Diagnosis

It occurred to me, on the way back from Tesco earlier (always fun), that the notion of mental health diagnosis is completely wrong. Or at least inflexible.

As those who follow this blog may recall, I've been chasing an ASD (autism spectrum disorder) for several years; specifically in regards to Aspergers syndrome.

My diagnosis was based on a mode selected by the diagnostic team with a binary outcome: either I 'pass' or 'fail'. That is to say: either I meet their criteria, or I don't. I didn't and so they dismissed me as being 'ok' and leaving me to the tender mercies of societal expectations and norms. Something that I (and one of the reasons for seeking a diagnosis) find difficult.

This binary approach seems to me incredibly flawed. It does nothing to address the reality of the patients experience - even if we consider whether or not that experience is 'real'. What does it even mean for an experience of mental health to be real? If I feel that I struggle with ASD-like symptoms - regardless of the specific condition - then surely that is enough?

But the diagnostic process doesn't address that. It simply measures patient responses to a series of situations or questions. In my case I maintain those questions were based on tools suited for childhood diagnosis. In fact I was told that, without corroborating evidence from my childhood, I couldn't expect to secure a diagnosis. It didn't help that, when I questioned this, as I have consistently to anyone that'll listen (including YOU!), I was told it wouldn't have mattered either way - so they'd decided against me either way.

They were not prepared to consider maybe a different cognitive model might fit. They didn't take into account issues of anxiety or depression. In fact the presence of such conditions - a credible consequence of being someone trying to live in our society with something like an ASD - inhibits the process. I don't really know why, since I see no connection between the conditions in terms of teasing out a diagnosis. But even if they accept the presence of such conditions, receiving a negative diagnosis still doesn't concern them enough to do...something.

So my question: why can they not grant me a diagnosis even if doing so doesn't fit their model? I need to be able to live in this society. I need the protection (however toothless that might be) that a recognised official diagnosis can provide. Surely it is no different that expecting a disabled driver to present a blue badge in order to use a specific parking bay? Ok maybe that's an egregious example, but the point is made I think.

As I've said before, we do not have a holistic all encompassing approach to mental health that treats it as part of someones entire life. Not just a singular aspect they are to effectively ignore and cope in spite of. This is the model of health espoused by the DWP and in my view, certainly int he context of mental health, it is destructive.

Surely part of supporting people is to accept what they say as true - within reason. That must mean that, even if I don't fit a particular diagnostic model, the weight of circumstantial evidence, surely must entail some sort of recognition. But that recognition is too specific and granted only in highly specific, stingy, circumstances.

I've spoken to many people when explaining these problems, be they doctors, counsellors, or people from the various social enterprises I've engaged with. Even including a DWP Work Psychologist (with psychology credentials, though I STILL have no idea what Work Psychologists are meant to do in the system). All of them have recognised or agreed that something is there; that, within my cognitive makeup, there is something that isn't 'normal'. This is important. But the diagnostic process will not recognise this and, to the point of my writing this, isn't interested in granting in anyway.

This is a problem because it shuts down the possibility of investigation and support or, where necessary, treatment - whatever that may encompass. Obviously there's no cure for being neuro diverse, but without a recognised label dealing with the likes of a WCA become that much harder.

And I bet I'm not alone in thinking this. I hope I was clear today: I think granting the person, within reason, a diagnosis, even in lieu of meeting all formal criteria, is a necessary part of the support and healing process. It is no different than the problem with DWP WCA tests that, if you fail, just abandon you as soon as you do. If you fail that test, you're cut off and left to your own devices with the stroke of a pen.