Wes Streeting's move against autism - NAS - time to step up

It was featured on the 6 O'clock news just now and it seems not just aimed at people like us but people with anxiety and depression too. Personally I think that people are pushed towards "talking therapies" whereas years ago you'd have "mothers little helper" aka valium, I remember whole estate of zombie mums wandering around hardly able to function because of the amounts of stuff they were being prescribed, the problems not new by any means, we just talk about it more. It used to be a running joke at uni, that you'd go to see the nurse with a cold and come out with anti-depressants! She'd ask if you were feeling miserable and when you said yes out would come the presecription, no acknowlegdement that colds do make you feel miserable.

I think many talking therapies are inappropriate for the conditions people go with, how many people here have had problems with CBT? Or have found that thees no knowlegde of any ND's? The NHS like's the CBT model, because it's fairly short and fits in better with the drug regimes they're used too.

I do think that more people are being diagnosed as ND, often because their children are and so the parent seeks diagnosis for themselves. I think the world has speeded up and we have less personal space that before and as we all know having our space is really important. It shouldn't be the case that the government have to think about legislating to allow people to turn off thier work phone when they're at home, we're not talking about on call doctors or vets here where being on call is part of the job, my DiL manages car parking services and often get scalled at 10pm and asked to sort something out and it's often not a quick fix either. 

I wonder how much increased screen time plays a part too? It's well known that the light from screens stimulates the brain into staying awake, this can't be a good thing? Everything seems so hyper all the time, so many people are a sense of offence looking for somewhere to manifest, I think everybody must be self censoring a lot of the time, either that or being wound up by all the nastiness out there. 

I don't know how this review will effect us, maybe a lot, maybe very little, but if they're serious about helping any sort of mental health problem then they will have to resourse help properly and maybe stop thinking about ND as a mental health problem, but something else, whatever they come up with it needs to be properly thought through and funded with a range of options.

BBC article as below:

The NHS are hiring another 8,500 mental health workers.

I think the keys point is the "value of diagnosis to individuals".

I wonder how they will define this? Fulfilling potential, passing exams, ability to work or continue working, being happier, requiring fewer NHS or schooling resources? It might be hard to define in purely monetary terms.

Those comments are frightening! I feel so powerless.

ArchaeC said:

l am concerned that the government will bow to public pressure that has built up from misinformation in the media. 

I agree.  I've just been reading the comments on the BBC article and there are plenty that support my fear above that diagnosis may be made more stringent again eg:

"Tests need to be more thorough- professionals and society should stop pandering to the TikTok mentality of wanting to be quirky to fit in. Remember, social media is not a valid source!"

www.bbc.co.uk/.../ce8q26q2r75o

Thanks B. The review in itself sounds like it could be positive, but l am concerned that the government will bow to public pressure that has built up from misinformation in the media. 

A non-autistic friend recently asked me (again!) why there are more autistic people now than there were years ago. Perhaps some people who aren’t neurodivergent have little interest in delving into the details.

The Sky news article is also interesting. 

I give the impression this is directed at the young?

"The Department of Health said 13 times more people were waiting for an autism assessment in September 2025 compared with April 2019."

The review will be led by leading clinical psychologist Professor Peter Fonagy, the national clinical adviser on children and young people's mental health, who will work with academics, doctors, epidemiological experts, charities and parents.

He will look at what is driving the rising demand for services, and inequalities in accessing support.

Prof Fonagy said: "This review will only be worthwhile if it is built on solid ground. We will examine the evidence with care to understand, in a grounded way, what is driving rising demand.

"My aim is to test assumptions rigorously, and listen closely to those most affected, so that our recommendations are both honest and genuinely useful."

The findings will be published next summer.

news.sky.com/.../soaring-demand-for-mental-health-adhd-and-autism-services-to-be-reviewed-after-overdiagnosis-claim-13479259

Mr T said:

that more people are being diagnosed due to increasing awareness

Definitely.

Mr T said:

surely the diagnostic criteria are based on the DSM international standards.

Yes, and they have changed a lot over the decades and I was referring to the most recent updates.

There is a good article here for anyone interested:

https://www.thetransmitter.org/spectrum/evolution-autism-diagnosis-explained/

surely the diagnostic criteria are based on the DSM international standards.

We can just say that more people are being diagnosed due to increasing awareness. There are more and more females being diagnosed who would probably be missed due to the higher propensity to effectively mask.

I have fears over the direction of travel for this review and what the ultimate aims are.

Thanks for the link ArchaeC 

Here is a copy of the purpose of the review:

"Purpose  

The purpose of the review is to provide advice and recommendations to the government on:  

• evidence on trends in mental health conditions, ADHD and autism in the population over the last decade, including:
  • factors that have contributed to drivers in prevalence for children, young people and adults
  • how these changes have affected demand for NHS mental health, ADHD and autism services (including assessment)
• evidence on inequalities in accessing support for children, young people and adults across the spectrum of need
• evidence on the role of diagnosis for children, young people and adults, including:
  • changes in diagnostic pathways, criteria and process over the past 10 years
  • the value of diagnosis to individuals
  • barriers to receiving a diagnosis and its impact on receiving support
  • the role of the independent sector in diagnosing individuals with mental health conditions, ADHD and autism
• evidence on the role of medicalisation in mental health conditions, ADHD and autism, including the appropriateness, potential harms and the difference between non-clinical need and disorder
• evidence on the role of medication in treating mental health conditions and ADHD, including the long-term outcomes of pharmacological treatment for young people and adults
• the role of preventative care and early intervention across the life course, including support for those waiting for services and ways to reduce demand and waiting times, working with relevant government departments to explore cross-sector opportunities to support this approach and create the conditions for good mental wellbeing

This work will include international comparisons covering prevalence, diagnostic systems and cultural factors influencing diagnosis."

There is a lot to unpack in the above and the mixing together of conditions doesn't help.

My feeling is that a review could be a good thing, but of course it depends on the outcome, + action taken upon conclusions reached, which might be beneficial in some areas, but detrimental in others.

Something has clearly gone very wrong since the criteria for an ASD assessment were changed and my personal fear is that diagnosis will be made more stringent again, which could mean that myself and others like me would once again be working in darkness where a diagnosis gave light. (see below)

evidence on the role of diagnosis for children, young people and adults, including:

• changes in diagnostic pathways, criteria and process over the past 10 years

Mr T said:

could this be an ADHD assessment?

True.  I was thinking ASD but Stuart333 could be referring to ADHD.

could this be an ADHD assessment?

Thank you for this thread Mrs S.

Having just spent several hours (including 3 hours on the road) at a hospital, I'm a bit weary.

I can see it's become quite fractured already, as these things will do, and I don't have the spoons to read it all.

Stuart333 said:

I do not believe, neither did my consultant, that some of the online diagnosis places that charge little and do it in one phone call can be doing a thorough or reliable job. You would have to be naive to think no-one is gaming the system. This helps nobody. I have sone other suspicions, but I can't substantiate them so will not say anything.

I'm not arguing with this but a bit taken aback at the 'one phone call' thing.

I had an online (ASD) assessment with a private company via the NHS.

For starters I had a lot of forms to fill in in advance which formed a part of the assessment, so it's not just (or even) a phone call.

In particular though, I was told that the assessment had to be in 2 parts so I had 2 Zoom calls, not 1.

So, it wasn't just a phone call.

This begs 2 questions for me.

Is it correct when you say that a phone call can be all there is?

Also, do you mean Zoom call which isn't a phone call as you see one another, and they were around an hour each.

I am aware though, that from what I've read of the (ASD) assessments of others, that they can be more thorough than mine, especially when in person.

I believe the application form format and criteria are flawed, and the assessment process is flawed, so some in genuine need miss out. 

Robert124 said:

And the number of homeless people begging on my city streets is shocking.  If they were getting full benefits they would be housed.  Instead I see people with missing limbs and wheelchairs sleeping rough in shop doorways.

I can’t speak for the homeless people you see, but I know that in my area there aren’t enough affordable homes for everyone. Many people have mental health conditions and some have escaped complicated domestic situations and can’t return home. Others have addictions and many just need a helping hand to get them into suitable accommodation. Quite a few have been in in the care of social services since early childhood and their support ended in early adulthood, leaving them vulnerable to abuse and ill equipped to navigate complicated social support systems.

It was recognised more than 7-10 years ago as needing reform.

The Tories said they would do something, increased NI to provide more money then the NHS grabbed it all. So it never went to social care. Then the cut NI before the election.

The cab just gets kicked down the road so people bed block because there is nowhere to put them.

In 1970 there were 423,000 beds. By 1980 356,000, by 1990 270,000, by 2000 240,000, by 2010 144,000, by 2025 147,000 following a blip in COVID times.

So 1/3 the beds and the population has grown 27% on that time. 

According to a hospital manager on ITV News at Ten last night, lack of appropriate social care is causing the most problems for hospitals. Patients waiting on trolleys in EDs, lack of bed availability on wards, theatres not operating on full capacity etc.  

Why is social care not adequate? Lack of money?

I don't know where it goes .

This year the disability benefits bill is £75.3bn which includes PIP, out of total welfare budget of 316bn (forecast to go over 400bn in 4 years).

Pip is probably about 23bn of the 75bn, but no separate number is available. Up from 15bn in 2020.

Thank you

As you have said it is cherry picked. The inclusion of non-means tested PIP is a significant leap in the dark. Working people claim PIP as well.

It is not a lifestyle benefit but is there to enable disabled people to live and afford the higher costs of being disabled.

I agree about the motability scheme being used as a cash cow for the providers and needs reform. For many it is a lifeline.