Championing autism

The Championing Autism campaign led by the RCPsych Autism Champion Ian Davidson started in October 2016 as a pilot with pump priming funding from DHSC through to March 2017.

The College decided to continue the programme and council in July 2017 authorised it to run to July 2020. It has now been extended again, and Dr Conor Davidson took over as Autism Champion in May 2021.

Aims

  • audit the autism continuing professional development (CPD) needs of all psychiatrists in practice in England;
  • update and scale up the existing CPD autism training programme to meet identified CPD needs;
  • develop and implement models of best practice in support and selective referral to local specialist autism teams and
  • develop and implement a patient (individual) level best practice commissioning manual for joint working with health (NHS England) and local NHS social care commissioners.

and to produce outcomes that include:

  • timely ASD diagnosis and appropriate services to refer to;
  • autism friendly mental health services;
  • reduced stress and anxiety – not only for those with ASD, but also for families, carers, social workers, GPs and psychiatrists;
  • improved health outcomes with equitable access to the NHS;
  • a reduction in wasted resources by earlier recognition and less crisis management.

Autism Champion Blog – May 2021

Hello and welcome to the Autism Champion Blog. I’m planning to do a blog post every couple of months or so to keep you updated on the work of the College in the field of autism.

I’m just a couple of weeks into the College Autism Champion role and it has been a bit of a whirlwind so far. I’ve never had a formal role with the College before and there is a whole new set of structures to get one’s head around.

The previous Autism Champion Dr Ian Davidson (no relation! – even though we are both from Northern Ireland, where of course everyone knows everyone else J) has been tremendously helpful in showing me the ropes and sharing his wisdom, as have Tom Berney and Peter Carpenter, respectively the outgoing and incoming chair of the Neurodevelopmental Psychiatry Special Interest Group.

Ian has achieved a huge amount in his nearly five years in the role, including updating autism CPD for psychiatrists, heading up a national autism training program for psychiatrists, and lobbying for improved autism services with many and varied VIPs, up to and including the head of NHS England.

Perhaps the biggest achievement though of the last few years is the increase in visibility for autism throughout the psychiatric profession. When I started as a psych trainee in North Yorkshire 16 years ago, autism was pretty much seen as the domain of specialist services, and not something general psychiatrists ever gave much thought to.

I first got interested in autism when as a Senior House Officer (remember them!?) I was asked to see a patient with Asperger syndrome, and realised I didn’t know the first thing (or the second thing, or indeed the third thing) about Asperger syndrome.

After learning a bit more about neurodevelopmental conditions, I realised that here was a whole new vista of psychiatry. And because autism is strongly associated with a wide range of mental health problems, and can drastically influence how patients present, I came to firmly believe that to be a good general psychiatrist it’s essential to have a decent working knowledge of autism.

Attitudes have changed a lot in the intervening years. Now in conversations with colleagues it is rare indeed to come across psychiatrists who profess that ‘autism isn’t my business’, or claim that ‘ADHD doesn’t exist’. There is a great appetite from mental health professionals to learn more about autism and neurodevelopmental conditions.

This is particularly true for trainees – in my adult autism service in Leeds we have a constant stream of higher trainees asking to do special interest placements.

Despite this progress, more needs to be done. There are unacceptably long waiting times (PDF) for autism assessments across most of the country. Autistic patients continue to report difficulty accessing appropriate mental health services, and reasonable adjustments aren’t always put in place.

Perhaps more than any other condition, autism cuts across everything we do as a College and as a profession. It doesn’t matter whether you work in CMHT, inpatients, CAMHS, ID, forensics…whatever your job, you will come across lots of patients with autism. My core message is that autism should be the business of every psychiatrist.

You can help by checking out the neurodevelopmental pages on the College website, which contain excellent resources including the College guide to assessing for autism. You could also sign up for an autism CPD e-learning module, or one of the ND SIGs conferences (I can vouch that they are invariably of fantastic quality).

And in your day-to-day practice, be alert for the possibility of autism, and remember to ask autistic patients about any reasonable adjustments they might need. Even relatively small actions like dimming the lights can make a huge difference for autistic people. For my part, over the next few weeks I will be focusing on pulling together a new autism working group within the College.

The aim is to have representation from across the faculties and devolved nations so we can develop a shared agenda on autism matters.

Many thanks for taking the time to read this blog (I know how busy you all are especially in these COVID times). I’ll continue to update it with the latest news from the Championing Autism program, so stay tuned…

May 2019 Update

A partnership between Health Education England, RCPsych and Cheshire and Wirral Partnership NHS FT led to Dr. Ian Davidson, Autism Champion, developing and helping to deliver a series of training days (January to March 2019) for psychiatrists on Autism. The course was aimed at psychiatrists who are not Autism specialists. It drew upon multiple feedback from psychiatrists, autistic people, families and other organisations.  This included the following research background but was much broader than this.

It reached 350 psychiatrists and more details will be posted when the report is finalised. Thanks and acknowledgments to Rachel Moody and Clair Haydon for their contribution to the core content, and to the following partners who hosted and organised the local parts of the courses:

  • RCPsych Neurodevelopmental SIG for national launch day and regional events were hosted by Devon Partnership Trust,
  • Greater Manchester Mental Health NHS FT,
  • NTW (Newcastle Tyne and Wear) NHS FT, combined North Central London (Camden & Islington and Barnet, Haringey & Enfield NHS FTs),
  • Worcestershire Health and Social Care Trust. 

The Autism Champion is now part of the All Party Parliamentary Group on Autism (APPGA) advisory group and attended the inquiry session as a witness at the session on support for Autistic adults in May 2019.

The Autism Champion is now on the Department of Health and Social Care (DHSC) task and finish group on health and well being which is contributing to the review of progress since the Autism Act 2019 and Think Autism 2014. He attended a meeting of all the task and finish groups in May 2019.

The Autism Champion contributed to responses on the consultation on mandatory autism training for health and social care staff in England.

Helen Matthews is now on the Championing Autism committee representing Wales but we still have no Scottish or Northern Ireland Psychiatrist member. If anyone is interested please contact the chair, Terry Brugha, via the neurodevelopmental Special Interest group.

Twitter: @PsychAutismCham

2017/18 Update

The campaign has worked collaboratively with faculties and divisions within the College and with multiple groups and organisations outside the College to improve services for Autistic people and particularly through supporting and improving the skills, values and knowledge of psychiatrists relating to Autism.

We are delighted that many psychiatrists are contributing to Championing Autism in many ways through research, education, training and clinical service developments and practice over and above the role of the formal programme itself. It is clear that over the time since 2016 these have all increased in number and profile.

In terms of the formal programme the pump priming included money for revising the Autism training package offered by RCPsych (led by Terry Brugha, Tom Berney and Peter Carpenter) and to encourage development of additional e-learning modules. These were delivered.

Key events:

  • Presentation of the programme at various annual faculty meetings in 2017 and to the Northern Ireland Division
  • Participation in 'Autism and Mental Health' and 'Autism and Ageing' workshops
  • Revision of RCPsych guidance - CR175 and CR191
  • Discussion of ways to include Autism in the College Curriculum and to support CPD needs of psychiatrists regarding Autism

In England:

  • Contributed to discussions on the reform of the Mental Health Act and the NHS Long Term plan
  • Worked with NHSE and NHSI to ensure that approaches to Autism are Autism focussed (not tacked on to discussions about Learning Disabilities or Mental Health) whilst at the same time advocating that those Autistic people who have a co-occurring Learning Disability or Mental Health problems

In Wales, Scotland and Northern Ireland the RCPsych national divisions lead on interaction with health and social care planning and delivery as each country has different arrangements. The Autism Champion is therefore less directly involved but links with colleagues in each country and helps to share learning across the College.

In 2017, agreement was reached between Health Education England and RCPsych Neurodevelopmental SIG to run a small number of training days for psychiatrists in different parts of England. The days are called 'Autism essential for Psychiatrists' and take participants beyond Autism awareness training.

These will therefore benefit the participants but also through evaluation and feedback will help Health Education England and RCPsych in shaping future approaches to training on Autism. There are 6 in total with the aim being to reach a total of 200 psychiatrists attending across the 6 venues.

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