Decision Report 201303289

Summary

Mrs C complained on behalf of her son (Mr A) that the board failed to provide him with an earlier diagnosis of Asperger's syndrome. She said that for many years he had been under the care of mental health services in both England and Scotland. In 2010 he saw a consultant psychiatrist in New Craigs Hospital, and continued to see him until early 2011. During this time, Mr A was not considered to show signs of mental illness, although he spent time in hospital for assessment. He was encouraged to become more active and independent, establish proper sleep hygiene and reduce his medication.

Mr A requested a second opinion and was moved to the care of another consultant psychiatrist. No formal diagnosis was made and, again, Mr A was encouraged to develop independent structures in his life. While he appeared content with this, Mr A also mentioned the possibility of Asperger's. He was referred to a consultant neuropsychologist for review and was diagnosed with Asperger's later that year.

Mrs C complained that it took too long to provide this diagnosis and that meanwhile her son had been treated incorrectly, which was very traumatic for him. She also complained that his medication was withdrawn too quickly and without proper support.

We took independent advice from one of our medical advisers, who is a mental health specialist. Our investigation found that this kind of diagnosis was very difficult to make, particularly where the condition was mild and where the spectrum for the diagnosis overlapped with the general population. We noted that there was no specific treatment for such a diagnosis. We found that Mr A was treated reasonably and appropriately during his treatment, and that referrals were made in a timely way. Although an earlier diagnosis was not made, this did not have an adverse effect on his management and treatment. There was no evidence that Mr A's medication was unreasonably withdrawn or that he was not given appropriate support, and we did not uphold Mrs C's complaint, although we made a related recommendation.

Recommendations

We recommended that the board:

• give consideration to setting up a specific team to ensure multi-disciplinary assessment as per the recommendation of the national Strategy for Autism in Scotland.