By Angela Browning
I presented an adjournment debate to this house on the subject of Asperger Syndrome, an autistic spectrum disorder.
While many of the Autistic symptoms are present, people with Asperger Syndrome usually have good language skills and can be of average or above average intelligence.
They do however demonstrate many of the traits associated Autism, resulting in communication problems, ritualistic behaviour and difficulty in social relationships resulting in social isolation.
... where health and social services work together, particularly with agencies that specialise in Autism, the results are good.
Not least because stress and anxiety are reduced – thus, reducing the patients mental health needs and ... a high incidence of suicide.
Whilst the causes of Asperger Syndrome and Autism have yet to be positively identified, research to date shows that it is related to a physical dysfunction of the brain that may have more than one cause, including a genetic base.
What it is not, is an illness and neither are the behavioural symptoms of Asperger Syndrome caused by psychosis. Intervention will not cure the condition, it is a lifelong. But it will vastly improve the quality of life and maximise opportunities to live independently.
We are talking about a vulnerable group of people who have a strange mix of abilities which masks characteristics that can include obsessive behaviour and lack of imagination which results in them not being streetwise, yet can be coupled with a range of educational abilities up to degree level.
Behaviour can be challenging, particularly if routines are interrupted and can be at best quirky and at worst threatening to those who are not familiar with the individual concerned.
Such behaviour is almost always triggered by events rather than emotional response.
It is in this context that I wish to focus on adults and adolescents who under stress and presenting strange or challenging behaviour, find them selves in contact with the mental health services, particularly in patient treatment.
It is true for Asperger people that they can become mentally ill, as with any other person. Indeed, depression is particularly common.
Apart from any physiological reasons such as low serotonin levels in the body, it is not rocket science to understand why by adulthood, people with Asperger Syndrome – desperate for the social and employment opportunities in which they see their peer group participating, finding themselves friendless, locked out and socially isolated because of an inability to relate to other people.
... It is all too common for psychiatrists to ignore an existing diagnosis of Asperger Syndrome.
Behavioural symptoms are NOT recognised as ‘normal' autistic behaviour, but are treated – often with strong drugs – often to little or no effect.
When the drug does not work, psychiatrists then work their way through the prescribing lists – building a cocktail of medication which fails to address the symptoms.
Why should they? The cause is physiological.
It is quite common for the Asperger person to be mis-diagnosed as being schizophrenic and then medicated on this basis.
Many of these cases result in long hospital stays with all the damage of long term neuroleptic drugs.
Drugs which themselves need to be addressed. ... Most of the damage done to the in-patient will be done in the first 4-6 weeks of inappropriate medication, when carers – often parents – have met the most resistance.
I suggest to the House that this cannot be tolerated and I am looking to the Minister to introduce the following – as a matter of urgency.
- That unless a psychiatrist has received an ‘accredited training course' and has arecognised working knowledge in the treatment of Asperger Syndrome / Autism, then a second opinion on the treatment and management must be sought from a professional who has.
- The Department of Health should set up an immediate investigation into the number of adolescents and adults with an Asperger Syndrome diagnosis who have also been treated for schizophrenia.
- Where an undiagnosed adult is suspected of being Asperger Syndrome, then a referral must be made to a professional who has experience of autism. Diagnosis of adults cannot be learned from a textbook.
- The Department of Health should make available to all psychiatrists, a list of those hospitals and staff who have a qualification in psychiatry plus a recognised specialisation in autism.
- Primary Care Trusts should identify their Autism/Asperger professionals both in patient and CPN level and implement a structured training and accreditation programme. They should hold a referral list, even if this is out of area.
... It seems psychiatrists are laws unto themselves. There is an ignorance and an arrogance that permeates their approach to Asperger Syndrome which is all too common.
Let me conclude with some quotes from cases that have crossed my desk in recent months ...
A mother writes:
“I am appealing to you in desperation. The consultant has said that he will not refer to the Autism specialist until the drugs he has prescribed have removed the mania”.
Another writes:
“We have suffered from deliberate delays perpetrated by the lead clinician supported by the Trust”
This scandal must be brought to a close.
It is leading to family breakdown where increasingly aging parents and carers bear then strain of lack of provision, failure to diagnose or to recognise a diagnosis.
It has in some cases led to permanent damage caused by inappropriate medication.
I can think of no other area of healthcare where this would be permitted.
The patients are the least able to self advocate and carers are sidelined.
It is cruel and unjust - it must stop.
No comments:
Post a Comment