Meeting of the Parliament 01 April 2025
Michael has spent more than 15 years in hospital. He is autistic with a severe learning disability. He finds routine comforting, and unexpected changes cause distress, leading to self-harm or lashing out. At times, he is placed in seclusion for his and others’ safety.
Michael is ready for discharge—he has been ready for discharge for years. His father has seen multiple housing plans fall through, and he fears that Michael has become institutionalised, with limited support to maintain his independence or his skills. Cost concerns and the risk of unsuitable shared accommodation add to Michael’s father’s worries. After years of setbacks, he doubts whether Michael will ever be discharged.
The Mental Welfare Commission for Scotland highlighted that story just a couple of months ago in its report “Hospital is not home: The circumstances of people with learning disability and complex needs who have been in hospital for 10 years or more”.
Unfortunately, Michael’s story is not unique. In the Equalities, Human Rights and Civil Justice committee this morning, we heard that 55 people in Scotland have been institutionalised for over 18 years—10 of them for more than 25 years. That is 25 years of living in hospital when there is no medical or clinical reason for them to do so.
The Scottish Human Rights Commission told the committee this morning that prejudicial attitudes to people with learning disabilities, autism and neurodivergence are entrenched. The SHRC and all the third sector organisations that support autistic people and those with learning disabilities should not still be having to make the case that independent living is possible for everyone. It is not a matter of opinion; it is a matter of human rights. Everyone has the right to live in the community and can do so if they are supported appropriately.
Attitudes are clearly demonstrated through actions. When actions such as seclusion, restraint, overmedication and restrictions on food become the norm, and when people are cut off from education or their wider support network and prevented from forming relationships or from choosing with whom to live, and when those actions happen daily, it is clear that discriminatory attitudes and cultures must change.
In committee, we were specifically discussing the findings and recommendations of the SHRC’s report “‘Tick Tock…’ A human rights assessment of progress from institutionalisation to independent living in Scotland”, and it was clear that our collective failure to meet promised timescales for change or to implement various legal reforms for empowerment and redress should shame us all. We should not, and cannot, ignore the failure of the state to support the realisation of basic human rights.
It is for those reasons that the delay in bringing forward the LDAN bill, in addition to the delay in the Government’s proposed human rights bill and in other pieces of legislation, is so frustrating. Other members have discussed many issues that the LDAN bill would have helped to address, but I want to highlight one area of concern with regard to how the proposed bill was developed, which I hope that the minister will address in closing. During that process, the voices of autistic people and of those with lived experience of neurodiversity were not always heard. Serious concerns were expressed by those people about the use of behaviourist approaches such as positive behaviour support and applied behaviour analysis, but those were not addressed and were not taken into account in the consultation on the bill. The trauma that approaches such as PBS and ABA cause was ignored.
Can the minister outline how the Scottish Government is actively listening not just to organisations that support autistic and neurodiverse people, but to autistic and neurodiverse people themselves? They know best about their lives.
I very much thank Daniel Johnson for securing this important debate, and I express my immense gratitude to all those who work so hard to ensure that we hear the voices of autistic and neurodiverse people and those with learning disabilities, because their voices matter.
17:35