Plight of autistic doctors revealed

A quarter of autistic doctors have attempted suicide, more than three-quarters (77%) have considered it and nearly half (49%) have also self-harmed.

These are the findings of a new study by Brighton and Sussex Medical School (BSMS), Thomas Jefferson University and Autistic Doctors International (ADI) – published in Frontiers in Psychiatry.

Dr Seb Shaw

Lead author Dr Sebastian Shaw, lecturer in medical education at BSMS and ADI research lead, called it ‘deeply concerning’ to see the extent to which his fellow autistic doctors have struggled with their mental health.

But he felt perhaps this was unsurprising considering the many barriers and challenges faced by autistic people working in the healthcare sector.

‘We also found that those who considered autism to be a “disorder”, rather than a difference or disability, were more likely to have attempted suicide. This may reflect a degree of internalised shame from being trained to understand autism as a disorder through their medical practice. 

‘This association would seem to support a neurodiversity-affirmative view of autism. Fostering more acceptance of autism as a difference may potentially improve the well-being of autistic healthcare professionals and patients alike.’

He told Independent Practitioner Today the study gathered no specific data about private practice because of the international/worldwide context, where the distinction of private practice would not always have held similar meaning in each country. 

He added: ‘I suppose it may be possible though that any autistic doctors who may be forced out of NHS roles due to their differences may find some refuge in private practice, where there is typically more independence, albeit with its own sets of unique challenges, I’m sure.’ 

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Keep diagnosis a secret

The study also found many autistic doctors did not disclose their diagnosis in the workplace, with 29% not having told anyone at work, 32% having disclosed being autistic to their supervisor and 30% to their colleagues. 

Linked to this appears to be a sense of isolation. Although four-fifths reported having worked with another doctor they suspected was autistic, only one-fifth reported having worked with another doctor they knew was autistic. 

Those having never worked with any suspected autistic colleagues were also more likely to have considered suicide.

As awareness and diagnosis of autism grow, more medical students and doctors are discovering they are autistic; the study showed an average age of formal diagnosis of 36. 

Some were diagnosed following difficulties in stressful clinical environments or highly demanding career paths – and found that support from employers was inconsistent, with some colleagues refusing to believe a qualified doctor could be autistic.

Better support needed

Dr Shaw said: ‘Key to improving the experience of autistic doctors is ensuring that neurodivergence is viewed in a positive light. Workplaces need to provide better support and improve awareness of autistic healthcare professionals. 

‘Employing a well-supported and neurodiverse medical workforce will mean that the diversity of the public is reflected in their medical providers, with likely improved experiences and outcomes for neurodivergent patients.’

Despite these striking findings, overall, three-quarters usually enjoyed their work as doctors (74%) and three-quarters (73%) felt being autistic was helpful in their role as doctors. 

Dr Mary Doherty, senior author and founder of ADI, commented: ‘Autistic doctors are a hidden minority in the medical work­force, and the range of specialties in ADI challenges autistic stereotypes. General practitioners are the largest subgroup, followed by psychiatrists.’

Dr Wendy Ross, director of the Jefferson Center for Autism and Neurodiversity, added: ‘This study is a call to action for the entire medical field to meet the needs of autistic medical talent as well as patients.’

The cross-sectional study, the first to gauge the experience of autistic doctors, modified a pre-existing survey of autistic school staff, with 225 members of the organisation ADI taking part in the study.

The full study is published  at 2023.1160994/full