How our service can help you
The Transforming Care in Autism TCA) Team provides indirect and direct clinical input to support health professionals and mainstream services (across Lambeth, Lewisham and Southwark) to work with autistic adults who are at risk of admission, or currently an inpatient in psychiatric hospitals.
For individuals in forensic services or those considered to pose a significant risk to others, they would be more appropriately referred to the Forensic Intellectual and Neurodevelopmental Disabilities (FIND) Community Team: email: firstname.lastname@example.org or Tel: 02039276150
For individuals with a formal diagnosis of moderate to severe intellectual disability; they would be more appropriately referred to local Mental Health in Learning Disability: (MHLD) services: email: email@example.com
The aim of the service is to:
- reduce and, where possible, prevent the number of inpatient admissions and support a successful and timely discharge back into the community for autistic adults,
- provide a service development pathway, involving supporting staff in inpatient and community mental health services to develop knowledge, skills and confidence in working with autistic services users who have mental health needs and/or present with behaviour that is deemed ‘challenging’.
- Service Type: Community Service Service Borough Covers: Lambeth, Lewisham and Southwark Treatment type: Adult Mental Health Services (Specialist)
Contact the serviceSite Location: Maudsley Hospital Email: TCATeam@slam.nhs.uk Phone Number: 07718423537 - Shaun Byrne (Team Administrator)
- Address: Bethlem Royal Hospital TCA Team 1st Floor Monks Orchard House Monks Orchard Road Beckenham,Kent, BR3 3BX
- Business Hours/Visiting Hours: Monday – Friday, 9am – 5pm, excluding bank holidays
- Conditions: Transforming Care in Autism; autism
Other essential information
An individual is considered to be in a crisis if they are at risk of being admitted or are already in an inpatient setting. At the point of crisis, the team can offer short-term support through assessment, formulation, and development of an intervention strategy in conjunction with relevant services across health and social care. This may include direct and indirect interventions from one or more members of our MDT; attendance at Care and Treatment Review (CTR) meetings, support identifying appropriate service provision; staff training; staff supervision and consultation.
Our initial point of intervention is to provide a professional or consultation meeting with existing local and inpatient professionals involved to gather information and create a formulation before deciding what further input will be appropriate. Our input/response will be bespoke and adapted according to individual needs and the resources and capability of the non-specialist service available.
The team can also offer network meetings as part of the open dialogue principles that have been adopted into our team. Open Dialogue is a model of mental health care which involves a consistent family and social network approach where all treatment is carried out via a whole system or network meetings, which always include the patient.
As a team we are also able to offer Non-violent Resistance (NVR) groups to parents and guardians if the autistic service users we support. NVR is a parenting approach which has been shown to help in families where there are additional difficulties including neurodiversity, aggression and/or avoidance. The group uses NVR principles to improve relationships between parents/guardians and their (adult) children.
We consider a crisis resolved when the risk of admission is reduced or there has been a successful transition to the community and/or the treating team are able to provide ongoing support due to input from the TCA team.
Training, Supervision and consultation
The team can offer specialist input to mainstream SLaM services, including bespoke staff training, supervision, and consultation. The aim of this internal service development pathway is to increase understanding of autism, support non-specialist teams to carry out autism adaptations, and increased confidence working with this group. Examples of bespoke training we have provided in the past include Positive Behaviour Support Planning, Adaptions for Autism Spectrum Conditions, and Managing Risk, Clinical overlap between psychosis and autism.
We ask that SLaM teams in the first instance review the training offered on LEAP which staff can access to develop general knowledge on autism:
Please send specific training requests and the areas or topics you would like cover to our email address – TCAteam@slam.nhs.uk
We require a written referral and referral must be made by a SLaM team. New referrals are discussed in our weekly team case discussion meetings every Tuesday morning. Currently, we do not operate a waiting list and we aim to process referrals as quickly as possible.
Autistic adults can be referred if they meet all of the elegibility criteria.
- Adult service; be 18+ years-old
- Have a confirmed diagnosis of autism, including Asperger’s syndrome and pervasive developmental disorder (please send a diagnostic report with confirmation of autism with the referral)
- Must be registered with a GP and live in the boroughs Lambeth, Lewisham or Southwark
- Must be on/or eligible for the Dynamic Support Register (DSR) and be categorised as red/amber due to risk of admission to mental health psychiatric hospital or already inpatient
- Must be open to another SLaM team who will continue to hold clinical responsibility for the duration of TCA input
- Registered with a GP and/or live in the Croydon borough as Croydon has not commissioned our service
- In forensic service or poses a significant risk to others
- Diagnosed with a moderate to severe intellectual disability
- Not open to another SLaM team
- Principal/Lead Clinical Psychologist
- Consultant Psychiatrist
- Systemic Family Therapist
- Assistant Psychologist
- Occupational Therapist
- Speech and Language Therapist
- Clinical Nurse Specialist
- Behaviour Support Practitioner
- Advice and support from a range of topics from the National Autistic Society https://www.autism.org.uk/advice-and-guidance
- How to do a great assessment for someone who has autism.pdf
- Top tips for working with people with autism.pdf
- Transforming Care in Autism Referral Form August2023.docx
- NAS-Good-Practice-Guide-Therapy.pdf [pdf] 2MB NAS-Good-Practice-Guide-Therapy.pdf
- NAS How to talk and write about autism.pdf
Prior to any input starting, you may wish to consider:
- Does this person have a communication passport? A template is available here: https://www.autism.org.uk/advice-and-guidance/topics/physical-health/my-health-passport
- Has a care and treatment review been conducted? Care and treatment reviews are undertaken by commissioners to ensure that people are only admitted to hospital when absolutely necessary and for the minimum amount of time possible. The CTR is in place to make sure that services are meeting the person's needs and all aspects of their care are considered. More information is available here https://www.england.nhs.uk/learning-disabilities/care/ctr/
- If there is a risk of admission, a CTR should be completed.
- To organise a CTR, please contact the respective commissioner:
Frequently Asked Questions
Why the team exists:
- The need for our service emerged when it became apparent that autistic adults without a learning disability were falling between service gaps and not receiving the care they needed.
- Autistic adults commonly experience mental health conditions. They can experience barriers to accessing timely support from health and social care services. Some autistic adults are admitted to mental health hospitals because there is a lack of autism-specific support in the community when they are in crisis. An admission is sometimes the most appropriate clinical intervention, but some autistic people stay in hospital for longer than needed because of a lack of autism-specific input on the ward or because it is unclear how best they can be supported in the community.
- Some professionals working in mainstream mental health services do not have much knowledge about autism or experience of working with autistic people.
- The Learning Disability and Autism (LDA) strategy (previously Transforming Care Agenda) had been developed by the NHS so that autistic adults at risk of admission to a mental health hospital or in hospital can be offered autism-specific support when they need it, to help reduce risks and avoid lengthy inpatient admissions.