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Oct 12 2023
It’s OCD Awareness Week and CAMHS are still failing Autistic young people

Obsessive Compulsive Disorder (OCD) is one of the most misunderstood mental health diagnoses that exists. Misrepresentation in the media and everyday vernacular means that OCD has come to be understood as something that requires a meticulous attention to detail and love of order. The truth is far more upsetting for those who are diagnosed with this condition, and Autistic children and young people represent a significant portion of this population. despite this Child and Adolescent Mental Health Services (CAMHS) are failing to support Autistic children and young people with what can be a very debilitating experience.

How common is OCD amongst Autistic people?

“Autism is not a mental health problem, but as many as 7 out of 10 people with autism also have a mental health problem such as anxiety, depression or obsessive compulsive disorder (OCD).”

Hampshire CAMHS

Accordine to Meier et al (2015) people diagnosed Autistic were twice as likely to be additionally diagnosed with OCD, and those diagnosed OCD were four times as likely to later be diagnosed Autistic. Martin et al (2020) found that, of young people ages 4-17 years, 25% of those diagnosed OCD were also Autistic, with a total of 5% of Autistic young people being diagnosed with OCD. In contrast to this is the general population, of whom around 1.5% are Autistic (Baron-Cohen et al, 2018) and 3.5% are OCD (Fineberg et al, 2013). It is clear that OCD and autism have an complex relationship that warrants attention.

If OCD is so common for Autistic young people, how many are being treated by CAMHS?

According to Devon NHS trust 1 in 10 CAMHS patients are Autistic. I have spoken before about how alarming this statistic is (see here). To really capture the fallout of these failures La Buissoniere Ariza et al (2021) found that 13% of parents reported suicidal ideation in their child when autism and OCD co-occur. Please don’t forget that Autistic children in general are twenty eight times more likely to think about or attempt suicide (Royal College of Psychiatrists). OCD is not just a significant issue for Autistic young people, it is threatening their lives. Still, CAMHS are refusing to support these Autistic children.

What are the barriers to CAMHS supporting Autistic young people with OCD?

In my opinion, the biggest issue is professional competence. Myself and Tanya Adkin have written previously about her concept of neurodivergence competency. Despite Autistic children and young people representing a huge portion of the populations that need access to CAMHS, professionals do not have the skills to support them safely and effectively. This presents huge barriers to access to CAMHS because they are either turned away or given treatment that can have life threatening consequences.

If we wish to reduce the rates of suffering amognst Autistic and OCD young people, we need to fight for a CAMHS that not only lets us through the door, but also upskills it’s professionals, and creates an environment within which Autistic and neurodivergent professionals can work. There is more to be said about the hostile environment that has been created for Autistic CAMHS professionals.

Sign the petition here

Sign the open letter here

Check out Autistic and Living the Dream and Autistic Realms for more on autism and OCD!

If you enjoy these articles, please consider purchasing one of David’s books! Click here for more information.

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David Gray-Hammond 0 Comments
Feb 13 2023
Mental health and the diagnostic process: A neurofuturist perspective

As I discussed in my recent article about co-occurring conditions, the diagnostic process in psychiatry is inherently flawed on the basis that we have failed to find any meaningful relationship between the so-called “symptoms” of psychiatric conditions, and physical biomarkers which can be measured. Despite this lack of physiological cause, we are still diagnosing people as mentally “ill”. Despite this model not improving outcomes for around half a century.

So now we are faced with the issue of how diagnosis is not just given, but also how it is given responsibly.

One of the biggest flaws of psychiatry is the circular logic that dominates the diagnostic process. A person is Schizophrenic because they have symptoms of Schizophrenia, and they have those symptoms because they are Schizophrenic. This logic does not allow for a nuanced understanding of why a person may experience this particular cluster of traits, it simply follows that A = B, which is because of A.

If this is the case, how does one escape from circular logic?

We have to look for causes for traits and “symptoms” outside of the realm of medicine. While I have often remarked that external factors are the only thing with a meaningful relationship to these experiences, medicine is yet to catch up. It seems reasonable to assume that traumatic experiences are the cause of psychiatric conditions and not a problem within the body. This has ramifications for the future of psychiatry.

If people are not “unwell”, psychiatry now has a moral duty to advocate for it’s patients. Psychiatry needs to evolve into a tool for social change, and cease to be a weapon wielded by normative society. Beyond this, psychiatry needs an understanding of the relationships between neurodivergence, trauma, and psychological distress. It is not enough for psychiatrists to bandage the wound, they need to remove the knife from the hand of society.

This requires us to radically rethink our entire perspective on normality and cultural normative standards. We can not just medicate people and expect them to assimilate into society. We need to help them understand their own unique space in the environment and how to embrace their journey through that space.

As I discuss in my book A Treatise on Chaos, identity is a shifting and ever changing value. We are, at our core, beings of chaos. Psychiatry needs to be a tool for supporting us in the more challenging parts of that chaos, and not serve as a ring-fence around the Self.

Psychiatry is not completely off the trail. Medication can serve as an important tool to support a person’s wellbeing, and can be very helpful for reducing the more troubling and distressing aspects of psychological distress. The most important thing is that we all put in the work to evolve psychiatry and mental health support into a means to challenge the oppressive systems that exist within our world.

It’s time to stop the navel-gazing, and build a better future.

David Gray-Hammond 1 Comments
Sep 27 2022
Neuroqueer: Authentic embodiment of mental health

This article was Co-Authored by David Gray-Hammond and Katie Munday

Trigger Warning: Discussion of mental health

It is a surprisingly contentious discussion to have, but the neurodiversity paradigm does not just apply to autistic people and ADHD’ers. Neurodivergent is a broad and inclusive term that applies to any bodymind that diverges from the neuronormative standards of a person’s given culture. This includes, but is not limited to;

Cerebral Palsy

Epilepsy

Down Syndrome

Traumatic Brain Injury

Learning Disability

Foetal Alcohol Syndrome

The list could go on for some time.

Something else that needs to be included on this list is the plethora of psychiatric diagnoses that exist, currently standing at over 300 in the DSM 5. It becomes apparent that there are far more than a handful of ways to be neurodivergent. Let’s not forget about the people who are multiply neurodivergent, existing in the overlap between multiple shared experiences.

This is what neurodivergence is, it is shared experience amounting to identity and culture.

Some of this shared experience is wonderful, there is a beauty to be found in neurodivergent communities. However, some of the experience is truly awful; the truth is that we (the authors of this article) would have to think really hard if we were offered a magic pill that would take away our negative mental health experiences. Things such as;

Intrusive Thoughts

Rumination

Paranoia and Anxiety

Incapacitating Depression

There is a balance to be found between “how much of this is me, and how much of this is something that is happening to me?”. There is a lot more to be said for the effect that our environment has on us.

So, how does one authentically embody the entirety of their neuropsychological experience?

We can embody our full-selves by accepting that sometimes, we need to step away, and allow space to exist with whatever we are feeling at the time. Feelings come and go, it is necessary to observe and acknowledge those feelings without judgement of yourself.

One of the main issues with this is that when you have mental health concerns, we have a tendency to judge that part of our lives as a wholly negative experience. Understandably, it can be very difficult to identify positives when the world focuses on perceived deficit and disorder.

Some of the positives we have found are;

Intense creativity

Self-awareness and introspection

Increased empathy

Intense positive experiences to offset the negatives

Greater attitudes of acceptance

In order to authentically embody our entire neurocognition, we first have to learn to co-exist with all of our experiences. This requires a level of acceptance that not everything will be wholly positive or negative. Self-acceptance is a radical notion, not necessarily in the traditional sense, more so in the way it changes our outlook on life. The boundary between neurology and the mind is so obscure that a change in one can alter the other.

Embracing our negative experiences is only a part of this. We are well aware of how harmful toxic positivity can be. Not everything is okay, and nor should it be, especially when experiencing trauma. We have to learn to co-exist with ourselves, that doesn’t mean we have to find enjoyment in every aspect of our inner and outer world. We need to show up for ourselves by giving our inner-self the same grace that we afford others.

Things aren’t always okay, but with a little self-compassion they can be better. It is an aggressively neutral thing, being neurodivergent.

David Gray-Hammond 1 Comments
Apr 20 2022
The truth about Obssesive Compulsive Disorder – OCD

Cw: obsessive intrusive thoughts, self harm, mention of violence.

Alot of people wrongly assume that Obsessive Compulsive Disorder (OCD) is a cute tidy ‘quirk’, a need for everything to be organised and ‘just right.’

When in reality OCD is often a very disabling and harmful condition which chips away at a person’s energy levels, emotional regulation and grip on reality.

In more intense periods of OCD, people can be trapped in obsessive checking of windows and doors and whether they have turned off the oven – the safety of themselves, their home and their family can become all consuming.

Some people can take hours to do their rituals when locking up for the night or leaving the house. Sometimes leaving a room can be laden with compulsive steps which must be done entirely *right* before the person can move on.

Some people with OCD are enveloped by their need to be extremely clean and germ free. This can be very tiresome and take up the emotional and cognitive energy of the person. Compulsive cleaning can also cause medical issues due to the over use of harmful cleaning products. This can take over people’s lives making it difficult to be outside of your own low-germ household.

Consistent intrusive thoughts can also be a part of OCD. These are often interlinked with PTSD and can cause someone intrusive thoughts when awake or intrusive dreams when asleep. These thoughts can be violent and aggressive and are often the antithesis of the persons morals.

They are frightening and they make you question your own personal beliefs about yourself and others. These thoughts can be one-offs or can last for days or even weeks. They are often exacerbated by periods of high stress, hormonal changes and physical health issues.

For me they often involve self harm or the harm of others – this is a thought I have carried around with me for years, I have never and will never act of them but they are horrifying all the same.

My OCD ramped up after having my baby which is not unsual – there is a whole new person dependent on you, another person to obsessively worry over and have intrusive thoughts about.

OCD is exhausting, it is draining, it can feel humiliating and shameful. Some of the thoughts I’ve had sicken me and they don’t leave my brain. No matter how politely or forcibly I ask them. There they remain.

Intrusive thoughts and obsessive routines are really difficult to talk about publicly, people often dismiss them or they are just too painful for people to talk about. I am worried what people will think of the thoughts I have.

People with OCD routines are often ridiculed or invalidated by phrases such as ‘we all do that’ and ‘yeah, I’m a little OCD about my car being locked.’ When their struggles are so much more than that.

I find with being OCD I am often very alone in my experience and because I live up to the tidy, everything-in-its-place stereotypes I am told that my being OCD is of no surprise. People are not seeing appreciating the very real struggles those of us with OCD can have.

My OCD is not being tidy- which is more likely due to my fastidious Autistic being – its actually a very difficult and emotionally harmful thing to live with.

Some people, myself included, struggle with compulsions to self harm and sometimes those compulsions win.

OCD is real, it is intense, it can be disabling and isolating. The only way we can make it less so is to end the myths and stigma related to it.

I want to own my struggles so I can help others. I am Katie, I am OCD, I take medication for my mental health, some days I am fine and others I feel like I am losing my very soul.

See me. Support me. End the stigma, end the shame.

Katie Munday 0 Comments
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