Dr. Mary Doherty:

I fully agree with the Senator regarding diagnosis in primary care where a GP has a special interest.

In the UK, they are at the beginning of setting up a training programme for GPs who have a special interest, and it is a question of whether that will then move towards GP diagnosis. However, I know some GPs who diagnose within wider settings. That is the direction we need to go in. It is not some obscure diagnosis that needs a specialist multidisciplinary team for a lot of people. For some it does, absolutely, but not for everybody. That is the first thing to say.

On making training mandatory, we are a long way from that in this country. We need to start with education within the medical schools. We need to embed training in the medical school curriculum, and into the usual, routine continuing professional development that GPs access. Rather than making it something special, let us just get the training into where they already go to get training about heart disease, cardiovascular issues, respiratory conditions - where people upskill and access continuing professional education. That is the route into education, particularly among the GPs. For the wider health and social care professional setting, perhaps mandatory training might be more appropriate. I do not know. I just know how under pressure GPs are in particular. We need to embed training for the doctors and medical staff in hospitals right throughout the country, and again that can be done as part of the regular training programmes that people attend. It does not need to be a specialist programme.

I have not seen the content for the Oliver McGowan mandatory training, so I can not really comment on that. However, I know there is, unfortunately, a lot of training available which really just perpetuates that negative view of autism, and that deficit disorder-based approach, which is in direct contrast to the neurodiversity-affirmative approach, and has really negative mental health outcomes. We have some data from a study we carried out among our own members, and we have shown that considering autism to be a disorder is associated with prior suicide attempts. That is quite shocking, really. The mental health statistics from our own members are absolutely shocking. Some 75% experience suicidal ideation, and a quarter of our members have had previous suicide attempts. Within the autistic community, we know that a neurodiversity-affirmative approach - and this is not just all positivity, or a rainbows and unicorns approach - recognises the strengths, challenges and needs of autistic people in a way that gives kids a chance to grow up with good mental health and positive self-esteem.

The other thing I have not mentioned that is vital is access to communication, and in particular for kids who do not speak, access to augmentative and alternative communication, AAC devices and training on how to use these so that they have a viable means of communication, is absolutely vital. Our medical professionals have no training in dealing with people who, for example, do not speak, and use AAC devices. That needs to become normalised within healthcare so that people can equitably access the services that other people can.