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Are you talking to me?

Who doesn't remember Taxi Driver? And this mythical phrase, so simple yet so fantastically said by Robert De Niro in the role of the taxi driver Travis Bickle, is still in our memory today? In this scene specifically, the character of the taxi driver are representative of his expression of growing intolerance towards the world around him. It reminds me of what I feel happens in many autistic people when one tries to reflect on what remains to be done to improve health care provision in the autistic community, especially in adults. It is true, in the middle of the 21st century, with the increasing scientific and clinical knowledge about Autism Spectrum Disorder, and we are still asking this question. Do you understand now why I remembered Taxi Driver? Sometimes I confess that I think Autism Spectrum Disorder must really be a "special" condition to the extent that even today it is so difficult to provide appropriate health care. Fortunately, there have been more examples of needs assessment that have been done in this area, hiding the autistic community itself. And not only by collecting information from clinicians, although this is also fundamental to the improvement of the process. I would add that in relation to the latter it is still essential to give more and better training so that they can carry out their clinical duties more and better, both in terms of diagnosis and follow-up. There is no more ways of saying this, as demonstrated by numerous scientific research studies and years of accumulated clinical experience. Autistic people present a higher number of co-occurrences of other psychiatric disorders and as such their mental health and general well-being is much more compromised. In addition, autistic people have a greater number of other general health conditions, which leads to premature mortality in this group. This alone should be enough for health services to organise themselves to receive in quantity and quality all adult autistic people. Therefore, when we try to reflect on this issue with autistic people they seem to feel like the taxi driver himself in feeling that the ticking of his meter reminds him of a bomb. It is because the whole situation is a bomb that is constantly going off. Be it in the daily psychological suffering of autistic people and their family. Or in the increasing number of suicide situations that continue to occur among autistic people, and in greater numbers among women. And a whole set of other events that worsen the general condition of physical and mental health and Quality of Life. Even so, when we tried to cross-reference the survey on the needs of autistic people with the clinicians, we could find common points. Namely, in the contact with health care it is fundamental to improve the client-clinician relationship. Ask an autistic person about their experience when using certain health services and you will understand. Furthermore, it is also necessary to make adjustments in the care itself. For example, providing alternative places to wait for an appointment, rather than subjecting the person to the waiting room, which often leads to withdrawal or avoidance. And the evaluation and diagnosis process itself, which continues to cause so much fuss and even so there are many adult autistic people who receive their diagnosis late. The improvements to be made are fundamentally behavioural, as always. And for that it is important that the clinicians themselves are helped to develop a different attitude towards their clients. Sounds easy, right? I don't think it needs repeating, right? Otherwise Robert De Niro can explain!


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