Another January and another month with an advertising campaign for a major telecom company that masquerades as concern for mental health. A campaign that is supposed to make those of us with mental health concerns feel better about talking about it. Warms the heart. Nothing says one’s needs are important like being told that we should only talk about mental health in limited ways.
Most of the time when someone seeks mental health care one is sent to a counsellor or therapist. More often than not, the therapist uses an approach called “Cognitive Behavioural Therapy” (CBT). For those on the autism spectrum the most common treatment is ABA, Applied Behavioural Analysis to make the person present more neurotypical. Both of these treatments are presented as miracle cures that can help solve all of a person’s problems. The problem is, they aren’t.
Of the two, CBT is likely what most people have heard about. CBT applies to people in many age ranges. Further, it does help many people who are treated using it. A commonly quoted statistic is that it is 80% effective. That’s pretty good! Wonderful for those whom it helps. I truly am happy for those for whom it has worked, and does work well. Where the problem lies is that it is the primary modality that is used. For many, medications are needed in addition to therapy. Yet, if CBT doesn’t work for someone they are often told they are not working hard enough at it.
In my own case, CBT is not a modality that works for me in active therapy/counselling. I know the techniques and I use a number of them regularly. It has not, however, ‘cured’ me. I am autistic, I am on the spectrum. This is not something that is cured, but something that is worked with and managed. Each autistic person seeks to find ways of navigating the world that does not kill us. As a result, I am up-front with any new person I’m seeing for counselling/therapy that CBT is not what I need. This saves time for me, time for the person I’m seeing, and saves money on sessions that are not helpful. All of this is before starting to talk about ways to work with my neurodiversity and past traumas.
When it comes to autism the Gold Standard Treatment that is held up for parents and autistic people is that of ABA. The stated goal of treatment is to help those who “suffer” from autism. The underlying assumption is that we all need to be ‘fixed’. Made to present as neurotypical and normal in society. Most autistic advocates do not support ABA. It is, at its roots, based on reparative therapy for LGBT+ people. Let that sink in.
In Ontario, the only funding available for working with autistic children is for ABA services, and the person has to be a certified ABA practitioner. This is to the tune of $500 million. More critically, there are few, if any, services for older autistic people. Once a person reaches 18 years old, the services disappear. There are no job supports, there is no housing support, there is no support for managing day to day living challenges. In addition, for many the effort and stress of seeking out supports is overwhelming.
When health concerns are combined, for example being autistic and having other health issues, seeking help becomes even more difficult. “We can help you with you’re challenges with autism, but we can’t help you because you’re trans.” Or, “we can help you with transition, but, nope, you are suffering from autism and can’t know your gender.” Or, “you need to do these things to manage your physical health, but we won’t help you do so in ways that are compatible with being autistic.” The list goes on and on.
What can be done?
This is a situation where we need people to stand in solidarity. For those with the energy and ability to come forward and help advocate for change. In Ontario we have a provincial election coming up. Ask your candidates how they plan to help all people who have mental health concerns. Will they advocate and work to making funding and supports available for those of all ages? Will they work to ensure that what supports that are made available are diverse enough to meet the needs of all those seeking aid?
Ask the tough questions, hold organizations accountable. Most importantly, pay attention to those who are advocating for change who are representative of those who are being treated. At one point being trans, being gay, being lesbian, were all things to be cured. We are not big chunks of meat that need to be ground into sausage and cured.