MHM Magazine

Issue 5 | 2022 | MENTAL HEALTH MATTERS | 23 MHM Without a diagnosis, you just get another label There are also long-term consequences that come from autistic individuals being misunderstood by society and by people who care for them. Without a diagnosis, autistic children don’t have access to healthcare or education that makes sense for them. At school, they are misinterpreted as being “rude”, “disruptive”, or “stubborn”. As one autistic individual put it, “without a diagnosis, you just get another label. For example, mine was brat.” Due to the stigma that surrounds disability, parents of autistic children may be isolated from their communities when they need support the most. And without a diagnosis, caregivers don’t have the right tools to help them accept or accommodate their child’s strengths and challenges. As a result, undiagnosed children are often unable to access help or intervention, particularly in South Africa’s socio-economic context. Missed diagnoses also lead to autistic people misunderstanding themselves. Without an explanation for their differences, many individuals tend to internalise these as personal failings. Some report an inexplicable, yet pervasive, sense of being “wrong”, “bad”, “evil”, or even “fundamentally unlovable”. This is exacerbated by chronic masking, which leads to low self- esteem, a lack of self-worth and destructive core beliefs. As one individual described it, “masking is learning against your will to hide your entire being and still not being enough. It is throwing yourself away and still being abandoned.” It’s never too late Early diagnosis is critical for caregivers, educators and health-care providers to facilitate support, growth and development. But a diagnosis late in life can also alleviate significant interpersonal, mental and physical strain. It can also mediate self-acceptance, a more helpful construction of identity, and access to resources to help mitigate co-occurring health challenges, including psychopathology and suicidality. Suicidal ideation is often driven by a seemingly objective assessment that it is the only option. An accurate autism diagnosis brings new questions with new answers and alternative routes that weren’t there before. Primary health care providers can play an instrumental role in facilitating the diagnostic process, especially if they are aware of: 1. how autism can present across different genders, age groups, and contexts 2. How to screen accordingly 3. Where to refer out for further assessment. You ca n click here t o access the pre-diagnostic screens depicted in the infographic below. It would be remiss not to acknowledge that autism can be hard to talk about – it’s going to take time for patients as well as healthcare providers to unlearn misconceptions about what autism “looks like”. Ultimately, explanatory models like neurodiversity help us to understand that being “neurotypical” is not the only way to be. And you can’t underestimate what having another option might mean.