Strictly Clinical

An awful neurodiversity take the government is merrily dancing into

So apparently the fact that there are loads of people being diagnosed with ADHD and Autism in the UK and thousands of people on waiting lists (13 times more for autism in 2025 compared to 2019) and loads more kids with Special Educational Needs in schools -should be “resolved” by questioning diagnoses, having even fewer of them and working out how to spend vastly inadequate resources on pointless interventions (that last bit is my extrapolation, not official government policy). Also by lumping neurodiversity and mental health stuff together. (Also not the words of official government policy). Information about the review announced by Health Secretary Wes Streeting Here

I don’t comment publicly much on media stories about autism and ADHD. Coming from a neuro-affirming, neuroqueer perspective means I would basically be in a constant frustration of “I do not agree with any of the terms of their discourse” and accidentally ending up seeming to condone the way things are currently framed. But I’m going to jump in on this one. Even though it meant I had to read about the proposed independent review as described by politicians and press. Which was like digging through a sad trifle with fake cream and not even sponge at the bottom and also randomly finding bits of shoe and barbed wire and spaghetti in there. (ie: something well intentioned but fundamentally wrong in often quite surreal ways).

I’m just going to focus on one statement by Wes Streeting the Health Secretary (whose Christmas with frustrated ADHD relatives I’m happy to imagine, since he mentions knowing how hard it is for some of them not to have access to their medication. I bet familial Health Secretary-baiting could provide a lot of compensatory dopamine). He said:

We must look at this through a strictly clinical lens to get an evidence-based understanding of what we know, what we don’t know, and what these patterns tell us about our mental health system, autism and ADHD services.

That’s the only way we can ensure everyone gets timely access to accurate diagnosis and effective support.

I am now looking forward to a new Saturday night show “Strictly Clinical” in which only people with PROPER DIAGNOSES are allowed to dance with professionals (who will be extensively screened to ensure that they do not exacerbate mental health conditions caused by capitalism, dancing when they are not very good at dancing and being shouted at by people who have been learning American Smooth since they were in the womb. Accommodations such as fragrance-free fake tan, a sensory room filled with even twinklier lights and Rose Ayling-Ellis’ silent bit playing on a loop will be available at the producers’ discretion.

Wes Streeting’s statement is fine apart from all of it is factually incorrect. But going into ALL of how and why would involve a challenging of categories of knowledge and being that I was up for doing in a funded PhD, but not a Substack post, so let me just say that there is another way to ensure that everyone gets access to effective support (it’s quite a biggie and not in the Labour Party manifesto though, or that of any political party):

ACTUALLY recognise that neurodiversity (different brains/minds/ways of processing the world) is a GOOD AND INEVITABLE THING, not something to be pathologised (though of all services who should know about how a particular person’s neurotype impacts them, then medical services, along with social, care and education services are at the top of the list). ALSO recognise that vast swathes of the current set-up of society do NOT recognise or accommodate this which is why there is a huge amount of unnecessary suffering. This set-up and this suffering DOES actually benefit many profiteering organisations and companies and is also really out of date and based on old ways of thinking and doing things, which also reinforce sexist, racist, ableist and colonialist paradigms. You’d sort of have to question THE ENTIRE BASIS OF NEO LIBERAL CAPITALIST PRODUCTIVITY MINDSETS to deal with this though. And if you’re not a political party that’s up for doing this then- AWKS.

There is pragmatic resistance to this being practiced (not as much as I’d like, but more than there was six years ago because humans without support be humanning and supporting as they always have and will). What might it look like if we stopped pretending this was a MEDICAL crisis and recognised it is a social and structural one? Let us at least ask that question- which would lead people to think and act differently.

I imagine if the school where I ran poetry sessions this week did that. It’s an ordinary academy school in an area of North East England which is fairly deprived by social metrics. Visiting with my now-established neuro-affirming lens was surreal. I felt very Marty McFly in Back to the Future. Or maybe like someone who hadn’t been at school in the nineties suddenly being transported there. A “woah, why’s there’s a poster of Jimmy Savile and a size 12 woman singing “Zig a zig ah” & being called fat?” type thing.

I now spend so much time in neuro-affirming environments that any “normality filter” that might have come from being used to being in ones that are not, was well and truly gone. I was stood in the (well equipped, colourful and bustling) library when a loud, buzzing, screaming alarm sounded for several seconds temporarily paralysing my brain. “Is that, is that your bell?” I asked the teacher I’d been talking to, astonished. “Yes, it’s loud isn’t it?”. “Erm, yes, must be painful going off several times a day for some of your neurodivergent students?”. “Yes, but we can’t turn the volume down for eight more years because we’re a Private Finance Initiative building”

Erm, okay right. I had to undrop my jaw and hope they have enough copies of Alice in Wonderland and Kafka’s The Trial in there.

Some kids do however get permission to leave lessons early so they don’t have to face the corridor chaos of jostling bodies which is good. Though in a way it’s more confusing-why are certain sensory accommodations understood and others not?

It was hard in certain ways to be in the strip lit classroom of SEND kids. Some of whom reminded me of the polar bears pacing in a small cage with a tiny dirty pool at my last zoo visit decades ago. Why are they being made to move from uncomfortable classroom to uncomfortable classroom all day? Some of them would be so much happier in nature or doing something with their hands. Well, obviously that’s the case for loads of the caged kids throughout the school. No wonder forest schools are full of neurodivergent pupils. I thought society was beginning to re-understand the value of vocational education too- and project-based learning?

They were a lovely lot in that class though -clearly supportive of each other and feeling well supported by their teacher. They’d formed their own neurome. Though again, I had to make an effort to hang on to my filter: “Gosh, yes, it’s good that you get on so well with this class & get them, what with your kids having an ADHD and Autism diagnosis. I’m sure it must never have occurred to you that due to the genetic basis of these neurotypes YOU YOURSELF ARE CLEARLY NEURODIVERGENT. I HOPE THERE’S A STAFF QUIET ROOM OR SENSORY ROOM BUT I EXPECT NOT. OH LOOK IS THAT AN ADHD P.E TEACHER JOGGING PAST?”

It was slightly heartbreaking to be asked three separate times “What’s it like being a poet with autism?” by students who, it felt like were asking from a position of this having seemed an unlikelihood. Also, me knowing the “with autism” means they’ll be talking to, or reading stuff by, people who are mainly steeped in deficit narratives. (This isn’t judging them and I wouldn’t have “corrected” them. It just told me their main sources of knowledge weren’t from autistic/neuro-affirming perspectives because otherwise they’d automatically say “autistic”).

Oh-and there’s an ADHD girl struggling to damp her emotions down enough to join in -and another, maybe AuDHD, who said by far the most interesting thing when I asked them to contribute a line to a group poem. And they, and all the other ones I, and probably medical professionals, didn’t spot, will not have their experiences taken into account in this “strictly clinical” review, and probably will be more vulnerable to various mental health challenges, which ironically will impede their ability to contribute as much as they could to the capitalist economy that alleges it’s so eager to harness innovative, questioning, focused minds.

Do they, do any of the kids and teachers in this school really need a “strictly clinical”review? Or do they need the education system and its buildings and processes to be fundamentally redesigned to accommodate universally human friendly ecosystems which allow people to access their particular talents and joys and which minimise sensory and emotional overload? Or shall we just stumble on and continue to scapegoat those individuals whose visible distress means they’re canaries in the coal mine showing the multiple ways that contemporary society is not designed with basic human flourishing in mind?