The latest monthly Assuring Transformation NHS Digital data shows that in November 2023: 

• In total 2,035 autistic people and people with learning disabilities are in inpatient mental health hospitals in England
• 1,340 (66%) of these people are autistic
• There are 210 under 18s in inpatient units that are autistic or have a learning disability. Of these, 95% are autistic.

This is the most up-to-date record of how many autistic people and people with learning disabilities, both adults and children, are currently in inpatient units in England. 

Despite some progress moving people with a learning disability out of hospital and into the community, the number of autistic people in inpatient facilities has increased. In 2015, autistic people made up 38% of the number in hospital, now it is 66%. In fact, the number of autistic people without a learning disability detained in mental health hospitals has increased by 100% since 2015.

Do autistic people need to be in inpatient units and why do they get ‘stuck’ there?

It is widely recognised that for most autistic people, care in an inpatient unit is rarely helpful – in fact, it can be deeply damaging. 

The average length of stay is around 5.2 years and we continue to hear alarming cases of overmedication, seclusion and unnecessary restraint.

The overwhelming majority (91%) of autistic people and people with a learning disability who are detained in hospital are put there using the Mental Health Act 1983. We and hundreds of thousands of campaigners have been calling for changes to mental health law for years, so it respects autistic people’s rights.

In June 2022 the Government published a draft bill to reform the Mental Health Act which could stop people being sectioned just because they’re autistic and make it easier for autistic people in hospitals to leave. This was a big step forward. However, the Bill was not included in the 2023 King’s Speech, meaning the Government has no plans to introduce the Bill before the next General Election.

A history of broken promises

In 2011, shocking abuse was uncovered at Winterbourne View Hospital, an inpatient unit for people with learning disabilities. This scandal led to the acknowledgement that there is a significant number of autistic people, those with a learning disability or both, stuck inappropriately in inpatient settings – largely because services to support them in the community simply do not exist. 

The Government’s response came in the form of the Transforming Care programme which aimed to close up to half of the inpatient mental health beds and move people back to their local communities by 1 June 2014. This did not happen.

Several targets have been set since which have not been met. The 2019 NHS Long-Term Plan committed to halving the number of autistic people and people with learning disabilities in inpatient care from 2015 levels by March 2024. In 2022, this target was reaffirmed by the Government in its ‘Building the Right Support Action Plan’. However, the number of autistic inpatients has only increased, and it is likely this target will also be missed.

In both 2017 and 2019, the Conservatives included manifesto commitments to reform the Mental Health Act. Despite this, the Government has failed to include its Mental Health Bill in the 2023 King’s Speech, meaning legislative reform is unlikely to happen before the next General Election. This is yet another promise broken.

A social care system on the brink of collapse

The fact is, despite pledges to transform mental health care and develop better services for autistic people, there is simply not enough of the right type of community support available. This is a key reason why autistic people are still being admitted to inpatient care and why it’s often so hard for them to move back to the community. 

Last month, the Care Quality Commission, regulator of health and social care in England, published its latest report on the state of care in the country. This report highlights the dire situation in social care, with record staff vacancies and pressure from the cost of living crisis meaning the gap in support for autistic people is only widening. To protect the human rights of autistic people and end the scandal of unnecessary detentions in inpatient care, this worsening lack of social care provision for autistic people must be confronted by the Government. 

What is the National Autistic Society doing?

Alongside autistic people and families, we have been highlighting these injustices and campaigning for better support and services from the Government and the NHS for years. 

In 2022 we presented oral and written evidence to the Joint Committee on the Government’s Draft Mental Health Bill, emphasising how important it is to reform mental health and social care services in the community. Our contributions have been reflected in the Committee’s report and impacted the recommendations they have given to the Government.

Most recently, we launched our Time to Act campaign in collaboration with Mencap which called on the Government to reform outdated mental health law and include the Mental Health Bill in the 2023 King’s Speech. Our open letter to Prime Minister Rishi Sunak received 18,324 signatures and was handed in to 10 Downing Street last month. Despite this, the Government has ignored the thousands of autistic people and their families calling for reform by omitting the Bill from the King’s Speech.

We will not stop fighting for fair mental health laws and will be continuing to campaign for urgent reform in the run-up to the next General Election and beyond. We will be engaging with all parties on this issue. This means meeting with MPs, asking important questions in Parliament, and demanding the Government do more to end the scandal of autistic people being wrongly held in mental health hospitals.

Further information

• Read our news story on the Joint Committee’s report on the Government’s Draft Mental Health Bill
• Read Alexis’ story about being “locked inside” various mental health hospitals for three years.
• Read our information, advice and guidance about autism and mental health.
• Read our news story on the omission of the Mental Health Bill from the 2023 King’s Speech