Falling through the gaps? Investigating the experiences of autistic young people within Care and Education Treatment Reviews

尽管在NICE指南中特别提到了自闭症和伴有学习障碍的精神疾病的管理，但一个关键的挑战是为患有学习障碍和自闭症的人提供适当的精神卫生服务。然而，服务的发展受到研究的影响，皇家精神病医学院（2020年3月）最近的指导表明，“缺乏关于精神健康问题和轻度ID的高质量证据，这些证据在整个文献中得到了回应。"（第13页）因此，并不是所有地区都为患有LD和自闭症的人提供专科服务，因此使用者必须依靠一般的精神健康服务来支持他们，这并不奇怪。上述研究项目认识到自闭症年轻人在医疗和护理系统中的复杂需求仍然存在困难，它将试图更好地了解定制服务提供的方式根据年轻人自己的直接观点和经验，我可以为自闭症服务用户提供更好的服务（从而改善结果）。通过在地方当局SEND服务部门工作，我对自闭症和学习障碍的年轻人的心理健康和教育支持服务有直接的经验。（或缺乏），更具体地说，护理，教育和治疗审查（CETRs）和更广泛的NHS转型护理议程。因此，我对识别有入学风险的儿童和青少年的“实地”实践有着深刻的理解，并将能够胜任地识别和探索存在于CETR的设计、访问和影响方面的许多挑战。捕捉有学习障碍的自闭症青少年的观点是这个项目的核心，也是我与自闭症青少年合作的经验（作为一个LSA，教育福利主任和特殊需要主任）将使我能够利用一系列的沟通方法（包括使用视觉14/16支持），以有效地确保他们的意见。此外，我的经验，共同制作，通过业主咨询和服务重新设计将支持这个项目的发展方式，是真正的参与。对儿童和青少年服务提供的看法和经验是什么？2.当地服务提供者如何在CETR团队的职权范围内制定基于优势的方法来支持自闭症患者，从而改善他们的结果？3.如何才能真正尊重和分享有学习障碍的自闭症年轻人的观点？这将是一个跨学科的，以社区为基础的参与性研究方法，旨在解决这些具体的地方需求，也将有更广泛的国家适用性和利益。我将带来一个独特的，现实世界的视角来发展研究设计，我非常兴奋的机会，以传播的方式，可能会影响在地方和国家层面的做法的研究结果。

Despite specific reference to the management of autism and mental illness with learning disabilities (LD)within NICE Guidelines, a key challenge is access to suitable mental health services for those with LD andautism. Invariably, service development is influenced by research and recent guidance from the RoyalCollege of Psychiatrists (March 2020) suggests there is a "lack of high-quality evidence on people withmental health problems and mild ID echoed throughout the literature." (pg.13) It is thereforeunsurprising that not all local areas provide specialist services for those with LD and autism andconsequently users must rely on general mental health services to support them.The above listed research project recognises the continuing difficulties of autistic young people withcomplex needs within health and care systems and it will attempt to develop a better understanding ofwhat bespoke service provision (and thus improved outcomes) could look like for autistic service users,based on the direct views and experiences of young people themselves.Through working across local authority SEND services, I have direct experience of mental health andeducational support services for young people with autism and learning disabilities (or lack thereof) andmore specifically, of Care, Education and Treatment Reviews (CETRs) and the wider NHS TransformingCare agenda. Consequently, I have a strong understanding of 'on the ground' practice relating to theidentifyication of children and young people at risk of admission and will be able to competently identifyand explore many of the challenges that exist with the design, access and impact of CETRs.Capturing the views of autistic young people with learning disabilities is central to this project and myexperience working with autistic young people (as an LSA, Education Welfare Officer and Special NeedsOfficer) will enable me to utilise a range of communication approaches (including the use of visual14 / 16supports) to effectively secure their views. Further, my experience of co-production through stakeholderconsultation and service re-design will support the development of this project in a way that is trulyparticipatory.The project will explore the following research questions:1. What are the views and experiences of service provision of children and young people being supportedby the Care and Education Treatment Review (CETR) Team?2. How can local service providers develop a strengths-based approach to supporting autistic youngpeople under the remit of the CETR team, thereby improving their outcomes?3. How can the views of autistic young people with learning disabilities be authentically and respectfullyaccessed and shared?This will be an interdisciplinary, community-based participatory research approach designed to addressthese specific local needs that will also have much wider national applicability and interest. I will bring aunique, real-world perspective to developing the research design and I am greatly excited by theopporunity to disseminate the findings in a way that may influence practice at both a local and nationallevel.