There is a common belief that Autistics are more vulnerable to mental health issues. Some think that mental health issues are a part of autism itself.
I have a different theory to that.
I think that many different factors go into the fact that so many Autistics experience mental health issues throughout their lives, and I will go through those factors in this article, but first I want to start right at the beginning.
Back when mankind first appeared on our lovely planet; when tribes of early humans littered the plains, those in the tribes that were markedly different to the rest where actually considered to be blessed, gifted, smiled on by the Gods. Over hundreds of years, civilisation grew and developed and, along the way, this idea of ‘normality’ was born. The concept that, if you were on the edges of the normality bell curve, that you were defective, weaker, abnormal, rejected, and ostracised.
This now inbuild repulsion of those that are not either reaching towards normality or those who lived comfortably within it. Those who were different became isolated and segregated away, mentally and often physically, from those classified as ‘normal’.
Fast forward to the present day and, although we have come a long way towards acceptance and inclusion of those that are different, there is still a very long way to go.
From a very young age, Autistics know that they are different. Their peers know that they are different and, sadly incredibly frequently, bully those that aren’t quite like everyone else.
Let’s face reality; children are mean. Schools across the world have those kids who thrive on targeting those that, they believe, are weaker than them, or have a quality that is different to other kids. Children haven’t lived in the world long enough to hone their social skills to the point where they can be softer, more subtle, compassionate.
Autistic and other SEND children are often targets for bullies and this alone can have a major detrimental effect on their mental health.
Still looking at this school age; in this country (the UK) it can take years to actually get an assessment and diagnosis for being Autistic. Not understanding why you are different to other people, often including members of your own family, is incredibly isolating and, especially if you have experienced bullying because of your differences, can have a terrible effect on your self-esteem, self-confidence, and your mental health. It is often likened to feeling like an alien on this planet. Feeling like there is something wrong with you. Understanding who you are is so so important. Finding the Autistic community; where your differences ARE the norm, is equally so.
I, personally, think that we need to move away from ‘diagnosing’ Autistics, and create Neurotype identifier centres, where you will find out if you are Autistic or ND at all.
A huge number of Autistic children either cannot cope with being in school, or find it a huge challenge. More often than it should be, until your child has a diagnosis, they do not receive any form of support in school, or have any adaptations made for them in order for them to be able to cope. Even when your child does have a diagnosis, it is pot luck whether they are in a school that has had any decent Autism training or has any real understanding of what support the individual Autistic child needs. A lot of schools have no knowledge or understanding of sensory needs; without even some of their sensory needs being met, an Autistic child is far more prone to overwhelm, meltdowns, and an inability to cope with school.
Just think for a moment; what effect on mental health do you think being in a state of overwhelm or fight/flight 5 days a week has? Being anxious for most of the conscious week? Feeling like you can’t cope and that you feel useless because everyone else is able to cope with it, but you can’t? That you feel like you don’t have a choice but to be in this damaging environment, that there is no escape?
How about when you are moved away from the rest of the class or when you have to spend lessons in the corridor on your own?
Think on that a moment.
Moving onto another aspect of some schools for Autistics; restraining. I understand that, on very few occasions, a child may need to be restrained in order to protect them from hurting themselves or others. However – a lot of the restraining techniques that are used are barbaric. I hear of children being held down on their face, with adults kneeling on their backs. I hear of children who are dragged on the floor from a classroom and into a cupboard. I hear of children dying because of restraining. Children.
I don’t think I need to spell out what effect THAT would have on a child’s mental health.
Talking of barbaric; another horrific experience that is thrust upon autistics of school age is Applied Behavioural Therapy. I’m not going to rant to you about how awful and abusive ABA is; there are plenty of articles out there on how damaging this is to Autistic children. But I will point out that one of the leading causes of PTSD in Autistics is ABA therapy.
The number of SEND and Autistic children that require specialist provision is rising. Sadly, though, the number of spaces in specialist provision is not. Leaving a child in a school that cannot meet their needs or that they cannot cope in, will only lead to one of three things; either the parents will eventually remove them from school and home school them (in order to protect the child’s mental health), they will end up getting excluded or expelled from school, or children with end up with serious mental health issues.
The time that it takes for us to be given the right support or a placement in a school that can meet our needs can be mentally devastating and cause trauma; often for children whose brains are still developing.
Throughout schools, services, the health sector, and the government, there is simply not enough good Autistic training that is both up to date, and based on what Autistics are actually like and what they need. Most of the current training seems to have been written in the 1980s and is only helping a very small percentage of Autistic individuals.
More and more Autistic run training programmes are being made; THIS is the training that should be given to anyone who is involved, in any professional capacity, with Autistics.
Even the mental health services do not have sufficient training and understanding of Autistics and how to correctly help and treat them. They use the standard, tick box, Neurotypical treatments that just don’t work on Autistic brains, and this often leads to the Autistic child or adult being discharged from the service, or made to feel even more broken than before – like they are a lost cause that cannot be helped; ‘if the professional mental health services can’t make me feel better or help me, then I must be REALLY broken’
A lot of Tier 4 mental health facilities don’t even have any Autistic training. So Autistic children and young adults who have been failed by insufficiently trained services, who tragically end up in a Tier 4 facility, are let down again and are then trapped in an unfamiliar environment, with noises, smells that they cannot cope with or escape, with staff who don’t make any adaptations for their needs and they are not supported in the way they need to be. Do you think that this is going to help or hinder these kids? Is this going to improve their mental health? No.
Did you know that 83% of under 18s in mental health facilities in the UK are Autistic? With no learning disability or other co-morbid conditions. Just straight Autistic children.
I was in a meeting last week regarding Tier 4 inpatient facilities, and I ended up sobbing when I heard of an Autistic 15-year-old who ended up in a Tier 4 facility that had no Autism training, and she was restrained 70 times in 7 months. I’ll say that again; 70 times. One of those times was for 4 hours with adults holding her on the ground where she couldn’t move and was utterly helpless. This Autistic child had an aversion to physical touch. Can you imagine what that poor girl experienced at untrained hands? She ended up with extreme trauma and PTSD from the experience. IN A MENTAL HEALTH FACILITY THAT IS DESIGNED TO HELP MENTAL HEALTH.
The general population, and the vast majority of professionals, believe and stick with the clinical model of Autism. That it is a neurological disorder. That it has a list of detrimental characteristics that mean that the Autistic individual is lacking in several areas. That we are socially inept, don’t experience empathy, have no theory of mind, communication issues. That it fundamentally means that Autistics are defective humans.
But Autistics don’t see it that way. We are neurologically different to the majority of people, but that doesn’t mean that we are ‘lesser than’ in any way.
The world is set up for Neurotypical people. It is loud, fast paced, bright, and intense. But just because we struggle in this Neurotypical world, it does not mean that, in conditions set up for us, we cannot thrive. When we are amongst other Autistics, we communicate just fine. There is no deficit in our communication skills, but there is a divide between how Neurotypical people communicate and Autistics do.
I fear I am going off on a tangent, so I am going to try to pull myself back to my original point; having this belief that we are broken, damaged, clinically disabled, pushed on us from every/most angles (school, professionals, family members, parents) will make us believe that we are broken. Having people show pity that we have a ‘disorder’ or underestimating our capabilities.
That alone plays a big part in damaging our mental health and self-worth.
The majority of parents, upon finding out that their child is Autistic, go in search of information and support on the internet. This can be a wonderful and fulfilling thing, but it can also go the other way and lead them to groups that are, essentially, martyr groups where parents come to complain about how tough it is having an Autistic child, and to dwell on aspects of their child where they struggle or are most different than other people. This attitude is like poison that can leech out into the parent that has, with the best of intentions, reached out for information and support, turn them into a martyr parent that looks at their child with pity or a wish that they were different from who they are.
Kids pick up on these things. Especially Autistic kids – we are very receptive.
The overriding theme here is a desperate lack of adequate training in all areas where Autistics are cared for/supported. The huge lack of understanding of what Autistics are really like is more damaging to our mental health than anything else.
As you can see from my 4-page rant, all of these detrimental effects on Autistic mental health can be easily avoided. Every damn part.
The 83% of inpatients need not be there. But we are burdened with this belief that mental health issues are a given for Autistics. An inevitability that can’t be avoided. But it can.
I’m not saying that if we fix all of these things that no Autistic will ever experience bad mental health. Of course not, and there are other causes of bad mental health such as abusive relationships, or bad life experiences. But for the cost of proper training and a desire to actually understand us, SO many Autistics could be spared. We have a high percentage of self-harm and suicide in our community. We feel very deeply and mental health issues hit us very hard.
But so much could be avoided if the powers that be in organisations, schools, services, etc. just opened their eyes, and their pockets, and took the time to learn and understand us.
If you are a professional reading this, PLEASE at least think about what I have said. What YOU can do to help support Autistics and their mental health. Our children are suffering needlessly.