bethany’s Dad (parent of an autistic teen detained in seclusion at an ATU for over 2 years).
3000+ adults and children detained in this way often after extremely traumatic experiences to get their as detailed here by Libby Hill (speech and language therapist) in an article about a ten year old boy in a secure unit on his was to ATU which frankly broke my heart.
So we know the end of the story but why are so many ending up in these places and suffering such horrendous abuse such as restraint, seclusion and pharmaceutical coshes? Well I have some ideas as one of my brothers spent a period in one and my own PDA son could so easily have fallen into the same scenario if I hadn’t learnt from my families previous experience.
The reasons I believe are failures with the system from the very beginning to the moment a child or adult is locked in a seclusion cell or restrained by staff and beyond (let’s not forget even when realised the trauma of these events may never fade for the victim). Here are the issues as I see them;
- Failure to diagnose. Long waiting lists, requests for assessments being turned down, failure to recognise atypical presentations such as PDA by professionals, assement teams being discouraged from diagnoses all but the ‘worst affected’ cases, all add up to diagnoses being delayed or never being arrived at. Whatever a professionals tell you diagnoses is the key that opens the door to any kind of funding for support. Without diagnoses no support, no support equals no understanding which is the first stepping stone on the path to the ATU.
- Lack of funding for support in schools/specialist provision. This means children are being shoe horned into education that doesn’t fit them and is often causing high levels of anxiety. This can lead to autistic overload and or violent meltdowns which, without support, can lead to ATU.
- Systematic refusal of EHCP assessments. The EHCP is the document needed in order to secure long term funding for supporting a child with additional needs of any kind. Although it is in theory possible to get some support via the school or local au authority without it without an EHCP that support will not follow on to the next setting. Many believe that requests for assessments and granting an EHCP after assessment are routinely turned down (which parents have to go to tribunal) because the LA just do not have the money. All of this takes time which means autistic children who need extra support are left without it for long periods of time which can result in school failing for them and behaviours related to poor mental health developing.
- Essential support teams being cut. Many areas now have cur OT, speech and language therapists and other essential services that support autistic children (virtually no services have ever existed for adults) to overcome obstacles and inform services how to best support a child,
- Huge cuts to mental health provision. This has lead to enormous waiting lists and even children and adults being turned away which means they may go into crisis while waiting and end up being sectioned under the mental health act for their own or others safety.
- Social work disability teams being cut, in some cases completely. This means family’s do not have support leaving them desperate and vulnerable when they see their child’s mental health and well being declining. Parents may get to the point where they can no longer cope or police may be called during a meltdown because there is no crisis team to call on. This often ends up with the YP or adult in a secure unit and/or ATU even if that is against the parents or autistic persons wishes.
- Support services for autistic adults and their families are nonexistent. Once school is done with, support starts to dwindle in college and then fall off completely. Autistic people who may need additional support get none, supported living is often poor and few and far between which means autistic YP and adults can spend years in ATU because there is no where else for them to go.
- Lack of knowledge The biggest reason of all for so many needing up in ATUs and being unable to move on is lack of understanding, across the board in society as whole, in services, in education, in the workplace and in the ATUs themselves. It is this lack of understanding which leads to lack of compassion.
In summery ATUs are being used as holding pens for autistic people who have been systematically failed by the system and by society. ATU are not suitable places for autistic children and adults to live, they were never designed for this and staff do not have the training to support autistic people through crisis. As a result of these factors ATU have become (or perhaps always have been) cruel and inhuman places and as a result many, including myself believe they should not be used. If you do too please sign the partition below;
However this on its own is not enough, we need real change to help stop autistic people getting to this crisis point in the first place. A few ways this could possibly achieved are;
- Funding for the support of autistic people needs to be there in all areas.
- Training needs to be implemented in all areas especially in the areas of atypical autism such a PDA.
- Support for families.
- Access to mental health services in a speedy manor.
- A better system for diagnoses with shorter waiting times.
- And above all….understanding from society.