Talking about mental health and keeping people out of hospital
Authors: Abigail Croydon and Bronagh McCoy
Continuing the Conversation
Part of the Estia Centre's Learning Together 2026 blog series, featuring articles from conference speakers and contributors.
Sharing our research at the Learning Together Conference
We came to the Learning Together Conference to share research on what happens when people with learning disabilities and autistic people need extra help with their mental health. The day was hot, but the event was friendly and laid back – giving us the chance to talk to people with professional and lived experience, and to reach out to the people we want to involve in our research: people with learning disabilities and autistic people who have experienced significant mental health challenges.
Why mental health support matters
After a productive morning, we began our session by talking about mental health and people with learning disabilities and autistic people. Most people experience ups and downs, but some get stuck at a very low level or reach crisis point. This is where Care (Education) and Treatment Reviews (C(E)TRs) – and our research – become important.
We discussed the uncomfortable reality that people with learning disabilities and autistic people are much more likely than the general population to experience mental health difficulties, with very high rates of anxiety, depression and other challenges. Yet we also know that getting help is harder for both groups. Mental health problems are often overlooked as part of their autism or disability, and they can wait longer than others for support because what is generally available may not be suitable for them. Alongside the inclination to overlook mental health difficulties is a tendency to over-medicate. These factors make mental health problems especially difficult to navigate.
We wanted to draw on the expertise in the audience to hear personal perspectives on why mental health difficulties are more common. Audience members talked about the lack of opportunities to do things that people find meaningful and rewarding, being stuck at home, and the difficulty of finding trusted and stable support when there is high staff turnover in social care.
We also asked people for examples from their own lives of ways to support mental wellbeing, citing the morning’s keynote talk, in which Simba Ngwarati brilliantly explained his music-making in the evocative track, ‘Panic Attack’.
Understanding Care (Education) and Treatment Reviews
This was all essential background to our topic. C(E)TRs are specifically for people with a learning disability and/or autistic people who are at risk of admission to a mental health hospital. Rooted in the response to scandals of abuse in institutions such as Winterbourne View, they take a holistic look at the person’s circumstances and support. The person and their usual care team come into dialogue with independent clinical experts and an ‘expert by experience’ – someone who has personal knowledge of what it is like to use mental health services.
What our research has found
Our research aims to find out how well these reviews are working – whether they are keeping people out of hospital, reducing the amount of time they spend there, or strengthening the care they receive in the community.
Bronagh explained the key findings from the first phase of the project, which looked at electronic health records at South London and Maudsley NHS Foundation Trust. Her analysis suggested that people were less likely to be admitted to hospital in the first six months after their C(E)TR, but this effect did not appear to continue beyond six months. Having a C(E)TR before admission to hospital did not appear to shorten hospital stays.
After a C(E)TR, there were indications of more activity in people’s clinical notes, such as mentions of a care package, but there were no clear signs that their mental health had improved. These records therefore tell part of the story but raise questions as well as providing answers.
Hearing from people with lived experience
We finished our session with a research update and a message we wanted to share. We have begun an interview study to help us understand the experiences of people directly involved in C(E)TRs. So far, we have had valuable contributions from professionals, but we have yet to hear from people with learning disabilities and autistic people, or from their families
We therefore reached out to our audience for help to find people who have recently been through a C(E)TR and who might contribute their experiences and views to the project.
The conference was a wonderful example of bringing together people with lived experience, professional expertise and research knowledge. We left having both given and received strong messages about the importance of hearing from people with learning disabilities and autistic people, whose voices are essential if we want to understand how services and support can be improved.
About the authors
Abigail Croydon is a research associate at King’s College London specialising in intellectual and developmental disability. She is also a parent carer and is interested in people’s opportunities to contribute to and participate in society on their own terms.
Bronagh McCoy is a research associate at King’s College London, with a research background in visual attention, learning and the co-occurrence of autism and anxiety. She is study manager of the OptiCaT project.