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For some time, there has been concern that not enough is being done to recognise, and respond to, prisoners with autism.

Yet more recently, a growing number of experts are commenting on the subject, determined to raise the profile of the issue and ensure it remains on the agenda.

Underdiagnosed prisoners

A report published in the British Medical Journal indicated that autism spectrum disorder (ASD) is underdiagnosed in prisoners and called for more investment for assessment in forensic settings.

The UK government strategy on ASD now refers to prisoners but in the BMJ study, forensic psychologist Sarah Ashworth noted that autism is of specific concern amongst prisoners because it can “slip through the gap between learning disabilities and mental health diagnoses.”

More formal assessments are being developed in forensic services but identification of ASD at the earliest possible stage in the criminal justice system could allow for better assessment and management of challenging presentations, as our offender healthcare candidates will know all too well.

ASD higher in prisoner population

ASD is present in 1% of the general population but believed to be prevalent in 2.3% of the prison population.

Writing earlier this year in the Independent, Clare Allely and Antonia Wood from the University of Salford suggested that Britain’s criminal justice system does not know what to do about autism.

It pointed out how excessive noise in prisons, the enclosed nature of the establishments and routines that can be disrupted, all make life even more difficult for those with ASD.

“Autism friendly”

One UK institution for young offenders, at Feltham, has taken steps to support prisoners with ASD.

Awarded autism accreditation and deemed to be “autism friendly”, the aim of accreditation is to improve autism practice across all areas of prison life, tackle issues frequently experienced by prisoners with ASD, and ultimately reduce the risk of reoffending in this group.

Feltham has worked with the National Autistic Society to improve the way offenders with ASD are supported. It has been praised by government ministers, yet across the broader prison system it is clear that prisoners with autism are not receiving the support they need.

Guide for prison officers

Network Autism, a website where autism professionals connect, has published a basic guide for prison officers covering aspects of autism that may assist prison officers in supporting autistic prisoners including sensory issues, communication and potential vulnerability.

Prisoners with ASD may be more easily led than other prisoners; be more vulnerable to physical and sexual abuse or the target of bullying and violence; lack outside contacts; have problems with self-care and mental health and be at heightened suicide risk.

The guide also encourages prison officers to seek further support, information and training on autism.

Critical role

While it is apparent that autism among prisoners is not being ignored, it is an area where prisoner officers, probation workers and those involved with the health and welfare of prisoners can play a critical role in an area that still needs more attention.

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