Monday, 12 September 2011

Alan Somerville- Mapping it out for a national Autism strategy

At the forefront of national Autism policy development, Scottish Autism Chief Executive Alan Somerville is no stranger to the complex and often frustrating problems of trying to formulate and implement strategy which treats people with Autism in a way which suits their individual needs, rather than a 'one size fits all' approach which, although simpler and cheaper, lets down most people affected by autisic spectrum disorders.

Interviewed in the Holyrood Review, Somerville talks about the main reasons for not supporting the Scottish Autism Strategy(Scotland) bill proposed by MSP Hugh O'Donnell last year. He argues that the bill would have just slowed down progress towards a joined-up national approach.

“It was quite a landmark that we chose not to support Hugh O’Donnell’s bill,” reflects Somerville. “What we saw happening in England was they produced a bill but the only measure in that bill was to produce a strategy, which strikes me as being exactly the wrong way round.”
Ultimately, the strategy being developed in Scotland will be more meaningful and have greater longevity, Somerville believes. “I think that unlike the bill, the act as now, in England that is on the statute, whether it achieves anything or not they will say,‘That’s done. We’ve done autism.’ Whereas we are continually able to say to the minister, ‘We may recognise the constraints you are under but we have not achieved this level and we want to keep going until we do.’ I think that is much more powerful."

Somerville defines Autism as not just one spectrum, but several different spectra. Severe Autism, he argues, where the individual requires 24/7 care is very different to a University professor with Asperger's syndrome and both impairments lie on very different spectra in terms of classifying disability., however we still try to push them together under the umberella of a 'learning Disability', something which is clearly not the case for the professor and many other people affected by Aspergers. He goes on to assert that Autism rarely exists in isolation, but with co-morbid conditions traditionally viewed as within mental health remits. "We need to better understand thecombinations of these co-morbid conditionsto determine the level and type of support that any particular individual requires" he says, adding that we also need to understand what the “map of autism space looks like in however many dimensions it takes to do it”.

Uncomfortable with studies which do not factor in these dimensions, Somerville and Scottish Autism have commisioned research which hopes to map out the co-morbid conditions associated with Autism with the aim of arriving at what he calls the 'escapable cost of Autism'. This he defines as measuring what happens if things are done well, with early intervention, and match that against a quality of life scale for people with Autism, for each of the different 'segments' or groups of affected individuals. "You add it all up and you come up with an escapable cost for Autism" he maintains, hoping that although this process will take a couple of years, it should "illuminate" government thinking and strategy from then on.

In the meantime, Somerville is happy with the soon to be published Strategy for Autism in Scotland. He is particularly pleased that the government has included his suggestion for framing the strategy around two, five, and ten year goals. the strategy will work by improving things such as diagnosis, post diagnostic support and intervention, and accessing services provided by local government more effectively. The five and ten year strands include transition planning, whole life strategy and joined up work across health, education and social care, with the eventual goal of getting central and local government to work together with relevant agencies. Ambitious? yes, but also achievable. As Somerville states at the end of his interview, “You’ve got research. You’ve got multidisciplinary teams. You’ve got functional area goals that are time related and build on each other. And you’ve got an administration that seems to be, at present, willing to put some money – it is not an enormous amount of money but it is enough to make progress. And I think that all adds up to quite a good story"

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