England, Wales and Scotland section of International Socialist Alternative

Neurodivergence: The crisis in diagnosis and support in the NHS

By Alison Gaughan, Socialist Alternative West Yorkshire

People referred for an autism diagnosis face an average wait of ten months to be seen by a specialist, with this wait going up to five years in some regions. For ADHD, waiting times for adults can be up to ten years. This is another example of our crumbling NHS’s inability to support those who need it most, and of the continuing ideological attacks by successive governments on the sick and disabled.

As neurodivergence becomes better understood, practitioners are coming to understand that many people who do not fit conventional stereotypes of autism or ADHD also fit into these categories. Historically, a number of oppressed groups including women and people of colour have been locked out of diagnoses due to biased diagnostic criteria. The rise in the number of people diagnosed as neurodivergent is therefore positive, however the lack of support available is not.

Neurodivergent exclusion

Neurodivergent people need a diagnosis to get support to access education and employment as well as health services and benefits. 78% of autistic adults are excluded from the workplace, so support and access to reasonable adjustments are essential to improve this situation. Even for people who need relatively little support, a diagnosis can be affirming of their differences (although it should be noted that within the international neurodivergent community, self-diagnosis is usually seen valid, given the difficulty of obtaining a diagnosis for those without the financial means to do so).

Undiagnosed neurodivergent people are under constant pressure to ‘mask’ (act as though they are neurotypical) which comes at significant expense to their mental health. The longer someone waits for a diagnosis and specialist support, the more likely they are to have mental health issues that push them into another cycle of waiting lists and referrals in another overstretched NHS department.

‘Fiscally responsible’ – failure to provide what is needed

Over thirty years of neoliberal economics followed by over a decade of austerity have hollowed out the NHS and insidious privatisation makes the situation even worse. Neither the Tories nor Starmer’s Labour are planning to reverse this process.

Both parties are eager to be seen as “fiscally responsible” rather than provide what the most vulnerable in our society need to thrive. It is clear that the only solution is a fully nationalised and funded NHS under democratic workers’ control as part of a democratic, socialist society.

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