Services for adults with autism and other complex needs are inadequate, leaving some stuck on hospital wards because there is nowhere else to go, according to the Mental Welfare Commission.

A report from the watchdog also found people with autism, and a learning disability and subject to mental health laws are are highly likely to be on antipsychotic drugs. However it is not clear whether the medication is beneficial or whether it is helping them or primarily being used to manage difficult behaviour, the MWC said.

Commission visitors met 54 people living in hospital or in the community across Scotland, and spoke to their medical and care staff, along with family members and carers.

It says the needs of autistic people can be overlooked in settings designed for people with other conditions.

those who also have a learning disability or mental illness as well as autism can find themselves being treated in general learning disability or mental health wards or care services which are not designed for people with autism.

Investigators found that nearly all (83 per cent) of those they met were on psychotropic medication.

Of 28 people living in hospital, 13 were fit to leave but could not due to a lack of suitable accommodation. Some thought had been given to how to make changes to the ward environment to suit patients particular needs, but this was simply not possible in some hospitals.

Meanwhile they found a wide variation in the quality of assessment and support across the country, with other conditions such as a learning difficulty making it more difficult for people to be properly assessed for autism.

Families said their experience of diagnosis and care had frequently been significant, distressing and had ongoing negative effects. Most of these family carers had not been offered support for themselves.

Nick Ward, Director of National Autistic Society Scotland said the system is often failing to meet the needs of autistic people with complex needs.

"The report echoes what families tell us, that they often feel let down by the lack of post-diagnostic support and are disappointed that the future of services such as One Stop Shops is unclear," he said.

He said too many autistic people were stuck in hospital as 'delayed-discharge' patients, "they are trapped in hospital because of inadequate specialist housing, care and professional support available at a local level."

Mr Ward described the numbers being prescribed "poweful" psychotropic medication, as worrying. "[This is] something which should only ever be used as a last resort for those with challenging behaviour and we welcome therefore the recommendation that a programme be put in place urgently to reduce these drugs and focus on more appropriate support.

There must now be a coordinated effort from Government, NHS Boards and Integration Authorities to improve post diagnostic services for autistic people so that they can be better supported to live in the community alongside their families.”

Dr Eleanor Brewster, chair of the Faculty of Intellectual Disability Psychiatry at the Royal College of Psychiatrists in Scotland, said: “People with autism need access to appropriate services before and after diagnosis.

“Unfortunately, Scotland continues to see significant difficulties around recruiting and retaining sufficient numbers of medical, nursing and other staff who specialise in learning disabilities, meaning some areas are better provided for than others.

“There is a lack of high-quality community accommodation and daytime opportunities for people with autistic-spectrum disorders and complex needs. Better community provision would help people to be discharged from hospital as soon as they are ready, so that they can live closer to their families and communities.

“Good community support should also mean that medication is only used for the small number of people with complex needs who still experience difficulties after psychological and social approaches are in place.”

Colin McKay, chief executive of Mental Welfare Commission, said the report had found a wide variation in the standards of help people with autism could expect.

“Getting it right takes time and can be expensive. But we found that getting it wrong, and failing to design services around the individual, could be even more expensive. Equally important, getting it wrong fails the individual and leaves professionals unable to give the high quality care and support we know they want to give."

He said it was not possible to be sure how many of the 45 patients on antipsychotic medicine were being given it for appropriate reasons, but the widespread use of the drugs to manage behaviour appeared to be excessive.

“While we cannot say that in individual cases it was unjustified, we are nevertheless very concerned by the scale of its use, and we are asking the Scottish Patient Safety Programme to work with the NHS to reduce this.

“We are also disappointed that we have again found very long delays in discharging autistic people from hospital to community settings. This has been reported several times – we now need a clear plan to solve the problem," he said.