By Kieron JH, Founder, The Reasonable Adjustment
Introduction
England is still using the Mental Health Act 1983 to detain autistic people. In 2025, that law is older than most of the people it is being used against. It predates the Equality Act, modern autism research, the neurodiversity movement and any meaningful human rights framework for disabled people.
The result is predictable. Autistic people are now the single most overrepresented group in mental health hospitals, and the numbers are rising every year.
The Latest Data Is Impossible to Ignore
The National Autistic Society’s latest figures speak for themselves:
Source: National Autistic Society — Number of autistic people in mental health hospitals
- 2,040 people are currently detained in mental health hospitals in England
- 1,480 are autistic
- That is 73 percent of the entire inpatient population
- For under eighteens, 250 are detained and 240 are autistic, which is 96 percent
- Detentions of autistic people without a learning disability have risen by 144 percent since 2015
- Long stays remain common, stretching to more than four years for many
This is not a marginal trend or an obscure statistic. It is a national system built on outdated law and missing community support.
Why the Numbers Look Like This
The Mental Health Act 1983 treats autism as if it were an illness. That is the root problem.
Because autism generates distress in overwhelming environments and because autistic communication can be misinterpreted as risk, clinicians can justify detention without needing a mental health diagnosis that fits modern standards.
The system then traps people.
- Behaviour caused by an unsuitable environment is treated as proof that inpatient care must continue
- Community alternatives do not exist or are not funded
- Discharge becomes impossible because there is nowhere suitable to go
- Families are excluded from decision making
- Autistic needs are reframed as psychiatric symptoms
A law written before autism was properly understood has become the mechanism that harms autistic people most.
Why Public Outrage Never Happens
If any other group made up 73 percent of a detained population, you might expect political pressure and public debate. That is not how autism is treated in this country.
Most people do not understand autism, do not recognise how broad the spectrum is and only care when the label lines up with their personal experience. Even then, the understanding tends to apply only to their autistic child, sibling or friend.
Autistic adults fall through the attention gap entirely. There is no national outrage because there is no national empathy. Autism is still treated as an oddity, a behavioural inconvenience or a childhood condition that people supposedly grow out of.
That apathy is part of why the Mental Health Act remains untouched.
A 1983 Law in a Modern System
The law predates:
- The Human Rights Act
- The Equality Act
- Reasonable adjustment duties
- Autism diagnostic improvements
- The neurodiversity movement
- Any serious research showing inpatient environments can actively harm autistic people
Despite decades of promised reforms, governments of all colours have failed to replace or modernise the Act. The result is a system running on assumptions from the early eighties applied to autistic people in 2025.
Nothing about this is sustainable.
1983 to 2025, the world changed, the law did not
To understand how out of date the Mental Health Act 1983 is, it helps to picture what 1983 actually was. The Act is being used today in a society it was never designed for.
- The internet did not exist as a public thing. On 1 January 1983, ARPANET switched to TCP/IP, which is widely treated as the birth of the modern internet. In other words, the Mental Health Act was written at the exact moment the digital world was just starting. Today, nearly every part of life, work, healthcare, education, identity, and community now runs through that digital layer. The law was never built for a world where isolation, sensory overload, online support networks, and digital evidence are daily realities. (Source)
- Autism was barely understood, and the diagnostic criteria were narrow. In the 1980s, autism was framed around a much smaller group of people. The DSM criteria started widening in 1987, expanded again in 1994 with diagnoses like Asperger syndrome, and then moved to a single Autism Spectrum Disorder category in 2013. So the legal framework was written before modern spectrum understanding even existed. (Source, Source)
- The disability rights framework we rely on today had not been created. The Equality Act did not arrive until 2010, bringing reasonable adjustment duties into a single enforceable framework. The Mental Capacity Act, fully in force from 2007, created modern rules about autonomy and decision making. The Care Act, in force from 2015, established wellbeing and safeguarding duties in adult social care. None of this existed when the Mental Health Act was drafted. (Source, Source, Source)
- Disabled people gained explicit international human rights protections. The UN Convention on the Rights of Persons with Disabilities was adopted in 2006 and the UK ratified it in 2009. That convention rejects the idea that disability should be handled mainly through confinement or medical control. Yet England still relies on a 1983 detention law that predates that entire rights shift. (Source, Source)
- The data shows the cost of staying in 1983. In June 2025, autistic people made up 73 percent of those detained in mental health hospitals in England, and detentions of autistic people without a learning disability have risen 144 percent since 2015. The world moved on, the law did not, and autistic people are paying the bill. (Source)
The point is not that society is “more modern” in some vague way. It is that autism, disability rights, safeguarding duties, and the entire shape of daily life have changed beyond recognition. A detention law written in that old context is going to keep producing the same failures, because it was built on the wrong assumptions.
The Real Issue: Lack of Community Support
Autistic people are not being detained because they need hospital treatment. They are being detained because nothing else exists.
The data shows a sharp rise in autistic people without learning disabilities entering inpatient settings. That is not because autism has become more severe. It is because councils cannot fund placements, NHS teams cannot build community packages and the Mental Health Act allows hospitals to fill the gaps.
Hospitalisation is being used as a substitute for social care.
What Needs to Change
A credible reform programme would include:
- Removing autism from the definition of a mental disorder used for detention
- Creating a separate legal framework for neurodivergence and sensory crisis
- Mandating community support as the default
- Funding ring fenced autism supported housing and crisis response
- Independent oversight of length of stay
- Legal limits on the use of hospitals for non therapeutic purposes
- National reporting on outcomes, not just bed numbers
The law cannot stay where it is. The numbers prove that the system is getting worse, not better.
Closing Thoughts
Autistic people are being detained under a law written before modern autism research existed. The evidence is clear, the harm is documented and yet the government continues to rely on a framework that treats a neurotype as a psychiatric illness.
This is not an unfortunate oversight. It is a direct failure of political will, clinical culture and legal reform.
While the country looks the other way, autistic people remain in locked environments for years at a time, without therapeutic benefit and without a lawful modern framework that reflects who they are.
The Mental Health Act 1983 has had forty years too many. It is time for the government to replace it with something that understands autism and protects the people it currently harms.
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