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From A to B

"Ai, Portugal, Portugal

What are you waiting for?

You've got one foot in a galley

And another at the bottom of the sea"


Portugal, Portugal by Jorge Palma


From A to B - Forgive my Anglo-Saxonism, but what I'm going to talk about is England's strategy, not ours. And no, I'm not going to talk about England's tactics in the European game against Italy. But I will ask, Let's bring it home! More specifically, that they bring also to "our home" (meaning Portugal), the strategy that I will talk about.


Autism has been spoken about for about 80 years. And 40 years ago, this concept was included in the Diagnostic Manual of Mental Disorders - DSM, then in its third version. Much has been investigated, developed and implemented among autistic people, but also among families, educators and teachers, health professionals, the police and judicial system and society in general. But it is also true that throughout all these years we continue to verify a large number of failures or non-compliances and serious breaches of legislation, the Constitution, Community Directives, the Declaration of Human Rights and of People with Disabilities.


And do not get the idea that all these needs are only for autistic people. They certainly are, in that, just like anyone else, they need their needs, from the most basic to the most complex, to be met. The way autistic people are integrated in society says how our society is itself weakened, namely in fundamental values of humanism.


As it often happens in the clinic, we need to evaluate the person, listen to his/her requests and complaints in order to be able to diagnose and conceptualise the clinical situation. And this with the purpose of keeping in mind the therapeutic objectives and the path to be followed. If this is not done, regardless of the model that guides the health professional, we are not helping the person. In the same way if the country does not have a strategy for mental health and more specifically for autism. This will also lead to a lot of confusion, both on the part of health professionals and the specialised teams, who will be doing things in a different way and with little or no coordination. And also a bewilderment for autistic people themselves and their families.


In the United Kingdom, in the last few years, there has been a whole set of documents designed, written and implemented to change the course of events in the lives of autistic people and their families. Indeed, prior to the Autism Act/Law, autism was often misunderstood by the public and professionals. As well as many autistic people having faced significant barriers to living their lives fully and fulfillingly in and around the community. In addition to it being clear that action was needed to improve services and support for autistic adults and their families, and to improve society's awareness of autism. Yes, autistic adult people. Not least because until quite recently, and still today some people, find it difficult to think about autism throughout their lives. And as such, in 2009, the UK developed the Autism Act, mainly applied to adult people's lives.


It is July 2021. We have been living a pandemic situation since March 2019. And many autistic people still face long waits for their diagnosis - and don't always receive the support tailored to their needs at an early enough stage. Many autistic people still struggle in childhood, both to get a diagnosis and the support after a diagnosis, including at school, and it's hard to get a job when they reach adulthood.


And there's no point in us going out of our way, each other, whether we're health professionals, educators and teachers and society in general, to say we're doing everything we can to be inclusive. I feel that every time something is written pointing out these gaps, there are always those who say that in their school or in their clinical practice they do everything in respect of the autistic person. Great, I say! But don't expect a prize. People, all of them, have fundamental rights that must be respected. Nobody is doing anyone any favour.


Since the last autism strategy was published, new challenges for autistic people have also emerged, as has our understanding of the barriers people face throughout their lives. We have started to see the number of people identified as autistic being admitted to mental health services, and that number increasing. The life expectancy of autistic people itself is decreasing, and now we are talking about 16 years less compared to the general population.


And given that we know that the figures indicate that around 1% of the world population is autistic. It is important that each country and then jointly take responsibility for creating a plan for autism.


In the UK, the next plan that will be in place from now and over 5 years, they want to create a society that truly understands and includes autistic people in all aspects of life. One where autistic people of all ages, backgrounds and across the country have equal opportunities to play a full role in their communities and to have better access to the services they need throughout their lives.


And that to do this, the UK will provide funding to: improve understanding and acceptance of autism in society, improve access to education for autistic children and young people and support positive transitions to adulthood, support autistic people into employment, tackle health and care inequalities for autistic people, building the right support in the community, supporting people into care, also improving support within the criminal and youth justice systems.


Reading these proposals I always get the idea that all of this is what should be considered for all citizens, right? But apparently, a strategic plan needs to be created to deal with this. Otherwise, we run the risk of talking about this again in another 5 years. And you, Portugal? Are you going to do as Jorge Palma sings it?


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