ACCORDING to research by leading autism charity AsIAm, almost half of all autistic people feel denied mental health services as a consequence of their condition.
Accessing an autism diagnosis in Ireland is an often challenging and potentially traumatic process, according to AsIAm CEO Adam Harris and Limerick woman Molly McNamara, both of whom themselves have an autism diagnosis.
Diagnosed as an adult, Ms McNamara says that finding specialised care for her condition was a daunting task that felt frustratingly out of reach, telling this newspaper that “there was one available autism specialist in Munster, and it was not a pleasant process. It was intrusive.”
AsIAm CEO Adam Harris emphasises that Ms McNamara’s experience is far from unique.
“One of the challenges facing us in Ireland is that there is no public pathway for autism assessment [for adults],” he said. As a result, Adam explains, many adults who were undiagnosed as children are now left without affordable options for diagnosis and support.
“We frequently see autistic adults misdiagnosed with mental health conditions or indeed treated for mental health conditions, but their neurotype is being overlooked,” he says.
In keeping with Mr Harris’ observation, after her own autism diagnosis, Ms McNamara says she experienced severe mental health episodes that were either overlooked or misunderstood by healthcare professionals.
“I went through a really bad mental health episode … but looking for a psychiatrist was very difficult,” she recalled.
‘If I don’t get help, I will kill myself’
She says she found herself dismissed due to her autism, which was “uncomfortable in the sense that, as someone who’s disabled and also depressed (she was) trying so hard to get further help, and then just to be kind of told ‘that’s all we can do’.”
Ms McNamara recalls being admitted to St Ann’s Hospital in Roxboro and “sitting at the table crying and being like, ‘if I don’t get help, I will kill myself’.”
She said the doctor who first treated her didn’t know anything about her condition, and so “he was just Googling” it.
For Molly, the lack of accessible resources and understanding from healthcare professionals meant that her recovery was marked by isolation.
“It was just the same disappointment that I was used to feeling since I was in mental health (services) … getting straight up refused (further help) for something like autism,” she said.
No wrong door
AsIAm CEO Adam Harris reflected that “the reality is we know that autistic people have a significantly shorter life expectancy, and poor access to healthcare and mental health care is one of the key contributing factors”.
While charities like AsIAm aim to fill the gaps in the public system, a lack of comprehensive healthcare can lead to destructive referrals, Mr Harris says.
“What frustrates us is when people are inappropriately referred to our support, or it presents as an alternative to State-based support,” he explained.
AsIAm has called for the creation of public pathways for autism diagnosis, ensuring that mental health professionals are trained to understand and accommodate neurodiversity.
More specifically, the organisation says that protocols like a ‘no wrong door’ policy are needed, which would ensure no person will be told to look elsewhere for help regardless of where they present — at a GP or mental health clinic.
Small changes
Mr Harris emphasised the importance of making accommodations in healthcare settings, highlighting that small adjustments benefit not only autistic people but also a broader range of patients.
“For example, being able to make an appointment by email — that might benefit somebody whose first language isn’t English, or someone who, for example, is hard of hearing or has a hearing impairment or someone who has dementia,” he says. “A lot of these accommodations have a broader accessibility benefit.”
A HSE spokesman told the Limerick Post that a new ‘Sharing the Vision’ policy is to be rolled out early next year, aiming to bringing together a combination of reforms to the mental health service, including provisions for disabled people and people with autism.
One reform is hoped to include a “single point of access” to services for people with mental health issues, including for people with autism. The spokesperson said that such reforms would also include a “no wrong door” policy.
With the help of people with lived experiences of in the Assessment and Pathways working group, the HSE spokesman said that the health body has developed a tiered approach to autism which will improve access to support for both children and adults and “ensure that every assessment is of an acceptable and agreed standard”.
Training for healthcare workers is also being designed in collaboration with autistic people, the spokesman said.
