People with autism spectrum disorder in the criminal justice system: improving recognition in criminal justice mental health services, identifying views of the ASD community and developing preliminary guidelines for support

Murphy, C. M., Harvey, J., Woodhouse, E. Louise, Robertson, D., Whitwell, S., Carrier, A., Forrester, A. ORCID: https://orcid.org/0000-0003-2510-1249, Murphy, D. and McAlonan, G. 2020. People with autism spectrum disorder in the criminal justice system: improving recognition in criminal justice mental health services, identifying views of the ASD community and developing preliminary guidelines for support. Presented at: INSAR Keynote Webinar, Virtual, 3 Jun 2020.

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Abstract

Background: People with autism spectrum disorder (ASD) may have contact with the criminal justice system (CJS) as victims of crime, offenders, or from misunderstandings. The number of ASD people who offend is unknown. However, it has been suggested that ASD is over-represented and under-recognised in the CJS. Despite this, neither ASD training for criminal justice mental health services (CJMHS), nor clear ASD care-pathways or guidelines linking the CJS and health/social services are available. Furthermore, ASD community and CJMHS staff views regarding this are unknown. Hence, interactions between the CJS and ASD people may be unnecessarily distressing, unsuccessful and costly. Lack of ASD awareness and absent ASD CJS care-pathways/guidelines may adversely impact on everyday police, court and prison processes and contribute to increased costs. Objectives: To improve ASD recognition in a local CJMHS, determine ASD community and CJMHS staff views and, with the ASD community, draft first available UK CJS ASD guidelines. Methods: Local CJMHS staff received 1 day’s ASD awareness training from ASD experts, including a) mental health/behaviour/communication/sex/risk/de-escalation, management of anxiety/distress, liason with local/national ASD services, local/national care pathways, b) Assessment (Observed-Structured-Clinical-Examination), c) 55-item ASD questionnaire (pre/post training), d) on-going supervision. Two focus groups gathered views of 6 ASD adults with CJS experience and their families and of 5 CJMHS staff about ASD in the CJS. A one day ASD CJS workshop invited expert speakers and multidisciplinary ASD/CJS professionals (including health/education/social care/CJS, and the National Autistic Society) to identify problems, solutions and develop ASD CJS guidelines. Results: CJMHS ASD knowledge significantly improved post-training (p < .05) CJMHS staff felt significantly more able to a) identify ASD people in the CJS, b) communicate with, and safely manage, ASD people, c) understand ASD mental health/behaviour/communication possibly contributing to CJS difficulties/misunderstandings, and d) identify and access local and national ASD clinical-care pathways Both focus groups expressed concerns; the ASD community regarding their CJS experiences and CJMHS staff regarding ASD awareness/management in the CJS. Both suggested possible improvements; these contributed to guidelines development. Local ASD CJS guidelines and an ASD CJS film have been made and will be a) freely accessible educational materials for all staff/students across the study site, so enabling widespread and cost-effective dissemination (36,000 university/hospital staff and 25,000 students, with over 4.2 million patient contacts each year), b) available to local and national CJS teams, c)included in local health/social care pathways. Conclusions: Brief training can raise awareness of ASD in CJMHS staff and may improve management of ASD people in the CJS. This supports statutory requirements for needs-led local services (UK 2009 Autism Act, 2010/2014 Autism Strategies) and responds to the UK 2009 Bradley report, tasking CJS liaison/diversion services to identify, assess and refer vulnerable people from their first police contact. The ASD community and CJMHS expressed ASD CJS concerns. The development of local and national ASD CJS training, guidelines, services and care pathways may enable ASD people to be better understood and to have their needs met, and may contribute to reduced individual and societal costs.

Item Type:	Conference or Workshop Item (Paper)
Date Type:	Publication
Status:	Unpublished
Schools:	Medicine
Last Modified:	09 Nov 2022 11:32
URI:	https://orca.cardiff.ac.uk/id/eprint/143715

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