Lockdown was a challenging time for all of us, but particularly for young autistic people and their families. Health and care teams in Wandsworth are working closer than ever to help people, like teenager Vincent (not his real name), get back to a happier lives.
Unable to go to school, isolated at home, and without access to their important routines, young autistic people were increasingly ending up in a crisis, according to Robert Dyer, senior transformation manager for Wandsworth’s child & adolescent mental health services (CAMHS).
Historically, such crises for autistic people have too often resulted in young people being admitted to a psychiatric ward,”
“Historically, such crises for autistic people have too often resulted in young people being admitted to a psychiatric ward,” says Robert. “For autistic children this response can prolong the crisis and worsen their emotional wellbeing, leading to them not being able to live at home”.
Health and care partners in Wandsworth have developed a holistic approach to services (both assessment and treatment) to support autistic children and others with social, emotional and communication difficulties. Co-ordinated by Robert and his team, this multi-agency response – which is called the Care, Education and Treatment Review – brings together health, education and social care professionals.
This is about bringing together people from lots of different teams across organisations to develop bespoke care and treatment, responding to people’s individual needs. This normally involves: Wandsworth Autism Advisory Services, Contact Wandsworth, CAMHS Learning Disability Services, new Behaviour Analyst support, Psychodynamic Therapies and new support from Autism Key Workers.
Lockdown was proving incredibly difficult for Vincent and led to a series of emotional and mental health crises.”
One young person who has been better supported through this approach is Vincent. “Vincent was a high achiever in his mainstream secondary school,” says Robert. “Like many autistic children, though, he had had difficulties with friendships, sensory issues and changes in his routine.
“Vincent was 13 when he was first referred to services early in 2020. Lockdown was proving incredibly difficult for Vincent and led to a series of emotional and mental health crises. After leaving home several times, he sadly had to be restrained on a number of occasions by members of the public and the Metropolitan Police.”
On each occasion, Vincent would be taken to A&E, then on to a paediatric ward and (on occasions) to a psychiatric ward. While the response to these incidents was supposed to help reduce immediate risk and to provide some treatment, for young people like Vincent this response can be challenging.
“Vincent was one of the first children to benefit from our new multi-agency response”
“Vincent was one of the first children to benefit from our new multi-agency response,” says Robert. “I organised a meeting, which brought together health, education and social care professionals and Vincent and his family. By meeting together, everyone could understand Vincent’s history and the causes of his distress and anxiety.”
After the meeting, arrangements were put in place. which were tailored to Vincent’s needs. The review included crisis planning by Wandsworth’s adolescent outreach team and an assessment by the neurodevelopment team, both part of CAMHS and run by the local mental health trust, South West London and St George’s. The review also organised a remote course of arts psychotherapy and a number of enriching activities that Vincent could take part in.
Together, these strategies began to re-focus Vincent. His thinking shifted from negative compulsions and allowed him to put his energies into positive activities.
“Because Vincent’s parents were fully involved in the process, they were able to understand the early signs of a crisis and the nuanced ‘functional behaviour’ that preceded these crises,” Robert says. “This enabled them to intervene in the right way so that Vincent could de-escalate over the course of a few hours without the need for an emergency admission. Over time, the crisis incidents happened less frequently, and then stopped altogether.
“Vincent is now in a new school (with autistic specialism) and is busy with a full programme of activities, living life as a happy teenager.”