The University of Kent, the University of East Anglia, University College London, Hertfordshire Partnership NHS Foundation Trust, Leicester Partnership NHS Trust and Partnerships in Care have been awarded funding from the National Institute of Health Research to conduct a three-year project called The mATCH Study.
The idea for the study came out of the Clinical Research Group on Forensic Intellectual and Developmental Disorders (CRG FIDD), originally set up with funding from the Mental Health Research Network (MHRN), National Institute of Health Research.
Within the mATCH Study, we want to understand what is happening for people with autism who are detained in hospitals so we can hopefully improve care pathways. The project has three key aims:
- To further develop a proposed sub-typology for people with autistic spectrum disorders (ASD) detained within hospital.
- To test the validity of these subtypes, by examining the relationship between these subtypes, clinical data, and neurocognitive variables.
- To examine the relationship between these subtypes and patient outcome in order to understand the most appropriate care pathway for each subtype.
The project started in October 2015 and will run for three years to October 2018.
Why are we doing this?
Some people with autistic spectrum disorders (ASD) are detained in hospitals under the Mental Health Act (2007) because of mental health problems, behavioural problems and risk. While all these patients have a diagnosis of ASD, their clinical presentations, risk behaviours, treatment needs and responses to treatment are very different. An inability to capture these differences adequately means that some patients stay in restrictive hospital settings for longer than needed. To minimise this risk and improve care, we need to tailor the care pathway to the needs of each individual patient. The current study aims to do this in two ways (1) systematically investigate a subtypology of people with ASD within psychiatric hospitals to examine whether this may help allocate people to receive the appropriate care, and (2) collect information over 1 year which can be used to improve their care pathway. This study will help to design better inpatient services and directly benefit patients by minimising the risk of them being in restrictive hospital settings for longer than necessary. We have asked people with ASD, and carers and family members to take part in this and share in the oversight of our research.
How are we doing it?
We are using focus groups and consensus methods with clinicians to further develop a proposed sub-typology for people with autistic spectrum disorders (ASD) who are detained within hospitals.
We will test the validity of these sub-types by asking clinicians from 15 different hospitals will rate all inpatients with ASD under their care using the sub-types. Then we will collect behavioural and risk data for all of these patients to describe their current care-pathway. We will use the behavioural and risk data to examine differences between patients of different subtypes. We will also make use of finite mixture modelling to explore the group structure within our data and revise our subtypes as appropriate.
For the next phase of the study, we will invite 100 of these patients to take part in neurocognitive assessments and examine the differences between patients in order to further examine the validity of the subtypes.
We also want to examine the relationship between these subtypes and patient outcome in order to understand the most appropriate care pathway for each subtype. To do this we will follow up these patients for one year, collecting data, and examine the relationship between the follow-up data and out revised subtypes in order to examine the relationship between different subtypes and care-pathways.