NHS healthcare providers have left autistic children at risk of self-harm | Society

According to an NHS internal report, potentially suicidal autistic children with mental health problems in Staffordshire risk self-harm after receiving inadequate and dangerous care.

An inquiry, prompted by serious parental concerns, revealed that the needs of the under-18s, who are very troubled in the county, were neglected due to serious failures in the provision of care by the two NHS-funded providers. In the region.

The unpublished 37-page report of the investigation team – insighted by the Guardian – shows how vulnerable young autistic people with problems, including anxiety, have to wait a long time for help from a specialist and have pbaded several times between different services. The two care providers quarreled over who was responsible for child custody, one focusing on autism and the other on mental health issues.

The NHS Clinical Commissioning Groups located in Staffordshire have commissioned the Northumberland Tyne and Wear Mental Health Report (NTW) to review services for young people with autism in their area. This has been triggered by long-standing criticism of two vendors, Midlands Psychology (MP), specializing in autism, and Midlands Partnership Foundation's NHS Trust (MPFT), from families.

The survey found that health professionals who were dealing with youth did not have an adequate risk badessment and did not demonstrate risky behaviors showing that they were at risk of harm, even though those under 18 with autism were more likely to try. take their own life.

It was also found that autistic youth with a mental health crisis received inadequate support, although this also increased their risk of self-harm or suicide.

NTW experts concluded, "As a team, we did not think that the current approach to risk badessment and risk management is sound, coordinated or secure."

They were so worried that they found that by the end of their inspection, last July, they wrote to the NHS bodies urging them to order the two providers to act "immediately" to attacking five areas of inadequate practice: in their opinion, presented a risk of harm to young people, without waiting for his official report.

CCG received the report last November, but did not publish it. Families are concerned that the NHS is trying to quell the "scandal" of caring for young people with autism. Despite the report making a series of recommendations, little has changed, they say.

The deficiencies in care were first identified in January 2015, but they continued to be a problem and were still apparent during the three-day service inspection last July, despite promises to eliminate them. indicates the report of the evaluation team.

"These are really alarming results. It is deeply troubling that families report that nothing really changed seven months after the report was submitted to CCG, and that most of the year that pbaded after the first statement of serious concerns at the beginning [to them]Said Liberal MLA Norman Lamb, Minister of Mental Health in 2012-15.

Tom Madders, Young Minds campaign director, said, "It is extremely worrying to see failures reported in CAMHS. [child and adolescent mental health services] in Staffordshire, and it is crucial that these problems be solved. When children do not get the help they need mental health services, this can lead to problems that unnecessarily worsen. "

Tracey Hay claims that she received very little help and that she had to wait a long time before receiving care while her son was in a mental health crisis, whereas he was tied ligatures around his neck and threatened to kill her. A member of the CAMHS team [at MPFT] told him to ignore him when he said that he wanted to kill himself, she added.

The survey also revealed that one or the other provider was violating a number of guidelines issued by NHS England, the Ministry of Health and the National Institute for Health and Care Excellence (NICE) to ensure or improve care provided to autists. Midlands Psychology, for example, was diagnosing autism using an approach that did not have the support of NICE "and that is also not effective in addressing the needs of young autistic people and that clearly lacks an approach focused on nobody".

Families with autistic children have found Midlands Psychology "extremely difficult to contact by phone" because its switchboard was only open between 9am and 1pm. It was not long enough and the social enterprise should extend this to at least 9 am to 5 pm, the team said. Despite the recommendation, the hours of opening remain unchanged.

The report attributes a lot of problems to the long-standing "difficulties" and "tensions" between the two providers, who refused to treat some patients, claiming it was the responsibility of the other. "Because of this confusion, youth and their families would often be involved in a series of multiple referrals between CAMHS and MP," the report says.

This undermined the quality of care because "the two services were not working together effectively to provide youth with autism badessment, support, interventions, and appropriate and coordinated care."

Claire Bailey, Executive Director of MPFT's Child and Family Protection Group, said, "Patient safety is a priority for MPFT and I would like to rebadure you that there is no case victim. [But] I acknowledge that the preliminary report contained identified deficiencies. Improvements have been made.

Angela Southall, executive director of Midlands Psychology, said she had won awards from the National Autistic Society for the quality of care provided. An action plan to tackle the problems has been identified and changes have already been made, she added.

Case study

Julia Carter has complained to the NHS of the care provided to her 14-year-old son, whom she prefers not to name. She is one of the parents whose concerns led to last year's independent investigation into the services provided by Midlands Partnership NHS Foundation Trust and Midlands Psychology, which cares for under-18s in Staffordshire with autism and mental health issues.

My son has autism spectrum disorder, severe dyspraxia and deep dyslexia. He was never diagnosed as psychotic, but I had the impression that he had had psychotic episodes when he was talking to himself, asking for a voice in his head if he was to hurt himself, crying and swaying. The care he received from the two services, which should have intervened to help him at a critical moment, was appalling.

The doctor who saw him in MPFT's Mental Health Services for Children and Adolescents [CAMHS] was more interested in who should be responsible for his care than through treatment, and psychologists from Midland Psychology, after finally seeing my son, first sent me to my GP, claiming that 39; was the fastest way to obtain a reference to CAMHS, and this was not the case.

He was 11 years old at the time. He had recently become very worried and started to refuse to eat and to hurt himself. From the beginning, his mental health was not well managed and I had to give up work to support him. This had a significant impact on family life. He was being treated by Midlands Psychology for his autism, but his GP referred him to the MPFT CAMHS team. However, the trust refused to accept the referral and informed the general practitioner that he should return to Midlands Psychology. When the NHS Ombudsman subsequently investigated my complaint about it, MPFT admitted that he should have accepted the referral.

Then, to make matters worse, when trust finally accepted the dismissal – after Midlands Psychology declared it urgent – they should have seen it the same day or the next business day. However, they did not offer him an appointment for 11 days and only evaluated him five days later. The ombudsman considered this to be a violation of the urgent referral deadline.

The impact on my son has been profound and long term. We are still struggling. Initially, because of his delay in treatment, he was unable to start high school in the 7th grade. He had to stay at home, eventually receiving tuition fees paid by the local authorities. Often these lessons took place with my son hidden in the closet under the stairs or he just could not stand them at all.

The emotional impact has also been profound. Our family struggled to protect my son during his extremely bad mental health episodes. He discussed with him his flight and the need to stop everything. He was not aware of his environment or me during these episodes. It was scary and heartbreaking to see. Her two sisters, one aged 16 to 10 respectively, were to help keep the doors and windows in case he tried to flee during these episodes, while I was trying to get him through and calm him down.

Both services let him down at a critical period of his young life and what we experienced because of this should no longer happen again. People who order NHS services from troubled youths like my son need to start exercising more rigorous monitoring of services, because next time a parent may not get to the window quickly enough.

When a child asks for help from a parent, the natural thing for any parent is to provide that support. When your child asks for help and his life is in danger, not knowing if you can get help for him has a huge effect on you. It changes you and life is never the same, because you feel like you are dropping your child, your best fight has not been enough, you should have done more. But I like that so many parents in Staffordshire have a hard time knowing what else we can do, when brick walls are erected instead of compbadion and attention. "

As said to Denis Campbell