Emily Katy didn’t know she was autistic when she spent three months in an inpatient mental health unit at the age of 16.

But she believes undiagnosed and unsupported autism played a big part in the crisis that led her there, as well as the distress she experienced while she was on the unit which led to a section to keep her in.

Emily, 21, had started having panic attacks in her early teens and says: “I think a lot of my distress came from not understanding myself and feeling different and confused. I’d also put a lot of pressure on myself for my GCSEs, revising eight hours a day.

So when I was first admitted, I don’t think I was clinically depressed, I think it was autistic burnout.

“And then my distress was exacerbated on the unit because it was so chaotic and I felt very misunderstood while I was there.”

She first went into the Child and Adolescent Mental Health Services unit informally. But after three weeks, staff suddenly took her personal notebook off her because they said its ring binder was dangerous – and Emily had a meltdown.

“It led to me demanding to leave and being put on section 2 for 28 days,” she says. “I feel that it was because I was autistic – because that’s how I was managing the situation. It was my special notebook that I had been writing in all the time since I got there.”

The unit was stressful for Emily in many other ways, too. The food was different, alarms would go off regularly, a leaky shower meant her bedroom carpet smelled of damp, there was nowhere quiet she could go during the day, and plans and routine regularly went out the window.

However, she agreed to stay after the section 2 ended, and when she left after three months with a diagnosis of mixed personality disorder, she had mixed feelings.

I was very angry and upset at my experience because I felt I shouldn’t have been sectioned and they didn’t understand me. But it had kept me safe and it felt like the first time my distress had been recognised.

Looking back through the piles of medical notes from her time in the unit, she is “baffled” that healthcare professionals did not pick up on the fact she was autistic.

“It was very obvious, but they didn’t have the training and the understanding. It’s almost like they thought I was being manipulative and demanding.

“My notes refer to ‘hysterical attacks’ when I didn’t get my own way, but I was literally having meltdowns because they would change stuff all the time and that made me really upset.”

When she was finally diagnosed as autistic six months after leaving, it was a huge turning point. “I suddenly felt a bit lighter. I understood myself and why certain things had happened. I felt like I finally had an answer.” She was also diagnosed with ADHD earlier this year.

She found the autistic community on Twitter and became one of its leading voices, amassing almost 70,000 followers by speaking out on mental health and autism as @ItsEmilyKaty. She also set up her blog Authentically Emily and became a trustee of the Autistic Girls Network.

While all this was happening, she also got her A Levels, went to university and trained as a mental health nurse, qualifying just under a year ago. She now works on a community team supporting neurodivergent young people.

“I always thought I would work on a CAMHS unit because I was so angry that I wanted to make it better,” she says. “And then I realised it wasn’t that easy – it brought back a lot of memories during my placement.

I feel a drive, because it’s unfair how many autistic people end up in crisis and in mental health units. They’re not getting the help and support they deserve.

What Emily wants to see is a much better understanding of autism within mental health services, including alexithymia, autistic burnout and sensory needs.

And she says there also needs to be adaptions to the treatment offered to autistic people. “For example, I found CBT useless, I just didn’t understand what they were talking about,” she says. She points to the Peace Pathway for autistic people with eating disorders as an example of tailored therapy.

“It’s not always that difficult” she added. “I think it just sometimes involves a therapist not sticking to the script but looking at the person and how they think.”

You can follow Emily at

• Twitter - @ItsEmilyKaty
• Instagram and Threads - @itsemilykaty
• Blog - https://www.authenticallyemily.uk/

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