reason's psychiatrists may not want to give a diagnosis

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I am 43 and trying to get a diagnosis. I done lots of online tests that always come out affirmative and when I listen to people on the spectrum describe their symptoms on youtube it seems so on the money that i'm sure it's something I have. I've spoken to two shrinks that were both convinced I didn't have it after less than 5 minutes of time with me. Some of what they said was not consistent with what I've learned about it. The second refused to tell me someone else I could see about it and was a real a**hole in general, like he just wanted me to leave and not come back. In fact, they both seemed like they were trying to provoke me. Not sure what to make of it. Could there be political motivations or monetary motivations? I am in NC and I'm now on Medicaid.

Not even the most experienced, best trained, psychologist could diagnose or exclude autism in only 5 minutes, especially for a patient in middle age, who probably has all sorts of coping mechanisms in place to deal with the non-autistic world (which the patient may not even be aware they are using.)

Some other reasons why patients are brushed off so easily might be...

- Specialism bias. You saw a psychiatrist, who therefore assumes that you either have a psychiatric condition or none at all. As autism is neurological rather than psychiatric, the professional is not trained to look for this condition, so uses the same lazy misconceptions about autism that a random member of the public might use.

- Training lag. The professional is aware of autism, but received their training long ago when the description of it was different to now. This particularly applies to Aspergers type autism, which was not even recognised until the 1980's, and took longer still to filter down to front-line practitioners. It's also unlikely that such a person would be familiar with the ways in which autistic people use "passing" as a coping mechanism.

- Professional arrogance. How dare a mere patient suggest a diagnosis, that is exclusively the professional's job! It's worth noting that some of the on-line questionnaires are actually used for formal screening as the first stage of a formal diagnosis - they are not just internet pop-psychology. (the Cambridge University EQ/AQ test was used as part of my assessment, for example.)

I have been referred to psychiatrists a few times. They all seemed deeply unpleasant and arrogant to me and I felt they didn't listen to me properly. They just ignored my own opinions about what I thought might be going on with me and seemed to become fixated on just one element of my behaviour to the total exclusion of everything else, so the reports they produced looked very inaccurate to me.

In contrast the two clinical psychologists who diagnosed me were really nice which helped enormously with the extreme anxiety I had about the diagnostic process.

^ That sounds very familiar, Sandpiper, I had much the same experience with the first few CBT counsellors that I saw. I think this also relates to what the OP said about feeling "provoked". Now that I understand that I'm autistic, and have had some CBT with an "autism aware" counsellor, I can see in hindsight some of what was going on...

Note: What I wanted to write about my counselling experiences seems more appropriate in a thread of its own. I think many points I want to make are relevant here, but others might lead this thread off on a tangent. I'll try to remember to pop back here and link to the new thread.

Here's a <link> to my thread about the CBT experiences, as promised in the previous post. Warning - it's a long one!