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Indian GPs and ASD

Arran

In my neck of the woods it's a case of find a GP who isn't Indian. The numbers must be so few that one could count them on their fingers.

It's a well known fact that young south Asians in Britain are attracted to studying medicine (the human body), and it's commonplace for their parents to push them to into becoming doctors, but it's rare for a south Asian to choose to study psychology (the human mind). Just visit a university and you will find about 2 out 3 students studying medicine are south Asian but the students studying psychology are almost exclusively white and British.

The south Asian community also happens to be behind the curve (for a multitude of reasons including those that are cultural or religious) when it comes to ASD than the white British middle class are. A significant proportion of south Asian medicine students attended private schools which often do not recognise ASD or want any children there with ASD.

Has anybody given any thought to the effects of this on getting a diagnosis of ASD via a GP? In general, GPs (of all races and backgrounds) are behind the curve when it comes to ASD but when cultural factors are brought into the picture it adds a new dimension. Trying to encourage more young Asians to study psychology will be like trying to encourage them to study classics - which is a subject they show virtually no interest in studying.

  • My psychologist comes from India. My psychiatrist comes from Nigeria (IIRC). Both seemed perfectly fine with the concept of ASD.

    Only issues I have with them is difficulty understanding their accents.

  • NAS9920 said:
    taking in consideration then the asd issue. any form of deformity would of course inhibit or prohibit the ability to raise oneself or ones family from caste. the social stigmas would apply then; also in caste systems. this is when karma needs to be considered: karma being the idea that what one suffers in this life is due to past life events. any 'abnormality' would be considered one's 'karma'. autism would be considered 'karma' from this perspective.

    The knowledge base for psychology, mental health, and ASD was developed over the years primarily in Europe and North America by people of European bloodlines who were Christian, Jewish, or not religious on subjects of the same description. The Indian subcontinent has played very little role in  psychology, mental health, and ASD (since 1945) and the thoughts and perceptions of its people are clouded by culture and religion. This also helps to explain why at secondary school children of south Asian origin tend to do better (even without the parent push) in culturally neutral subjects like mathematics, science, and computing than in subjects like English literature, history, and sociology where GCSE courses are designed in a way that they are more easily understood by people with a culturally British mindset.

  • Former Member
    Former Member

    - Unsubstantiated generalisation surely? -
    Quote "Many white middle class (particularly male) doctors are
    emotionally hopeless and are little use to someone with an MH problem". 
    Have you evidence for this?  Are any doctors working class? or outside
    Harley street upper class?

    Touché!

    But "many" does not mean "most", I was certainly not suggesting that you should avoid white middle class doctors because a few of them might not be well suited to the task in hand. The category, that I was talking about, is exactly the type epitomised by Doc Martin.

    I understood Arran's references to class to be in relation to the individual's socio economic background prior to medical school.

    Is the fact you were diagnosed by an Indian consultant proof that Indians are the best people to diagnose autism? Other than personal experience can you provide evidence?

    Oh, for goodness' sake and the avoidance of doubt. I was giving a sample (n=1) of a case where one indian doctor had diagnosed someone from a different race, creed, colour etc as a counter to the idea that such a thing might not be likely. There are excellent and terrible doctors of all colours, ages, gender, religion, class and cultural heritages. My point is not to say that one type of doctor is better than another but to highlight the dangers of generalisation without glossing over the potential issues that can still exist.

  • Former Member
    Former Member

    There are a number of issues rolled up in your post Arran.

    People with autism are often prone to dichotomous thinking. i.e. over categorisation, black and white thinking (a bit of a double entendre there!) and a tendency to stereotype beyond what is prudent. If you find yourself generalising and saying that all Xs do Y then you might have fallen into a trap.

    It is always a bit of a red flag to me when anyone says "It is well known that..." If something is true then there are probably some references that you could quote perhaps?

    Inter-racial communication absolutely (particularly in emotional senses) is an issue. Hence there are many articles such as www.theguardian.com/.../bme-mental-health-patients-marginalised. White doctors often struggle to understand what is going on in a black person's mind.

    Facial recognition can be an issue for white journalists trying to identify black athletes www.dailymail.co.uk/.../What-gigantic-gymnastics-gaffe-Philadelphia-newspaper-SLAMMED-confusing-Final-Five-members-Simone-Biles-Gabby-Douglas-embarrassing-cover-story-mix-up.html If you can't even tell who you are looking at then you might struggle to get any further into their minds and feelings.

    If you are trying to make yourself understood by another person then you have to overcome

    a) your own ability to express yourself emotionally. This is the Catch-22 of autism. How do you persuade another person that you have a problem with communication if you struggle with communication.

    b) the other persons ability to understand your emotions. If you suffer from a blank expression (common with autistic people) then that is another hurdle.

    c) the other person needs to be emotionally sensitive to your emotions. Lets take a fictional example of a white middle class doctor, Doc Martin, who's character is based on a doctor who has autism. Can you imagine that he might struggle to spot the emotional turmoil in another person?

    Mental health diagnosis and treatment is a cinderalla service for all people in this country. I don't think that it is particularly useful to call out one group of doctors for special attention. Many white middle class (particularly male) doctors are emotionally hopeless and are of little use to someone with a MH problem. If you struggle to make yourself understood by one doctor then by all means switch doctors but I'm not sure that tarring the Indian doctors with this brush does anyone any good at all.

    By the way, I was diagnosed by an Indian consultant who was entirely capable of identifying autism in his white middle class patient.

  • The only psy-not-quite-sure-what-exactly-he-was I felt did understand me was Indian or Pakistani, I've also briefly seen another consultant of a similar origin briefly, too short to tell if she understood me but they certainly do exist. Not saying your observation about students' preferences is wrong but I would expect this to change with time. Apparently mental health problems were something many Asians wouldn't really talk about (said a mental health advisor at uni - she saw many students who described their problems in a very physical way, as tummy ache or something) but this is certainly changing.

    On the other hand, the GP who told me an AS test is not available for adults through the NHS (and who actually sits on the board that decides in each individual case whether they fund it) could not have been more British...