London Daily

Focus on the big picture.
Thursday, Jul 10, 2025

Autistic people are being locked away in institutions. A radical change is needed

Autistic people are being locked away in institutions. A radical change is needed

My panel oversees reviews into detention cases of autistic people. I see how the system fails those it should help, says Sheila Hollins, emeritus professor of psychiatry of learning disability
Not many people have to worry that their children will be forcibly removed or locked away from society. Yet this is something I do worry about. My autistic son, who also has a learning disability, experiences the world differently. I am often in awe of his perspective, and he has inspired my more than 40 years of professional and voluntary effort advocating for better understanding, care and support.

When people like my son go into crisis there is a high chance they won’t be supported at home – not because they can’t be helped to live full, valuable and meaningful lives in their communities, but because our “system” doesn’t allow for it. Instead, they may be removed and taken, sometimes miles away, to an unfamiliar inpatient setting designed to treat mental illness, even though many are not mentally ill and do not need to be in hospital.

There are currently more than 2,000 people with learning disabilities and autistic children and adults in such settings in England and Wales. These often noisy and sensory-driven environments exacerbate the more troubling features of autism, instead of providing the routine, structure and predictability that autistic people need. It is little wonder that autistic people struggle to regulate themselves and fail to thrive in these places. Many get stuck, with the average length of stay for current inpatients being five and a half years, albeit skewed upwards by some long forensic detentions (those subject to legal or court proceedings).

This week we have seen shocking accounts of one man’s 20-year detention in such a setting, traumatised by a system that has failed him. Tony Hickmott’s brave, and now elderly, parents persuaded the judge in a court of protection hearing that his article 8 right to respect for family life had been breached – and that it was in the public interest for him to be named. They talked on national news about their 100-mile journey every week to see him. His father described having to break his journey on the way home to manage his own tearful distress. His mother said they don’t smile any more. The promise of his release by next spring offers some hope for Tony, who has spent nearly half of his life in hospital, but there have been promises before and it’s years too late.

Ryan, whose similar story featured in national news last year, recently moved back home to live near his parents. Neither Tony nor Ryan have forensic histories, but they are victims of inadequate planning and a lack of safe and adequate care and support in the community. Ryan’s mother wrote to me this week : “Ryan is doing really well in his new home, and the staff can’t believe how chatty he is, as in hospital he didn’t converse much. When he goes for a drive, my son looks forward to coming back home, and my husband heard him mutter, ‘Home sweet home.’ Each day when he wakes, he goes to the living room window, looks out and smiles, knowing that at last he’s free.”

The sad truth is families are not routinely involved in the way that is the norm for patients with physical health conditions. Instead, distressed families are seen as somehow part of the problem. The families of Tony and Ryan describe being ignored and marginalised.

It’s two years since Matt Hancock, the then secretary of state for health, appointed me to advise and oversee a DHSC-managed programme of independently chaired case reviews for 77 people detained in long-term segregation. The cases examined comprised people with learning disabilities and autistic people. I work with an oversight panel of experts, including experts by experience. For legal reasons we do not know the identity of the people being reviewed.

The reviews were intended to uncover the blocks in the way of getting people discharged more accurately. The reviews started just before the pandemic began and many had to take place virtually. Despite making urgent and achievable recommendations, there has been insufficient action to get people discharged even in cases where alleged rights violations have been reported. The numbers of people in long-term segregation have increased rather than gone down.

The independent reviews are continuing, and some people have been offered a senior “intervenor” as part of a pilot to speed up commissioners’ responses. Other recommendations include that when someone is admitted a clinical contract must be agreed in advance, and those responsible for that admission should be accountable for checking the clinical pathway is effective, timely and brought to a satisfactory conclusion. Autistic people and people with learning disabilities who do have a mental illness need a specialist environment with people who understand their sensory and communication needs and also have proven expertise in their health condition.

It doesn’t take much imagination to compare expectations for people with mental illness with those for people needing cancer treatment or a hip replacement. Both need to be assessed and treated by a competent clinical team.

I began this work by holding a good practice workshop to gather success stories to inspire commissioners, clinicians and families about just how much could be achieved for someone whose needs have previously not been recognised and met. One of the outcomes was a freely available booklet called Helping People Thrive.

Shockingly, many of those responsible for implementing aspirational government policies and for making decisions about people’s care seem to have very low aspirations themselves. There is some good practice but too often the hopes and needs of autistic people and people with learning disabilities are misunderstood or considered marginal, and once out of sight in a psychiatric hospital they are literally out of mind.

A radical system change may be the only thing that will make the lasting difference needed to see all autistic people and people with learning disabilities fairly treated, with an urgent programme of high-quality service development in every locality. We all have a right to an ordinary life, and for disabled people there is a right to extra support to live an ordinary life. We mustn’t stand by and allow them to be offered less than the rest of society.
Newsletter

Related Articles

0:00
0:00
Close
Severe Heatwave Claims 2,300 Lives Across Europe
NVIDIA Achieves Historic Milestone as First Company Valued at $4 Trillion
Declining Beer Consumption Signals Cultural Shift in Germany
Linda Yaccarino Steps Down as CEO of X After Two Years
US Imposes New Tariffs on Brazilian Exports Amid Political Tensions
Azerbaijan and Armenia are on the brink of a historic peace deal.
Emails Leaked: How Passenger Luggage Became a Side Income for Airport Workers
Polish MEP: “Dear Leftists - China is laughing at you, Russia is laughing, India is laughing”
BRICS Expands Membership with Indonesia and Ten New Partner Countries
Weinstein Victim’s Lawyer Says MeToo Movement Still Strong
U.S. Enacts Sweeping Tax and Spending Legislation Amid Trade Policy Shifts
Football Mourns as Diogo Jota and Brother André Silva Laid to Rest in Portugal
Labour Expected to Withdraw Support for Special Needs Funding Model
Leaked Audio Reveals Tory Aide Defending DEI Record
Elon Musk Founds a Party Following a Poll on X: "You Wanted It – You Got It!"
London Stock Exchange Faces Historic Low in Initial Public Offerings
A new online platform has emerged in the United Kingdom, specifically targeting Muslim men seeking virgin brides
Trump Celebrates Independence Day with B-2 Flyover and Signs Controversial Legislation
Boris Johnson Urges Conservatives to Ignore Farage
SNP Ordered to Update Single-Sex Space Guidance Within Days
Starmer Set to Reject Calls for Wealth Taxes
Stolen Century-Old Rolls-Royce Recovered After Hotel Theft
Macron Presses Starmer to Recognise Palestinian State
Labour Delayed Palestine Action Ban Over Riot Concerns
Swinney’s Tax Comments ‘Offensive to Scots’, Say Tories
High Street Retailers to Enforce Bans on Serial Shoplifters
Music Banned by Henry VIII to Be Performed After 500 Years
Steve Coogan Says Working Class Is Being ‘Ethnically Cleansed’
Home Office Admits Uncertainty Over Visa Overstayer Numbers
JD Vance Questions Mandelson Over Reform Party’s Rising Popularity
Macron to Receive Windsor Carriage Ride in Royal Gesture
Labour Accused of ‘Hammering’ Scots During First Year in Power
BBC Head of Music Stood Down Amid Bob Vylan Controversy
Corbyn Eyes Hard-Left Challenge to Starmer’s Leadership
London Tube Trains Suspended After Major Fire Erupts Nearby
Richard Kemp: I Felt Safer in Israel Under Attack Than in the UK
Cyclist Says Police Cited Human Rights Act for Riding No-Handed
China’s Central Bank Consults European Peers on Low-Rate Strategies
AI Raises Alarms Over Long-Term Job Security
Saudi Arabia Maintains Ties with Iran Despite Israel Conflict
Musk Battles to Protect Tesla Amid Trump Policy Threats
Air France-KLM Acquires Majority Stake in Scandinavian Airlines
UK Educators Sound Alarm on Declining Child Literacy
Shein Fined €40 Million in France Over Misleading Discounts
Brazil’s Lula Visits Kirchner During Argentina House Arrest
Trump Scores Legislative Win as House Passes Tax Reform Bill
Keir Starmer Faces Criticism After Rocky First Year in Power
DJI Launches Heavy-Duty Coaxial Quadcopter with 80 kg Lift Capacity
U.S. Senate Approves Major Legislation Dubbed the 'Big Beautiful Bill'
Largest Healthcare Fraud Takedown in U.S. History Announced by DOJ
×