By Lucy Scanlon
The main room is too loud. The lighting is too bright.
She cannot tolerate the taxi driver putting her seatbelt on.
These are the difficulties that one of my clients is experiencing when she attends a local day service. The service is primarily for adults with learning disabilities, but she doesn’t have a learning disability herself. She has autism.
I’ve had a meeting with the manager of the service about pursuing some adjustments, and these have been made. But I continue to feel this person’s needs are falling between the cracks and there should be more suitable options available.
A lack of local, autism-specific services is just one of the obstacles I come up against in my role as a social worker. I work specifically with people who have autism, to carry out social care interventions, and support people to create and implement self-directed care packages.
My role is also the only one of its kind in the council, so some of my time is dedicated to responding to phone calls and emails from health and social care professionals, who may wish to discuss autism cases and seek advice. I have developed my knowledge of autism through involvement in the diagnostic process, and this helps me to understand the difficulties my clients face, particularly when trying to access services in the local area.
Another issue I face is a delay in getting care packages signed off. These delays are happening because of the time pressures on local mental health professionals, who are responsible for authorising the care. In mental health, higher risk issues have to take priority.
One client, who simply needed an extra hour of support to maintain his flat, has been waiting several months. I feel embarrassed about the delay and frequently apologise. I have to explain that it may be weeks, if not months, before there is progress.
‘An ongoing battle’
A key part of my role is to improve access to GP surgeries, something that all my clients find challenging and anxiety provoking. I use a graded approach to help reduce anxiety around change, as well as motivational interviewing to enable clients to recognise the long-term benefits of being able to independently access their surgery.
Recently one of my clients agreed to make the journey to her surgery independently, on the proviso that I would be there to meet her and support her to communicate with the GP. On my arrival, she informed me that she’d been called in to see the GP early. She’d communicated the issue to the GP and received a prescription. This was an incredible achievement for the client, who finds unexpected changes difficult to cope with.
I also try and support clients to access GP services online where possible, as this can alleviate the difficulties in making appointments over the phone. But requesting reasonable adjustments for people with communication difficulties is an ongoing battle. When I succeed in acquiring adjustments, they are often forgotten by the next receptionist on duty.
Supporting clients to use online systems can be an intensive piece of work in itself: a new process, passwords to remember and a minefield of options. But I have had some success – and empowering clients to access their GP independently can reduce the amount of ongoing support they need from care agencies.
‘Hopes for the future’
It is positive that my position exists within the council and I really hope that in the future specialist intervention work for people with autism is allowed to continue. This has become a rarity in adult social work, where assessments are often quickly followed by a care package, and mental health teams only have time to respond to crises.
I will continue to advocate for the needs of autistic people to be prioritised equally to those of people with learning disabilities or mental health conditions – and reasonable adjustments made to prevent them from slipping through the cracks in social care provision.