~ aqnmu
Queensland Nurses &
Midwives’ Union
Submission to
Inquiry into the services, support and life outcomes for autistic people in Australia and the associated need for a National Autism Strategy
July 2020
® | 106 Victoria St, West End Q 4101
GPO Box 1289, Brisbane Q 4001
Introduction
The Queensland Nurses and Midwives’ Union (QNMU) thanks the Select Committee on Autism (the Committee) for the opportunity to make a submission to the inquiry on the services, support and life outcomes for autistic people in Australia and the associated need for
a National Autism Strategy
Nursing and midwifery is the largest occupational group in Queensland Health (QH) and one of the largest across the Queensland government. The QNMU is the principal health union in Queensland covering all classifications of workers that make up the nursing and midwifery workforce including registered nurses (RN), midwives (RM), nurse practitioners (NP) enrolled nurses (EN) and assistants in nursing (AIN) who are employed in the public, private and not for-profit health sectors including aged care.
Our more than 63,000 members work across a variety of settings from single person operations to large health and non-health institutions, and in a full range of classifications from entry level trainees to senior management. The vast majority of nurses in Queensland are members of the QNMU.
This year, 2020 will be dedicated to celebrating the International year of the Nurse and the Midwife, in celebration of the 200th year anniversary of the birth of the founder of
contemporary nursing, Florence Nightingale. The World Health Organisation (WHO)
nominated nurses and midwives for their invaluable contribution to health care and to highlight the need for a strengthened nursing and midwifery workforce to achieve sustainable development goals (SDG) and universal health coverage. The QNMU is proud to embrace this opportunity to invest in the nursing and midwifery professions, particularly the investment into minimum safe staffing ratios and skill mix across all health sectors.
The QNMU’s submission provides some general comments to the inquiry on the mental health prevalence of those with autism and the access to healthcare and services they receive.
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General comment
The QNMU welcomes the Committee’s decision to further improve services for those diagnosed with Autism Spectrum Disorder (ASD) and their families and we support the need for a National Autism Strategy.
Nurses and midwives are likely to care for individuals with autism in various healthcare settings. However, for our submission we have chosen to highlight the prevalence of mental health conditions for those with autism; access to mental health services and inappropriate admission to mental health wards of those individuals who have autism but not a mental health condition.
Co-occurring mental health conditions are common for those with autism and higher than in the general population. Research shows that between 69 and 79% of those with ASD experience at least one mental health condition across their lifetime (Howes, et al, 2018 & Lai, et al., 2019). When present, these conditions can add impairment and distress to the individual (Rosen, Mazefsky, Vasa & Lerner, 2018). This increased vulnerability to mental health conditions for those with autism points to the need for more tailored support and services.
The QNMU supports equal access to quality and specific mental health services for those with autism. This service should include evidence-based assessment guidelines and targeted interventions that are tailored for those at all levels of the spectrum (Rosen, Mazefsky, Vasa & Lerner, 2018).
Nurse-led models of care are well placed to assist those individuals with autism to access health services including mental health services. One such model is the Nurse Navigator who can identify and monitor the healthcare requirements of those with autism and ensure they have timely access to appropriate services (Queensland Government, 2020).
While we acknowledge the increased likelihood of those with autism experiencing a mental health condition, there are those with ASD who do not. In some instances, how a person with autism behaves can be mistaken for mental health issues or illness. The QNMU understands that people with autism have particular needs which may not always be met in healthcare settings primarily designed for those without autism. This sometimes leads to those individuals being treated in mental health wards regardless of whether they have a mental health condition. We strongly advocate for this to discontinue and for specialist services stepping in as part of the NDIS funding.
We also acknowledge that those individuals with ASD are more likely to report barriers to healthcare compared to those adults who have a disability and non-autistic adults without
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disabilities (Mason, et al., 2019). The QNMU strongly supports the Committee in determining these barriers to access and services as well as any barriers in the interactions between government and health agencies.
References
Howes, O., et al. (2018). Autism spectrum disorder: consensus guidelines on assessment, treatment and research from the British Association for Psychopharmacology. Journal of Psychopharmacology, 32(1), 3-29.
Lai, M.-C., Kassee, C., Besney, R., Bonato, S., Hull, L., Mandy, W., Szatmari, P. Ameis, S. (2019). Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis. Lancet Psychiatry, 6, 819-829.
Mason, D., et al., (2019). A systematic review of what barriers and facilitators prevent and enable physical healthcare services access for autistic adults. Journal of Autism and Developmental Disorders, 49, 3387-3400.
Queensland Government. (2020). Children’s Health Queensland Hospital and Health Service. Nurse navigator – autism spectrum disorder. Retrieved from https://www.childrens.health.qld.gov.au/chq/our-services/community-health services/child-development-program/nurse-navigator/
Rosen, T., Mazefsky, C., Vas, R. & Lerner, M (2018). Co-occurring psychiatric conditions in autism spectrum disorder. International Review of Psychiatry, 30(1), 40-61.
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