The Power of Neurodiversity-Affirming Mental Healthcare

The concept that all brains are different—neurodiversity—is not new, nor is the awareness that some brains operate outside of our concept of typical. “Neurodivergent” is not a specific diagnosis but rather refers to the range of brains that fall outside of the neurotypical scope. The Centers for Disease Control estimate that 20 percent of the population is neurodivergent in some way, and many who are neurodivergent have more than one form of neurodivergence.

Neurodivergence and neurodivergent individuals have historically been seen as a problem in need of fixing, with the “solution” usually being conformity to neurotypical mannerisms and behaviors. While many neurodivergent people require support that differs from neurotypicals, in recent years, many neurodivergent communities have pushed to reconceptualize neurodiversity as a natural part of human diversity. We provide support but do not see neurotypical-ness as a cure or end goal.

There is always resistance to systemic change, and “different” can be scary. Here are three reasons why neurodiversity-affirming care should be embraced and can improve the mental health system.

1. It works to improve trust in providers and the mental health system.

Since 2020, trust in the American healthcare system and its providers has plummeted, with a recent survey showing that six out of 10 Americans do not have faith or trust in their providers.

Of course, there are many intersecting causes for mistrust of the system; the COVID-19 pandemic, in particular, led to a sharp decrease in trust. The mental health system also has a long history of racism, misogyny, homophobia, and other oppressive harms. Many have good reason to be wary of the system and the professionals who operate within it.

There is not a simple solution to the problem of declining trust, but neurodiversity-affirming care can be one small step in the right direction. By acknowledging that clients are experts on their own experiences and inviting them to take an active role in their treatment plans, we can rebuild and earn their trust.

2. It fights the stigma and ableism perpetuated by the medical model.

When we see our neurodivergent clients as problems in need of fixing, we frame them as lesser than their neurotypical peers by default. This can lead to infantilizing, dehumanizing, denying autonomy, and more.

For instance, many autistic adults report that the “treatment” they received following a childhood autism diagnosis merely taught them to mask their autistic traits. Rather than having their needs met, they were taught that “progress” meant changing who they were to meet expectations. This approach can lead to trauma—and in what kind of mental health system is a so-called therapy considered effective if it causes trauma?

Neurodiversity-affirming care, on the other hand, focuses on supporting the client’s needs and meeting them where they are rather than treating them as a problem to be solved. It rejects the notion that neurotypical-ness (or passing for neurotypical) is an appropriate treatment goal, and it honors the client’s inherent strengths, centering their voice in their treatment.

3. It addresses the dangers and risks of misdiagnosis from observation-based assessment.

Many forms of neurodivergence are identified and diagnosed from a variety of assessment tools, including self-reports, personal narrative, collateral record and interviews, observations from the assessor, and observer assessments. While all of this information together can help the evaluator draw accurate conclusions, many rely on external sources of information to the point of downplaying the client’s own experience.

This can lead to misdiagnosis, as observations and records cannot reveal internal experiences that can only come from self-report. This can lead to assigning an incorrect diagnosis or overlooking a correct diagnosis.

In the autistic community, for example, a recent study found that one in four clients is misdiagnosed before learning that they are autistic. An inaccurate diagnosis can mean being denied appropriate supports or prescribed inappropriate medication, causing harm. It is also linked to anxiety, depression, and identity issues.

By centering lived experience, we can provide clients with accurate information about their diagnosis and needs, preventing harm.

Learn more in Neurodiversity-Affirming Therapy: What Every Mental Health Care Provider Needs to Know.