Experienced medic and public health coach Dr Susan Lowe, in voicing concern about the lack of psychiatrists trained to deal with autism in adults here, has urged the Ministry of Health to introduce scholarships to coax professionals to specialise in the area.

Making the observation during day one of the National Mental Health Conference at the Jamaica Conference Centre on Tuesday, Dr Lowe said the area was one of the gaps in mental health treatment in Jamaica that she has personally encountered and written about in trying to advocate for those affected.

“One [gap] is autism in adults. We have no psychiatrist here who is actually trained in dealing specifically with autism and I think the ministry should really look towards doing some scholarships for training in that. We have some psychologists who are familiar and some therapists and so on, but we don’t have a psychiatrist who has a dedicated line on that one,” Dr Lowe said.

Lowe in a 2018 paper published in the West Indian Medical Journal chronicled the experience of diagnosing a high-functioning, autistic, adult male as a non-specialist medical practitioner. The medic in that publication said the paper was inspired by the fact that despite the upsurge in the prevalence or diagnosis of autistic conditions, the majority of information on knowledge, attitudes and practice (KAP) concerning autism is shared only among those with the condition, those that care for/ live with them and the still relatively few specialists in the field. She noted further that medical authorities remain unwilling or unable to make a categorical statement about whether the upward trend is due to more diagnosis or actual prevalence.

The individual studied for the paper was a middle-aged Jamaican male, who had been diagnosed as autistic in his adult years. The individual, who struggled with depression and disillusion about not being stably married or having any children at his age and was on his third failed marriage, acknowledged himself as a “bad husband” and felt he was victimised by his spouses. The man who said he “had never lived conjugally for more than three years” said he grew up in a family in which the mother loved and viewed him as “different”, but said specialised investigation and contact were never done. The “difference” he said was subsumed in a competitive and academically successful household where all, parents and siblings alike, were achievement-oriented.

Autism is viewed as a spectrum of conditions with the cardinal issue being social and interpersonal dysfunction and difficulty, although the intelligence quotient (IQ) can range from low to genius level. The ability to function socially can also range from poor to high, and with the latter, it is often unclear what is atypical, other than that the person seems ‘different’ or ‘weird’

In May this year Patron of the Jamaica Autism Support Association Professor Maureen Samms-Vaughan said she is now diagnosing “many children” at the high school level with autism who had been under the radar because they had no significant symptoms.

She further pointed out at the time that “a lot of persons with autism are not diagnosed”.

“I tell everybody that they went to school with persons with autism, they work with persons with autism; they just don’t know. The research suggests that what is happening with autism is that we are getting better at diagnosing it. So persons who you would not have diagnosed years ago with autism, now we understand better and milder presentations,” she told the Jamaica Observer then.

Asked what milder cases looked like, she said, “Children who have more severe autism get diagnosed earlier because their language doesn’t develop, they don’t respond to their names, they are slower in developing the typical milestones than we would expect, but there are children with autism who develop appropriately, so the average person cannot detect and sometimes we don’t diagnose until they are in their adulthood or in high school.”

“I am diagnosing so many children now that are in high school, where their diagnosis is being made for the first time. Those children, what happened to them is that they are able to kind of stay under the radar with no significant symptoms until they get to the teenage years when social pressures, social interactions are greater, where you are meant to conform with your peer group, and children with autism tend not to have the same level of social skills as their teenage peers and so they stick out a little like sore thumbs,” Professor Samms-Vaughan stated.