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National Autism Unit

How our service can help you

The National Autism Unit (NAU) is a specialist inpatient service that provides assessment and treatment to men with autism spectrum disorder (ASD) as well as:

  • Comorbid mental illness associated with severe functional impairment​ 
  • Levels of complexity and/or risk that necessitate an inpatient environment​ 
  • Our multidisciplinary team has expertise in adapting evidence-based treatments to attend to the needs of individuals on the Autism spectrum.
  • Providing expert care and treatment to individuals with complex presentations
  • Treatment interventions are based upon a comprehensive multidisciplinary assessment involving diagnosis and formulation of developmental and mental health conditions and assessment of need. This includes consideration of sensory and information processing factors associated with neurodiversity.
  • Psychological interventions are formulation-based and tailored to the needs of the individual. All patients have access to individual psychological input delivered by Health and Care Professions Council (HCPC), British Psychological Society (BPS) registered psychologists and United Kingdom Council of Psychotherapy (UKCP) registered psychotherapists.
  • Amongst a range of evidence based psychological approaches, where clinically indicated, we provide Cognitive Behavioural Therapy (CBT) for mental health difficulties commonly associated with ASD, as recommended by NICE.
  • We have a well resourced Nursing team comprised of Learning Disability and Mental Health Nurses. These skill sets complement each other, while bespoke training ensures that our expert Nursing staff are able to meet a range of complex needs of autistic individuals in a person centred way. 
  • Due to the expertise required to support the individuals who access the service the NAU employs Senior Supports workers to deliver high standards or care and treatment.
  • Our medical team is expert in psychopharmacological management of mental disorders co-morbid with ASD. Our medical team and patients have access to a dedicated pharmacist that gets to know the patients well & adapts treatments to the patients’ needs.
  • We provide person-centred evidence-based treatments including a range of skill-building packages to develop life skills and promote independence.
  • Our flexible approach to assessment and intervention means Autistic Individuals really do get a bespoke, needs based treatment package which balances evidence-based practice with creativity and adaptations to suit each individual.
  • We are responsive to the Transforming Care process, working collaboratively with Community Mental Health Services, Commissioners and families to identify less restrictive opportunities and develop discharge pathways and aftercare packages within the community.
  • The NAU is partnered with the ESTIA centre to ensure our expert clinicians are involved in training and development. We support the sharing of evidence based best practice to other services as well as translating research into practice.

  • Service Borough Covers: National (Adult services) Treatment type: Inpatient
  • Contact the service

    Site Location: Bethlem Royal Hospital Phone Number: 020 3228 4183
  • Disabled Access:

    Yes

  • Address: Witley House,

    Bethlem Royal Hospital
    Monks Orchard Road,
    Beckenham,
    BR3 3BX
  • Business Hours/Visiting Hours:

    24 hours

  • Other essential information

  • Conditions: Anxiety, Attention deficit hyperactivity disorder (ADHD), Autism, Bipolar disorder, Body dysmorphic disorder (BDD), Conduct disorder, Dementia, Depression, Dissociative disorders, Eating disorders, Learning disabilities, Neuropsychiatry, Obsessive compulsive disorder (OCD), Personality disorders, Post-traumatic stress disorder (PTSD), Psychosis, Self-harm

Interventions

The NAU operates a three-stage treatment model:

Stage 1: 12 week Assessment 

Key tasks are: 

  • Physical health assessment ​
  • ICD-10 & ICD-11 diagnostic confirmation ​
  • Specialist risk assessment ​
  • Communication assessment ​
  • Positive behaviour support plan
  • ADL assessment & MOHOST ​
  • Community Assessment ​
  • Cognitive assessment ​
  • Psychological assessment and formulation ​
  • Treatability assessment ​

Stage 2: Treatment 

Key tasks are: 

  • Pharmacological optimisation ​
  • Maximise functional ability including ADLs ​
  • Develop communication strategy ​
  • Optimise positive behavioural support strategy ​
  • Address symptoms psychologically using a range of psychological therapies including Cognitive Behavioural Therapy adapted to meet the needs of people with ASDs and develop resilience ​
  • Psycho-education/group work ​
  • Social skills training ​
  • Reduce and manage risk ​

Stage 3: Transition 

Key tasks are: 

  • Identify and articulate aftercare needs ​
  • Develop placement profile (where appropriate) ​
  • Prepare patient for transition ​
  • Relapse prevention work ​
  • Share Positive Behavioural Support Plan ​
  • Share communication passport ​
  • Co-working period if possible

Patients are supported under the Care Programme Approach. The first CPA is held at the 12-week point to review the outcomes of the assessment period. If a further period of treatment is indicated, specific treatment goals are set and a mutually agreed timeframe for the treatment stage is established. 

Patients have access to the full range of Occupational Therapy services available at the Bethlem Royal Hospital site in addition to groups organised directly on the NAU. A Rolling programme of activities available on the unit includes, , Men’s Group, Pets As Therapy (PAT) Dog Walking Group, Cooking Group, Gym, Relaxation Group, Social Skills Group, and Open Sports Group.

Psychological groups are offered depending on the needs of the individuals on the unit at any given time. Previous groups have included Self-Identity, Compassion Focused Therapy, Psychotherapy and Art Psychotherapy. A Family Support Group is offered to parents of men on the unit.

Eligibility criteria

  • Male only (Referrals potentially accepted for transgender individuals or individuals with gender incongruence). ​ 
  • 18 years and over (referrals for CAMHS transitional patients accepted for assessment from 17 years 6 months).​ 
  • Patients may be informal or detained under the Mental Health Act.​ 
  • Diagnosed or suspected autism spectrum disorder, where diagnostic clarification is required as part of the admission  
  • Local services must remain involved throughout the admission and work collaboratively to source and commission appropriate aftercare. 

Referral considerations: 

The NAU considers each referral on a case-by-case basis, both with regard to the needs of the referred individual and the presentations of the other individuals on the ward at time of referral, to ensure safety and a therapeutic environment for all. We will always consider whether an individual can benefit from our assessment and treatment model. 

Where an individual has a learning disability, we will consider whether this is likely to impact on their ability to benefit from the NAU assessment and treatment model. Traditionally, the NAU has been more appropriate for individuals with mild rather than moderate to severe learning disability.

Presentations/difficulties we work with include: 

  • Obsessive Compulsive Disorder 
  • Psychosis 
  • Catatonia 
  • Anxiety disorders such as panic 
  • Depression 

We will consider referrals from the criminal justice system in conjunction with NHS funding and after-care and for those with challenging behaviour and will assess in these cases whether we can manage the presentation safely.  

We can accept referrals where there is diagnostic uncertainty, where developing diagnostic clarity and a working formulation are part of the admission aims.  ​​​​​​

Outcomes

  • Optimum function and quality of life for the person
  • Improved engagement with care/support plans
  • Improved social functioning
  • Improved psychological functioning
  • Improved understanding of needs by the patient and carers
  • Better physical healthcare leading to reduced morbidity
  • Fewer mental health admissions and bed days
  • Reduction in the total number of in-patient days
  • Reduction in level of support required
  • Identifying the level of care required for successful future placements
  • Expanded discharge destination options
  • Reduced overall care costs

Our experts

Dr Susannah Whitwell, Clinical Director: Read more

Inka Macku, Ward Manager: Read more

Dr Michael Craig, Consultant Psychiatrist: Read more

Dr Quinton Deeley, Consultant Psychiatrist: Read more

Dr Sophie Doswell, Consultant Psychologist: Read more

Dr Lucy Mackintosh, Clinical Psychologist:  Read more

Peri Mackintosh, Highly Specialist Psychotherapist: Read more

Carmen Brock-Southon; Lead Occupational Therapist: Read more

Leda Veloso, Senior Clinical Pathway and Social Care Lead:

 

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