Tier 4 Autism Mental Health Training

For many autistic people, inpatient mental health units are unsuitable and often traumatic places, which may exacerbate or increase the difficulties they experience. There are many reasons for this but often the environment is distressing, and staff may lack the experience or support to make the adjustments required for interventions, routines and milieu suited to their needs.

In an endeavour to build capability within provider organisations, we are offering places on Train the Trainer courses. Our curriculum provides a unique overview of best practice, through tuition based on research evidence and the participation of experts by experience who have co-designed the training material.

We want trainers to:

• Understand barriers experienced by autistic people in the community and hospital environment.
• Employ experience-sensitive and reflective approaches of working with, rather than on, or for, autistic adults.
• Gain expertise and a broad range of skills and practical strategies to meet the needs of autistic people and their families, as members of multidisciplinary and transdisciplinary teams, and wider teams of staff members.
• Model values of collaboration and acceptance, and promote a positive narrative about neurodiversity in their services.
• Demonstrate an understanding of key concepts, values and behaviours taught, and how best to communicate these to their teams.

The training will help inpatient teams understand autism, their own responses to autistic people, and how to adjust care to suit their needs. It covers subjects such as: what is autism; trauma informed care; the need for a whole team approach and the prevention of institutionalisation. Relevant material for Tiers 1 to 3 of the Autism Capabilities’ Framework, this course will enable a team to deliver care at Tier 3 capabilities.

The Train the Trainer course is delivered over six days. During this time the nominated Trainers from each Trust will receive and discuss information covering core issues, and learn how to deliver our materials. The nominated Trainers will be supported by our team, which includes autistic autism experts. We will ensure personalised support and practice to aid Trainers in developing confidence and expertise in facilitating training. We will support Trainers to enable their teams to value a strengths-based, person-centred, humanising approach for both the autistic person and the staff working with them. Trainers will have access to resources designed by autistic experts; some of them with lived experience of being in an inpatient unit.

The subsequent delivery of the core materials by Trainers to their teams is designed to take three days. The training package can be delivered flexibly in a form and at a pace that suits the circumstances of the team and the unit

Several national reviews have highlighted significant challenges regarding the quality of care within units. The National Autistic Taskforce was established in January 2018  to suggest a rapid set of improvements. One of the taskforce actions was to require services to ensure their staff receive training in autism. Our training is designed to give specialist service providers a sustainable means of training their current and future workforce.

The curriculum is based on a specification co-developed with an expert group of autistic people and non-autistic people against existing capability frameworks. It is designed to allow inpatient teams to function at the highest capability level –Tier 3. This describes the capabilities needed by health, social care staff and other professionals with a high degree of autonomy, to provide care and support in complex situations and/or also lead services for autistic people. Those delivering the training will adapt the programme to meet the needs of each professional group.  

AT-Autism and Anna Freud Centre autistic and non-autistic staff, and eleven autistic people and family members who have experience of inpatient mental health/ward units, have co-produced the training materials. Autistic and non-autistic scientific co-ordinators and speakers will train the trainers.

We have focused our curriculum on those capabilities that felt most relevant based on (1) the profiles of the nominated staff, their knowledge gap and emerging skills, (2) the priorities described to academic team members by our team of autistic academics, our autistic experts by experience and three family members of people with learning disability. In line with our submitted proposal, we will model co-production and co-delivery to teams to help them develop confidence and curiosity about learning from and with autistic people.

We have developed a variety of ways to cultivate synchronous and asynchronous safe spaces for professionals. These include self-reflective exercises, theory lectures, quizzes, films and vignettes, to promote a value-based approach to reduce stress, and the planning and rehearsal of strategies for those who support autistic adults who might exhibit behaviours of concerns.

We emphasise the need for staff to have:

• Time for preparation and reflection.
• A willingness and a safe space to examine their impressions; to understand them self and others.
• Time to rehearse and create contingency plans on how they (the staff) will respond in different scenarios.

Reducing the need for restraint, through deeper understanding, self-awareness and a sensitive and accurate narrative around 'behaviours of concern' is a thread that runs through all the modules. We aim to promote confidence in Trainers’ ability to apply what they learn by providing them with the latest knowledge on the interplay between autism and mental health conditions and an established autism-specific framework to work within.

Our autistic partners told us that, based on their personal experiences of these approaches, they did not want to deliver a programme of theoretical knowledge around common behavioural frames, such as ABA or PBS, and our approach respects this. In addition, we believe it is hard for people from different disciplines to gain a deep understanding of contextual behavioural frames in a day, and it is even harder to apply these in practice under stressful circumstances without oversimplifying what can become a reductionist understanding of the complex presentations of issues. In addition to causing offence and distress to autistic colleagues, evidence continues to emerge that such approaches are ineffective with autistic individuals, and it is easy for people to 'fail', even if they try their best.

Approximately 70 clinical educators from service providers across London and the South East will attend the training and  disseminate learning back to the teams working in their inpatient units. They will be supported by resources and a community of practice meaning that during the training and indefinitely thereafter, learners will have access to an online community of trainers, resources, course manuals, reflective practice groups and refresher training sessions.  

HEE have appointed an independent evaluator to undertake the evaluation of the Train the Trainer programme.  They will be working with experts by experience and people with lived experience on the design of the research tools for the evaluation. 

If you are interested and would like to book onto the training, please email the ASCLD team on ascld_training@annafreud.org

The link to other Autism CYP trainings can be found here.

The link to the animations open access can be found below.

• Animation 1
• Animation 2

The link to the online learning platform, Blackboard, can be found below.  Please note this is only available FOR REGISTERED TRAINNEES.

https://annafreud.blackboard.com/