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The Metropolitan Police Service Mental Disorder PolicyA response from The National Autistic SocietyThe Metropolitan Police are updating their Mental Disorder Policy which was last updated in 1994: 'We aim to treat mentally disordered people in a compassionate, skilful, and informed way. We will always seek the most appropriate course of action for any individual coming to our attention, in consultation and co-operation with carers, and other relevant agencies.'We will have regard for the safety of the individual, their rights, and the need to protect the public. We will only use force as is necessary to accomplish our lawful duty.' The National Autistic Society (NAS) is the leading charity for people with autistic spectrum disorders (ASD) in the UK. It has a membership of over 12,000, a network of 60 branches, and 80 partner organisations in the autism field. The NAS is in a unique position to comment on issues affecting people with autistic spectrum disorders because it has offices in all three nations of Great Britain. The NAS exists to champion the rights and interests of all people with autism and to ensure that they and their families receive quality services, appropriate to their needs. There are approximately 520,000 people with autistic spectrum disorders in the UK. The NAS welcomes this opportunity to comment on the Review of the Metropolitan Police Service Mental Disorder Policy.The National Autistic Society The National Autistic Society exists to champion the rights and interests of all people with autism and to ensure that they and their families receive quality services appropriate to their needs.The NAS does this by:raising professional and public awareness of the needs of people with autism, their families and carers working with governments and other organisations to provide and promote education, care, support and information to people with autistic, their families and carers lobbying and providing information to legislators and funding bodies to ensure adequate funding for services.Autistic Spectrum DisordersAutism is a lifelong developmental disability that affects the way a person communicates and relates to people around them. Children and adults with autism are unable to relate to others in a meaningful way. Their ability to develop friendships is impaired as is their capacity to understand other people's feelings. People with autism can often have accompanying learning disabilities but everyone with the condition shares a difficulty in making sense of the world. There is also a condition called Asperger syndrome which is a form of autism used to describe people at the higher functioning end of the autistic spectrum. "Reality to an autistic person is a confusing, interacting mass of events, people, places, sounds and sights. There seems to be no clear boundaries, order or meaning to anything. A large part of my life is spent just trying to work out the pattern behind everything."- A person with autism What are the characteristics of autism? All people with autistic have impairments in social interaction, social communication and imagination. This is referred to as the triad of impairments. Social interaction (difficulty with social relationships, for example appearing aloof and indifferent to other people) Social communication (difficulty with verbal and non-verbal communication, for example not really understanding the meaning of gestures, facial expressions or tone of voice) Imagination (difficulty in the development of play and imagination, for example having a limited range of imaginative activities, possibly copied and pursued rigidly and repetitively).Definition of mental disorderThe Mental Disorder definition that is used by the Metropolitan Police includes learning disabilities where there is a significant impairment of intelligence and social functioning. This would include people with an autistic spectrum disorder.Autism and criminal justiceASD is a hidden disability, but this can make people with the disability more vulnerable because their behaviour can be perceived to be odd eg poor awareness of personal space, repetition of strange sounds and words, making loud noises, hand flapping, inappropriate or no eye contact and lack of flexibility of thought. People with ASD are often victims of crime and antisocial behaviour; they can be teased, bullied, threatened, or attacked because of their odd behaviour.Nevertheless, some people with ASD can also display challenging as well as obsessive and ritualistic behaviours, which could lead to criminal offences. Types of offences committed by people with ASD fall into 4 categories as defined by Stehpenson (1995):The individual is deliberately led into criminal acts by others because of their social naivety; Aggressive behaviour caused by disruption of routines or changes in daily circumstances; Anti-social behaviour caused by lack of understanding, or misunderstanding of social cues; and Anti-social behaviour caused by obsessional tendencies.Social naïveté of people with ASD could lead them to confess to crimes they did not commit because of their desire to please others or because of their inappropriate answers to questions. There was a case involving a young man with ASD who was befriended by a gang of local petty criminals. The gang would ask the young man to take videos from a shop saying that they would pay the shop owner later. Instead, the gang would make off with the tapes while the man with ASD would end up being caught. Sadly, this scenario is not uncommon.The academic Pat Howlin (1997) notes the case of Joey who was fascinated with washing machines from a young age. In adolescence, Joey would enter any house where he could hear a washing machine in action, and was unable to appreciate the alarm this caused the occupant. In Scotland, the NAS is aware of many similar cases of obsessional tendencies such as Martin who was fixated with videos and would break and enter neighbours homes to take videos without realising the implications of his actions. For Martin, he was lucky in that his neighbours were aware of his disability and how it manifested itself, but not everyones neighbours are so understanding.Victims and witnessesThe first pilot to help vulnerable witnesses of crime with communication difficulties give evidence is currently on trial in Merseyside. The scheme is also due to be piloted in South Wales, Norfolk, Devon and Cornwall, Thames Valley and West Midlands before being implemented on a national scale if successful. The pilots will run until summer 2005 when recommendations will be made for further implementation.The scheme provides a communication expert, such as a speech and language therapist, to act as an intermediary to help a witness with communication difficulties. Through this additional support the witness will understand questions asked of them, and able them to give their answers in a way that can be understood by the police, judge, legal representatives and the jury. A register of 45 intermediaries has been established.Examination of a witness through an intermediary is one of the range of special measures provisions contained in the Youth Justice and Criminal Evidence Act 1999. Vulnerable witnesses with communication difficulties who could benefit from the assistance of an intermediary include:young children people with learning disabilities people who have communication difficulties arising from a physical disability or disorder, for example as the result of a stroke or an accident.This provision is available only to witnesses who meet the definition of vulnerability contained in section 16 of the Act. A witness meets this definition if the court considers that the quality of evidence given by the witness is likely to be diminished by reason of any of the following circumstances:or if the witnesssuffers from mental disorder within the meaning of the Mental Health Act 1983; or otherwise has a significant impairment of intelligence and social functioning (learning disability); or has a physical disability or is suffering from a physical disorder; oris under the age of 17 at the time of hearing.Witnesses are key to the success of the criminal justice system and bringing more criminals to justice. Witnesses need to feel confident and reassured about giving evidence. Vulnerable witnesses in particular must receive the help and support they need.After Merseyside, the scheme will be piloted in a further five criminal justice areas before being rolled out on a national scale. The aim of the pilots is to test out procedures and structures in order to create a robust model for national roll-out.Courts can be daunting places at the best of times, and witnesses can feel uneasy and vulnerable when giving evidence. By giving witnesses the confidence and support they need during court appearances, vital evidence is not lost due to communication difficulties. The intermediary scheme will help to meet the needs of the most vulnerable victims and witnesses.The use of an intermediary would be the appropriate special measure, to maximise the quality of evidence given by the witness - considering all circumstances of the case. Included in these measures would be any views expressed by the witness or other parties as to whether the measure or measures might tend to inhibit the effective testing of the evidence.Initial contactThe Codes of Practice of the Police and Criminal Evidence Act (1984) (Code C (1) (1.4)) states that:If an officer has any suspicion, or is told in good faith, that a person of any age may be mentally disordered or mentally handicapped, or mentally incapable of understanding the significance of questions put to him or his replies, then that person shall be treated as a mentally disordered or mentally handicapped person for the purposes of this code. Many people with Asperger syndrome can often appear very articulate and present themselves as very able during an initial contact. It could be very difficult for an officer, especially somebody with little or no knowledge of the disorder, to have any suspicion that a person has a mental disorder. This can be when difficulties arise as a person with ASD may give basic one word answers to closed questions, appear stubborn to questioning or not answer at all because they are so confused or anxious. Proposal: The NAS proposes that during initial contact the officer asks "Do you have any difficulties that I may not be aware of?" The NAS advises that families make themselves known to local agencies including the police so that there is a two-way relationship. However, this is not often the case and so the first time a person with an ASD comes into contact with the police, or vice versa, it is often likely to be in a stressful situation.Recognising persons with autism May be nonverbal or may only repeat what is said to them; may communicate with sign language or use gestures or pointing May not respond to 'Stop' command, may run or move away when approached, may cover ears and look away constantly May toe-walk, have pigeon toed gait or running style May appear as high on drugs or drunk May react to sudden changes in routine or to sensory input eg lights, sirens, barking dogs with escalation of repetitive behaviour; pacing, hand-flapping, hitting self, screaming (temper tantrums are an expected response to fear, confusion, or frustration as an effort to stop the stimuli) May not recognise danger or hurt eg continuing to walk with broken foot. May not recognise police badge or understand what is expected of them May appear argumentative, stubborn or belligerent; may say 'No!' to all questions; may ask 'Why?' incessantly Will have difficulty interpreting body language and facial expressions May have passive monotone voices with unusual pronunciations; often sound computer-like May have difficulty judging personal space May have difficulty in seeing things from a different point of view; may have difficulty predicting other peoples reaction to them Are usually very honest, sometimes too honest; have behaviours limiting credibility with others but do not or ably tell lies; often very blunt, not tactful.Suggested responsesTalk in direct, short phrases such as 'Stand up now' or 'Go to the car'. Allow for delayed responses to questions or directions/commands Avoid literal expressions and random comments such as 'What's up your sleeve?' 'Are you pulling my leg?' Talk calmly and/or repeat. Talking louder will not help understanding Avoid behaviours and language that may appear threatening Don't interpret limited eye contact as deceit or disrespect If possible, avoid touching the person, especially near shoulders or face; avoid standing too near or behind; avoid stopping repetitive behaviours unless self-injurious or risk of injury to yourself or others Evaluate for injury as the person may not ask for help or show any indication of pain, even though injury seems apparent Examine for presence of medical alert or tags; person may have seizure disorder Be aware or persons self-protective responses to even usual lights, sounds, touch, orders, animals If possible, turn off sirens and flashing lights and remove dogs or other sensory stimulation from scene Consider use of sign language, or picture or phrase books If you take a person into custody and even remotely suspect may have an ASD, to reduce the risk of abuse and/or injury, segregate the individual and not to place them in general incarcerated population before a health professional has evaluated them.Guiding principles: in a compassionate, skilful and informed way.Proposal: The NAS would like to work with the Met Police in producing and promoting this information. The NAS has met recently with the Strategic Disability Team to discuss the possibility of the NAS producing information factsheets about autism within the criminal justice system and also in the longer term the option of delivering training to the Metropolitan Police.We will always seek the most appropriate course of action for any individual coming to our attentionThe NAS commented extensively on the Anti-social behaviour Bill (Act) and highlighted its concerns that some behaviour by people with an ASD may be criminalised if their behaviour is perceived as anti-social. For the NAS view on the legislation see: http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=241&a=5166Proposal: The NAS would like to meet to discuss this response and the Review of the Metropolitan Police Service Mental Disorder PolicyFor more information please contact:Gavin OwenPolicy and Campaigns Officer - AdultsNational Autistic Society393 City RoadLondon EC1V 1NG020 7903 3558gowen@nas.org.uk" onclick="window.open(this.href);return false