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Autistic psychiatrists: Royal College of Psychiatrists response

Published online by Cambridge University Press:  22 August 2022

Conor James Joseph Davidson
Affiliation:
RCPsych autism champion, Royal College of Psychiatrists, UK; Email: [email protected].
Peter Carpenter
Affiliation:
Chair, neurodevelopmental psychiatry special interest group, Royal College of Psychiatrists, UK
Rajesh Mohan
Affiliation:
RCPsych presidential lead for race and equality, Royal College of Psychiatrists, UK
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Abstract

Type
Correspondence
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

The editorial by Sue McCowan et alReference McCowan, Shaw, Doherty, Grosjean, Blank and Kinnear1 raises the important issue of autistic doctors, in particular, autistic psychiatrists. As the authors point out, students of medicine are likely to self-select for certain autistic traits, such as diligence, attention to detail and perfectionism. Despite this, many autistic doctors report high rates of workplace stress and burnout. As representatives of the Royal College of Psychiatrists, in meetings and correspondence with the organisation Autistic Doctors International, we have been shocked – but not necessarily surprised – to hear that the majority of their members have been reluctant to disclose their autism diagnosis to work colleagues for fear of negative career impact.

Although autism is not itself a mental illness, it is associated with mental health disorders of all kinds.Reference Lai, Kassee, Besney, Bonato, Hull and Mandy2 Autistic people are significantly overrepresented in both community and in-patient psychiatric settings.Reference Nyrenius, Eberhard and Ghaziuddin3, Reference Tromans, Chester, Kiani, Alexander and Brugha4 Autism often affects how mental disorders present and how they are best managed.5 It follows, then, that all psychiatrists should be able to identify autism, treat mental health problems associated with autism, and make reasonable adjustments for autistic patients in their daily practice.

Psychiatrists should also be aware that they are very likely to have autistic colleagues, including autistic trainees. The obligation to consider reasonable adjustments extends to the workplace as well as clinical settings. Relatively simple adjustments – such as installing dimmable lighting or giving more explicit guidance on tasks and responsibilities – can make an enormous positive difference. It is not an exaggeration to say that in some cases, such accommodations are career-saving.

The Royal College of Psychiatrists recently published its new Equality Action Plan, which sets out how we will achieve greater equality for College members, staff, patients and carers. Autism, and other neurodevelopmental conditions such as attention-deficit hyperactivity disorder, are within the scope of the plan. However, we recognise that more work needs to be done in the domain of neurodiversity disability support. In consultation with neurodivergent members, the College has recently identified the following three priority areas.

(a) Supporting reasonable adjustments for all members who need it: the College itself must set an example in implementing reasonable adjustments for its own disabled staff and use its influence over employing mental health organisations to comply with equality law.

(b) Clear statements from the College supporting disability equality: the College must be visible and active as an organisation that welcomes equal participation of individuals with disabilities, including those with neurodevelopmental conditions.

(c) The College being an inclusive organisation for its members: for example, ensuring that all online content including learning material and publications, conferences and events are accessible for people with disabilities.

As our members are mental health and neurodevelopmental specialists, the Royal College of Psychiatrists is in a strong position to be a leader and trendsetter amongst the medical colleges in the field of neurodiversity support and equality. McCowan et al have provided a timely reminder of the difference such support can make to individual lives.

Declaration of interest

None

References

McCowan, S, Shaw, S, Doherty, M, Grosjean, B, Blank, P, Kinnear, M. A full CIRCLE: inclusion of autistic doctors in the Royal College of Psychiatrists’ values and Equality Action Plan. Br J Psychiatry [Epub ahead of print] 14 Feb 2022. Available from: https://doi.org/10.1192/bjp.2022.14.CrossRefGoogle Scholar
Lai, M-C, Kassee, C, Besney, R, Bonato, S, Hull, L, Mandy, W, et al. Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis. Lancet Psychiatry 2019; 6(10): 819–29.CrossRefGoogle ScholarPubMed
Nyrenius, J, Eberhard, J, Ghaziuddin, M, et al. Prevalence of autism spectrum disorders in adult outpatient psychiatry. J Autism Dev Disord [Epub ahead of print] 6 Jan 2022. Available from: https://doi.org/10.1007/s10803-021-05411-z.CrossRefGoogle Scholar
Tromans, S, Chester, V, Kiani, R, Alexander, R, Brugha, T. The prevalence of autism spectrum disorders in adult psychiatric inpatients: a systematic review. Clin Pract Epidemiol Ment Health 2018; 14: 177–87.CrossRefGoogle ScholarPubMed
Royal College of Psychiatrists. The Psychiatric Management of Autism in Adults (College Report 228). RCPsych, 2020.Google Scholar
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