Ending the abuse of autistic people and people with learning disabilities

The Autism Alliance is advocating for real change for autistic people and their families. Although over the past 15 years there have been successive Government strategies to improve autistic people’s lives, the most important outcomes – health inequalities, education and employment outcomes, the proportion of autistic people in long term inpatient care – are not improving as they need to.

The most disturbing of these failures is the continuing abuse of autistic people and people with learning disabilities. As this article in today’s Guardian makes clear, despite reviews, action plans and commitments, it has not stopped. The response to the appalling case of Winterbourne View in 2011 was supposed to put an end to this shocking practice. It failed.

To achieve real change requires system-level reform. The underlying causes of poorer outcomes and substantial inequalities for autistic people are complex and inter-related, and act across the system: accountability, funding, culture.

In the same way, abuse will only end with system reform. Stronger guidance, targeted initiatives, even reviews of individual cases of abuse, are too often like a drop of water into the ocean. They make no difference if the underlying causes and enablers of this behaviour are not identified and addressed.

Accountability is too weak. Providers whose staff are proven to have committed abuse should face mandatory tougher penalties, without exception. And there should be a single Minister with personal accountability for ending abuse in care, reporting regularly to Parliament on progress.

There needs to be a step change in provision in the community that provides the high quality, compassionate care and support many autistic people need, so that they don’t need to be admitted to long term secure facilities. This needs funding reform, rapidly redirecting funds towards timely early support and crisis prevention.

There must be a comprehensive Government strategy for social care. As part of this, the social care workforce needs to be properly paid, and valued both by the Government and by society as a vitally important skilled profession. Without addressing the gap in pay and conditions, it is more challenging to address unacceptable behaviour amongst a tiny minority.

And as well as mandatory autism training for all staff working in health and social care, there should be a programme of culture change, using leadership transformation and peer learning to build and maintain the right values and behaviours everywhere in the workforce.

There is another ingredient to this change. Attitudes to autism across society continue to improve, and while there is a long way to go, awareness and acceptance of autism continue to grow. We must harness this social change for the good, promoting positive and empowering language and behaviour at all levels in society, and across all public services; and including autistic people in every area of life, including policymaking. Social change is beyond Government, but reinforcing the change is where Government must show a lead.

The continuing abuse of autistic people and people with learning disabilities is abhorrent. It has to end. But it will only end if we take a system-level view of the problem, and take decisive steps to address its causes head on.

Real change needs real reform. Is there a Government prepared to step up and make this happen?