Asking GP for referral, prior problems, etc.

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Hi there.

I've already tried once to get a referral to someone who can assess me for Asperger's/ASD, this was two years ago, and I was given the brush off. I actually specifically asked for the referral to a specialist, but anyway.

I have recently been advised to use NICE guidelines, specifically CG142, but I have no idea what to say in regards to this. Is there a specific part I should be looking for?

My mum brought up the Asperger's/ASD issue when I saw a nurse from the mental health crisis team a while ago, but he said I had to go through my GP for referral as he doesn't have the power to refer, and I am not under the care of a psychiatrist, and the last psychologist I saw didn't know enough about AS/ASD to make the referral.

When I previously asked for a referral I was told there were no provisions for diagnosis in adults (mum diagnosed at 33, however) and that my problem was simply my social anxiety, for which I had already had CBT - I was told to refer MYSELF back to the local mental health team for more "talking therapy" (i.e. they couldn't even be bothered doing that!). Talking therapy might help the symptoms, but they don't diagnose any possible underlying condition.

My mum has Asperger's, as mentioned above, but I don't really know how relevant that is in the grand scheme of things. She was adopted so I don't know of any other family history.

I won't be mentioning that I've been referred for talking therapy for "self esteem issues" because I fear that'll add fuel to the fire of not being given a referral.

Does anybody have any advice? I can't take anyone with me because mum works and can't take any more sick days just to accompany me to a ten minute appointment (she has specifically expressed this).

I have an appointment with a GP planned for in a few weeks time - suffice to say that it is a different one than last time!

I don't have advice, but I'll be facing the same situation soon, with the possibility that my new GP will choose to disregard my prior Asperger's diagnosis, since adult autism is not a condition doctors like to acknowledge.

My own attitude about this is to accept that I'm part of a health care system that has certain standards, and does things in a certain way, and to just let them do their jobs. They're not prepared to diagnose or treat adult autism, and that's just how it is. They can put various other psychiatric labels on me, and recommend therapy and medication, and if the end result is that it's helpful, well then I don't care what label they write down in their little diagnostic notes.

What matters is that my survival needs are met - that I'm in a stable living situation, and functioning as well as possible. So in terms of health care, I expect doctors to acknowledge that I have some kind of serious psychiatric dysfunction, regardless of what they want to call it, and that I need help in specific ways. (For me, currently, this amounts to a doctor's note to get out of jury duty once a year, so I don't get fined or thrown in jail for not being functional enough to serve.)

In terms of finding happiness in life, talk therapy can be helpful, but in some cases the advice that works for NTs doesn't work so well for autistics. I find this forum more helpful, in learning what really works for autistic people.

My feeling is that the health care system is inadequate, and fails to meet the needs of adult autistics - and it's not right, but that's the reality we have to live with, at this time. More work needs to be done toward changing health care policies, and educating professionals on how to recognize and help adult autistics. And hopefully that will happen in time. But for now, the reality is that we sometimes have to deal with doctors who are stubbornly ignorant, and unequipped to help us. And when that happens, my approach is to simply thank them for their time, be grateful for whatever they can do to help me, but forgive them for being limited by the policies they're required to adhere to. And then I seek more helpful advice from other sources (such as this forum).

That being said, there are doctors who are open-minded about adult autism, and willing to make referrals, and I hope that your new GP will be of that variety. It seems that persistence is necessary, in getting your needs met through the health care system, and I admire your persistence. Good luck with your upcoming appointment!