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Mental health, autistic and learning disabled children

5 mins read

This advice applies in England only.

NHS England provides extra support to autistic and learning disabled children experiencing a mental health crisis. This includes measures to keep them safe and out of hospital, or making sure they are supported properly when discharged. 

In this article

What are escalating mental health needs?

Some autistic children and children with learning disabilities may need extra treatment and support if their mental health gets worse or hits a crisis point.

Escalating mental health needs in learning-disabled or autistic children and young people may look like:

  • Life-threatening self-harm or suicidal behaviour.
  • Severe, debilitating depression.
  • Severe distress that shows up as frequent challenging behaviour.
  • Restricted food intake (for example eating disorders like ARFID or anorexia).
  • Severe and debilitating obsessive compulsive disorder.
  • Psychosis.
  • Severe anxiety affecting their health.

If your child is experiencing a mental health crisis, it’s helpful to know what extra support is available. This can help keep them safe and out of hospital or make sure they get proper support when discharged.

What NHS support looks like

In rare circumstances, your child’s psychologist or psychiatrist may recommend your child goes to a child and adolescent mental health (CAMHS) inpatient unit for treatment. This is a mental health hospital or ward for children. We have a page all about CAMHS services.

Child and adolescent mental health (CAMHS)

CAMHS services offer assessment and treatment for families where children and young people have emotional, behavioural or mental health difficulties.

CAMHS

It is widely accepted, however, that inpatient mental health wards are not always the best place for autistic or learning-disabled children. The NHS is trying to reduce avoidable admissions and provide the support these children need in three main ways:

  • Dynamic Support Registers.
  • Keyworking.
  • Care (Education) and Treatment Reviews.

The NHS also uses these processes to help autistic and learning-disabled children and young people in inpatient units to leave sooner.

Dynamic Support Registers (DSRs)

Your local and health and care system uses the DSR to identify children, young people and adults most at-risk of being admitted to mental health unit or hospital if they don’t get the right help and support at the right time. The register also identifies local children and young people at risk of readmission to hospital, as well as those in danger of becoming at-risk of admission. Some areas call the DSR a dynamic support database.

If your child or young person is on the register, they should have a key worker to help co-ordinate community support, and the offer of a Care (Education) and Treatment Review. We explain how these can help your child further down the page.

Read more about Dynamic Support Registers on the NHS website.

Adding your child to the DSR

You can ask for professionals to add your child to the register if you are worried their mental health is getting worse and they may need to be admitted to hospital.

Check your local integrated care board (ICB) website and Local Offer to find out which organisation looks after the register and how to add your child to it.

Keyworker support

If your child is on the dynamic support register (DSR), they will be allocated a keyworker. This person can help to secure additional help and community support for your child and your family.

Keyworkers may work directly with you and your family. They may work with local social care, education and health services to join up your child’s treatment and plug gaps in support.

A keyworker can help prevent your child going into hospital by:

  • Advocating for them and you to ensure practitioners hear, understand, and respect your voices.
  • Ensuring you have the right, personalised support from services at the right time.
  • Ensuring support services work with you in a joined-up way.
  • Representing you if you feel unconfident about speaking up for yourself.
  • Providing information and guidance in a way that will help improve the quality of life for both you and your family.
  • Helping you to work with and access health, care, education, and voluntary organisations.
  • Building trust by being a person consistently present for the child or young person and family during transitions, including to adult services.

Check your local integrated care board (ICB) website and Local Offer for more information about your local keyworking service.

Care (Education) and Treatment Reviews (CETRS)

Your child will be offered a Care (Education) and Treatment Review (C(E)TR) if they’re on the DSR.

C(E)TRs are for children and young people admitted to or at risk of admission to a mental health hospital. The aim of C(E)TRs is to make sure people only go to hospital when they need to and don’t stay there any longer than necessary. They do this by making recommendations on the care and treatment the child or young person receives.

An independent panel of people carries out C(E)TRs. This includes an “expert by experience”. This person may be a family carer, an autistic person or a person with a learning disability. The panel also includes a clinical expert qualified to work in healthcare, as well as the commissioner who pays for your child’s care.

Check your local integrated care board (ICB) website to find out arrangements for C(E)TRs in your area.

Read more about C(E)TRs on the NHS website.