Southport Inquiry report highlights failures and misunderstanding of autism

[ProudAmberTurtle]

The Phase 1 report from the Southport Inquiry is out has found the attack "could and should have been prevented".

It was "highly likely" it wouldn't have happened if agencies and the killer's own parents had actually done their jobs over the years. Catastrophic failures everywhere - police, mental health services, social services, schools - all passing the buck, losing information and refusing to take ownership of the risk this boy posed.

But the bit that really jumped out at me is this: a "misunderstanding of autism" meant his violent, dangerous behaviour was wrongly blamed on his autism spectrum disorder.

Instead of treating the clear warning signs of murderous intent as the serious red flags they were, everyone just shrugged and said "it's his autism" and did nothing. No proper risk assessment, no real intervention, no one stepping up.

Neurodiversity / mental health services were so terrified of "stigmatising" or "criminalising" autism that they ended up enabling actual danger to everyone else.

The parents also apparently let weapons be delivered to the house and didn't report crucial things in the days before.

I only hope that England doesn't go down the 'Named Person' route as did Scotland. The concept - that there should be one named person for every child to avoid buck passing was a sound one. BUT there were big problems with implementation: firstly it was every child in Scotland so hugely expensive. Secondly, the named person could be anyone except the child's parents which led to court battles. Thirdly, there was no training & no costs allocated to the NP.
In practicality it ended up mostly being Head Teachers none of whom wanted the extra legal & practical responsibilities. It was ruled to be illegal by the Supreme Court which the SNP have largely ignored. It was also prone to abuse.

My opinion, having read a limited amount abou this case, is that the parents were overwhelmed (unsurprisingly) but DID reach out to the authorities for help. Even if they hadn't (you have to allow for young people with absent parents or kids in care / homeless etc) the authorities should have been able to stop this.
It is partly a lack of communication and joined up thinking. But, as the NP experiment in Scotland shows, it's mostly a refusal of adults taking responsibility.

My adult son has ASD and ADHD and an anxiety disorder. He also has OCD, I do mean actual OCD which cripples him in daily life, not just being very tidy. For years his issues were dismissed as being autistic or having ADHD. He was constantly being told his anxiety was due to one or the other. And this was by mental health professionals. It took 3 years and official complaints to get them to rethink. For info he is improving, slowly.
As you can guess, I'm not surprised that multiple services didn't consider anything other than autism to be responsible for this person's behaviour. Just like I'm not surprised that people were afraid of being labeled racist rather than accept that he was a violent, unhinged individual who was 100% likely to be violent.

Thats often parenting issues. If parents allow kids either ND or NT to bully some will. There is definitely more at play in that family dynamics than just kids being ND.

My own experience is in schools etc autistic kids are far more likely to be victims of bullying. This is experience as a parent and having worked in schools.

https://podcasts.apple.com/nl/podcast/i-catch-killers-with-gary-jubelin/id1506667049?l=en-GB&i=1000761115882

really relevant and potent podcast on this topic

ABSOLUTELY.
I have two ND young people (1 ASD/situational mutism, 1 AuDHD). Both were horribly bullied. 1 tried to start an ASD club at school. Her (severe) bully was allowed to start an ASD club & awarded for it at Leavers assembly. My other YP was bullied (police & solicitors involved) - the bully 'might be ASD' so let off.

There is both a lack of understanding of Autism & a lack of will to understand.

I think @Owninterpreter post is very helpful. There is a world of difference between ND 'dysregulation' which can be anything from nonverbal shutdown to chucking chairs and slowly methodically planning a well researched attack.
Many politiicans/ police/ services just want a quick and easy 'answer' with 'evidenced based' boxes to check off instead of doing long expensive work with communities and individuals to really understand & put in any helpful measures.

And as you've highlighted the difference is scale. I'm not sure toddlers pushing results in removal depends on the type of push surely? Context? Were they provoked? Was it an older child? Toddler could get a little over exited? After all adults push in a queue sometimes. People tailgate on roads. Can result in an accident. Doesn't result in removal often.
Your point is you would act. But at some point presumably go back. What if it doesn't then resolve? You might start thinking the soft play isn't right for my child. Seek out opportunities where there are less triggers. Toddler gets a bit older and it doesn't resolve - you might appreciate someone alongside you. A diagnosis. Something that explains the difference between your child and others because you are parenting well. However Escalating punishments and exclusions are not working and they are feeling like they are permanently bad. And that's at 5.
So you find the inclusive environment which is just right for your child and they still feel they are getting it wrong- and can't cope because other children do not seem to be struggling- and can't express that- can't quite manage the transition immediately- they feel they have failled- at 5- more behaviour-
What do you do? Keep taking them out of places? Keep them in? What then?
There is lots of short sharp shock treatment dialogue. No one talks about the long term trajectory. Which can actually be quite optimistic with the right approaches and support. But it's tiring.

I disagree. I have a DD1 with epilepsy - we saw for years how every hospital she was under, tried to send her to another one, she’d also been under, for treatment, which resulted in me running around for months between hospitals, the epilepsy nurses, GPs and pharmacists to get someone to take responsibility and deliver the treatment (surgery sometimes). Hospital A said she could have surgery at hospital B, even though hospital B had stopped doing it, due to low success rates. Hospital A then said hospital C could do it - the consultant took one look at her, and said they weren’t set up for this, and hospital A could do it. This took over a year of hospital A trying to avoid treating her, while she suffered massive deterioration.

Social Services were exactly the same - they tried to say the social care, DD1 needed, was being delivered by hospitals, when it was the duty of Social Services to provide overnight care at home for instance.

DD2 spent the whole of her pregnancy with the mental health trust and the perinatal mental health team arguing about whose responsibility she was. She never got any actual treatment and ended up being sectioned late on in the pregnancy, which could have been avoided if she’d had some non drug treatment much earlier!

All these public sector organisations (NHS, SEN education, Social Services, mental health trusts, the ICBs, etc) sit in their silos of funding and spend their time, trying to do nothing for the family, by pushing them onto some other organisation, with the patient left as the meat in the sandwich; and it’s by no means restricted to autism!

I think as well the whole 'care in the community' policy was ridiculous. There have always been people who just can't live in the community, they need to be in a proper hospital / facility where they are safe and the wider community is also safe. Some people can't be cured, just managed. I would suggest that he is one of these. Had those facilities been in existence , had he been arrested when he was caught with a knife on a bus, then none of this would have happened. But we don't have those facilities and in all likelihood we would be told his human rights took priority over any future problems.

The issue of the lead professional

There is both a lack of understanding of Autism & a lack of will to understand.

At least part of that is because ‘if you have met one person with autism …’

My brother has autism and if you asked me as a child if he was a bully I’d have said yes. He could be violent to me.

As an adult, I understand better and I realise firstly, he was immature and was functioning at the best part of five to ten years behind his actual age. It doesn’t take much imagination to realise a boy aged twelve or thirteen with an ‘age’ of six or seven is going to be a massive problem in terms of physical strength but lack of social awareness.

Then you have the problem that a lot of people with autism do lack empathy and don’t always understand ‘if someone shoved me down a flight of stairs it would really hurt so if I do that to my sister it would really hurt her.’

I’ve no idea what the answers are. I find both sides disturbing - the insistence that everyone who is ND is a poorly understood innocent victim is not right. It may not be a popular view but autism does lead to lack of empathy, which can come across as coldness and even selfishness. But equally the whole ‘in my day’ is not correct. When I started teaching a class had to be evacuated because a child started attacking people and throwing missiles out of the window, and that was in 2002, so twenty four years ago now.

I am not confident anything anyone did could have prevented this tragedy, actually. It was preplanned and meticulous and horribly cruel. We want to believe if we do the right things it won’t happen again and it won’t, in that format or in that way or in that town. It will happen somewhere else and to someone else though.

I do not agree that human rights prevent treatment. In general. Not speaking specifically about this case. Legislation is all there to assess. detain, restrain where needed what we lack are appropriate responsive secure facilities and often the budget. . Spare a thought for those staff in the facilities ( assault is assault) and also the impact of incarceration on the individual- which can be counter productive - there's no problem however with human rights legislation it's a balance of risk.

The “neurodiversity” movement and the 2013 revision of the DSM to “widen the spectrum” which effectively lumped a wide range of different difficulties into one, has really dumbed down the seriousness of the autistic diagnosis.

The diagnosis isn’t pool proof; there are a large number of differential diagnoses as well as over lapping ones. From trauma to BDP to social anxiety to schizophrenia. Many of these can be effectively managed and even overcome with the right interventions.

1 in 10 adults diagnosed with autism as children go onto develop schizophrenia.

The original concept and term “autism” actually came from schizophrenic diagnosis and research.

I teach children with autism in a send school and we do come across children for whom the strategies don’t work and who display very concerning behaviour from an early age.

It’s really important to get diagnosis right as the correct interventions can make a huge difference to these children’s lives, those of their family’s and of course potentially avert disasters such as this.

I have frequently been thinking about the autistic man who threw a French child off an art gallery roof (Tate?) just because.

‘Am a primary school SENDCO and violence isn't allowed to be called violence if it's an Autistic child who is the perpetrator (it's Dysregulation dear).’

Wrong and dangerous.

The Tate pusher was in care cos he kept trying to murder the family females.

Like AR, he’d been refreshingly upfront about his ambition to live in Broadmoor.

Interesting that the only truthful people who take personal responsibility in these two awful scenarios are the psychopaths.

This is true Forensic CAMHs are clear it they don't own the risk assessment.

This is exactly what I’m referring to at the other end of the situation. For some it’s a dead end diagnosis when they really could be given effective help for the specific issues they’re dealing with, such as OCD. And lead much happier fulfilling lives as a result.

Many are critical of Uta Frith’s interviews about the fact that the diagnosis has lost all meaning; one reason to revisit it and separate into different conditions is precisely because so many children and adults could be helped to manage crippling conditions such as anxiety or ocd.

And I’m so sorry that is what he and you experienced @loislovesstewie

very wrong and very dangerous, agree.

I think you misunderstand my point.if we permanently detained people who had committed no offence as such but clearly couldn't live in the community then I'm convinced that someone would start to invoke human rights. But some people really can't live in the community and, at one time, that was understood. We no longer have psychiatric hospitals which are effectively homes for life. We used to, there was one in the town where I was born, it was sold by the heath authority, it's now very upmarket apartments.

My recollection of my education in the 1970's in a former grammar school in its first year of being fully comprehensive is,
it was a few boys who were repeatedly naughty
corporal punishment was allowed in schools and for a lot of the naughty ones, The Slipper (or fear of getting it) kept incidents of bad behaviour down to manageable levels. The other punishment I recall being used a lot was sanding down and revarnishing the old wooden school desks.
there were special schools for "naughty boys" where they would be sent (I think trashing the classroom would have been a trigger to be sent to one) there was one in the nearest town to my village. Long since closed and houses now built where it was. The ex pupils were very happy there according to FB comments in the local page from them.

I think there's so many different layers to why it's all as bad as it is now
the old pre comprehensive education system may have worked better for the tricky disruptive kids, certainly it would have removed them somewhere else and the other children would have benefited from that. Schools weren't so big. Economies of scale mean these huge secondary schools aren't the close knit communities they once were.

Fear of physical punishment would be a factor. That's gone now.
Not having the "labels" meant you had to get on with it as best you could.

The budget cuts started coming in in the 1980's and it's been downhill ever since. UK population has grown a lot since then, become more diverse but all the time resources of everything get smaller.
Mental Health services aren't fit for purpose, they may talk a good game but it's frankly all bullshit. Eg. I'm in a large teaching hospital for an operation in a terrible mental state (suicidal) and despite the nurses making the call to "Psych" about me, they wouldn't come. I'm in my 60's and this is a lifetime of bad things which have built up. I've had to metaphorically open my mental health box of all the horrible things as it's too full to stay shut any more. Frankly it's a revelation of how bad things are in health services
fill in the online GP consultation which isn't straightforward by any means, far more complicated/unclear than the old econsult was
get the F2F GP appointment 7-10 days ahead and they refer me on to various MH things and prescribe the antidepressants I've asked for for the first time in my life.

i get emails from the medical secretaries following my decisions about RTC providers to ensure the referral paperwork is spot on for my Autism/ADHD assessments. No acknowledgement yet from RTC providers.
NHS talking therapies: apply, initial assessment 1 month later then some to and fro. Decided I need "level 3" trauma focused CBT but they can't even tell me how long I'll be waiting to get it. Not even a ballpark like 6 months, 12 months. They check on my what would I do if I start feeling like I'm going to do it plan and then that box ticked, I'm left to wait"
can see why people find the money from somewhere to go private if they can. Medical and education.

Of course phoning up to ask a question is impossible due to automatic switchboards that make it impossible to speak to a real person. You have to hope they call you.

The ideology is great but the reality, unintended consequences and how they decide to deal with it are something else.

Pressure not to stereotype at all as well.

So many chances to intervene so many excuses not to along the way.

Whilst utterly unpopular, not being able to appeal decisions will help to place these children in the correct setting.

My setting was forced to take a child on the basis of court appeal who was wholly unsuited to our set up. It took a year of cataloging events for the child to be moved to a more secure setting. An unhealthy, controlling and violent fixation on children weaker than him was one of the issues.

This is a very important post.

It has become an ideology. One that makes people money.

Yes it will get worse.

Spot on. Just waiting for the "lack of resources" and "lessons will be learned" fob offs that always follow. No heads will roll, no pensions removed. Such is life in the public sector.

No one is interested in listening to the staff that work in prus or schools that take children with SEMH.