Autism.....
where do I start with describing this condition, and the impact of autism on the
autistic person themselves and on those around them?
Autism is
a pervasive developmental disorder, characterised by deficits in certain areas.
Every child or adult with autism is different, however, each will have
persistent difficulties with social communication and relationships, social
imagination, repetitive and/or obsessive behaviours and sensory
sensitivities.
I live with this 24/7, not my own diagnosis, but the reality for four of my children and also my partner, who recently became my wife. After a lifetime of dealing with a diagnosis of both anxiety and depression and a personality disorder, she was finally 'correctly' diagnosed with autism earlier this year. A welcome and life-changing result after 30 years being failed by various NHS Mental Health departments.
As I type this blog entry it is midnight, and I am sitting downstairs alone, taking a break from the constant demands that come from having an autistic family and more recently an autistic partner. I am hurting from her lack of empathy, I am worn out from meeting her needs, I am exhausted by having to pre-empt situations all day every day....not just for her, but for my autistic children too. I love my wife and my family, unreservedly and without condition, but life can be very difficult in this autism bubble. I am sure it is equally difficult for them, but in different ways.
And then my thoughts, as always nowadays, turn to the 87,209 serving prisoners, locked away in their gated retreats. (Figures from NOMS
Population
and Capacity Briefing for Friday 25th August 2017)
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When I
worked in the Induction department at HMP Bronzefield, I very quickly
identified the ladies coming in who appeared to be on the autistic
spectrum. Having lived with autism at this point for about 23 years, I was well
served to spot the signs. The head of prison education soon realised I was
doing a good job and asked me to refer these ladies on to her for support.
However, it was a heartbreaking situation I found myself in. These prisoners usually came in
confused and distraught. Much of the time they had little understanding as
to why or how they were in prison. Their crimes tended to be down to their
autism and lack of understanding, rather than a chosen and planned criminal
behaviour. Sadly it was incredibly common in Induction to welcome new inmates
with mental health problems and learning difficulties, and many of these seemed
to have undiagnosed autistic difficulties or traits. Most ended up that first
night on the Healthcare wing, which was a cross between One Flew Over the
Cuckoo's Nest and Awakenings! Definitely the worst place for somebody with
sensory difficulties and a lack of social awareness.
The thought of my autistic children or my partner ending up in jail is terrifying. Being stressed by overpowering noise and smells, with restricted eating habits, a lack of social communication skills and in need of a safe and secure routine and familiar environment; prison is a living hell for people with autism.
The
British Medical Journal published a report in 2016 (BMJ 2016;353:i3028) in
which the researcher, a forensic psychologist, discusses the
over-representation of autistic prisoners in HMP settings, currently about 2.3%
of the prison population as opposed to 0.99% of the general population. And
this is just those with a diagnosis, the figure will be higher, as so many
prisoners seem to be undiagnosed. The article states:
"ASD
is of specific concern among prisoners because it can slip through
the gap between learning disabilities and mental health diagnoses,
for which more formal assessments, in addition to liaison and diversion
schemes, are being developed in forensic services. Identification of ASD at the
earliest possible stage in the criminal justice system could
allow for better assessment and management of challenging presentations and
minimise the risk of additional mental ill health"
Most of my fellow gated retreat customers who I identified as having autistic spectrum condition or ASC traits, were instead perceived to have mental health problems, for which there was very little help in the prisons I was a guest at, and even less so for someone who is misdiagnosed. The therapy for personality disorders, depression and other mental health difficulties are usually unsuitable when dealing with a person with autism. These incredibly vulnerable ladies were often considered, by untrained and often ignorant staff, to be manipulative and "putting on" their behaviours. A lady screaming and crying all night because her routine had been altered without warning was instantly and cruelly punished. Restricting access to cleaning materials for an ASC lady with severe OCD was a tactic I witnessed being used to mentally torture another fellow inmate.
One of the most important abilities you need to survive in jail is a skilled set of finely honed social skills. A new prisoner needs to be able to quickly assess other people, to be able to read facial expressions and tone of voice, The ability to make appropriate comments to both cellmates and staff is paramount. So how does this fit in with the intrinsic behavioural deficits of an autistic inmate? Well, it doesn't, leaving autistic prisoners open to bullying and abuse from all they come into contact with.
What is the solution?
Firstly we need to have significantly better, and compulsory, training for the police, usually the first point of contact within the criminal justice system. My very autistic 23 year old son, if questioned by our boys in blue, would be incredibly anxious and would take everything very literally.He would be so easily manipulated into admitting guilt. He would assume that a policeman, who is in authority, would know better than him. He trusts those in charge to protect him and make decisions for him. His behaviour may appear odd and can sometimes draw unnecessary attention, but as autism is often a hidden disability it may not be immediately obvious to other people that he is disabled.
The National Autistic Society explains well the reasons why an autistic person may become involved in the Criminal Justice System: (http://www.autism.org.uk/cjp)
Social naivety. The desire to have friends has led some autistic people to be befriended by criminals, and become their unwitting accomplices People on the autistic spectrum often do not understand other people's motives.
Difficulty with change or unexpected events. An unexpected change in the environment or routine, eg a public transport delay, may cause great anxiety and distress, leading to aggressive behaviour.
Misunderstanding of social cues. For example, many autistic people have difficulties with eye contact, which may be avoided, fleeting prolonged or inappropriate. This may be interpreted as making unwanted sexual advances.
Rigid adherence to rules. They may become extremely agitated if other people break these rules. For example, an autistic man was known to kick cars that were parked illegally.
Not understanding the implications of their behaviour. Due to difficulties with social imagination, an autistic person might not learn from past experience. They may repeatedly offend if not offered the correct support and intervention.
These situations can also occur in prison, causing the autistic prisoner to be
treated badly by staff and punished unnecessarily. Prison staff are
not currently well enough trained to deal with the multitude of mental health
problems and other disorders they will come across in our failing prison
system. There is a chronic lack of funding, and the educational entry
requirements for a prison officer are far too low in my opinion. Putting a young person, possibly just 18 years old, with very little knowledge of the world and human differences, in charge of a wing, is just asking for the officer/prisoner relationship to fail.
On my social media feeds I follow many families of prisoners fighting against wrongful conviction or inappropriate sentencing. One of the common themes in many of these cases is autism. One very young life-sentenced, joint enterprise, male prisoner has been diagnosed with autism subsequent to his trial. He was lucky enough to have the UK's top expert, Simon Baron Cohen, assess and diagnose him. Yet the court of appeal refused to believe a report from this renowned clinical psychologist and professor.......... and sadly it is incredibly common for courts to dismiss an autism diagnosis.
Autistic defendants and prisoners are suffering at the hands of an out of date criminal justice system, which fails to understand quite how autism infiltrates every single part of an autistic person and their behaviours. It isn't a part time disability, dealt with by medication or therapy. It is a complete way of being, which will never change, improve or get better. Autistic people need understanding and strategies in order to cope with our confusing world.
It is time, in 2017, to once and for all fully address the needs of our autistic population, and then to support them appropriately, thus reducing the risk of wrongly criminalising autistic people for behaviours beyond their control, and hopefully ending the incidents of re-offending in those already convicted.
