Nick Cohen’s article, ‘The Road to Hell for the Mentally Incapacitated’ takes two facts, and argues that one causes the other. The two facts are true, but his attribution of one to the other is mistaken.
FACT 1: Autistic, mentally-impaired and mentally-unwell people are treated very badly in our society.
FACT 2: Some people argue that disabled people have the right to make their own decisions and that humanity is neurologically diverse.
Cohen contends that Fact 1 is a result of Fact 2. In doing so, he fails to understand the disability rights and neurodiversity approaches, and lets the real culprits of Fact 1 off the hook.
Who or what is responsible?
Last Thursday, I was protesting against the funding crisis affecting Special Educational Needs and Disabilities (SEND). Thousands of people were doing the same at twenty-eight locations around the country. We were protesting a situation where funding for high-needs SEND fell short by £287m last year and will fall short by £1.6bn within two years. Half of all local area SEND services have failed their Ofsted or Care Quality Commission (CQC) inspection.
What has caused this crisis? Austerity, not the assertion that humanity is neurologically diverse.
The previous week, I moved a resolution at TUC Disabled Workers’ Conference, deploring the shocking number of deaths of autistic and learning-disabled people while in state care. The deaths have been mostly of people who could speak, who were competent in many ways, but who had physical or mental health problems. They do not fit the picture painted by Cohen in his article that only those incapable of advocating for themselves are victims of the system.
What caused these deaths? Neglect, cruelty, privatisation, under-funding - not the argument that neurological differences are natural.
Nick writes about the appalling practices of schools excluding ‘difficult’ learning-disabled children, of teenagers being kept in ‘seclusion rooms’. These are awful, horrifying practices. But what do they have to do with the neurodiversity approach? Nothing.
Who is responsible for the terrible situation that autistic, learning-disabled and mentally-unwell people face in this country in the twenty-first century? The government, not the neurodiversity movement.
Of course, Nick is not arguing that the neurodiversity movement has done these things. But he is arguing that its call for acceptance of diversity is at least in part responsible.
Governments will inevitably use the language of progressive ideas to shroud their thoroughly reactionary policies. They have been doing that for a lot longer than the twenty years in which ‘neurodiversity’ has been a word.
When Margaret Thatcher’s Tory government launched its ‘Care in the Community’ project in 1983, it claimed that it was liberating patients from the awful asylums. In reality it ‘freed’ them into communities without the resources and support they needed. This does not mean that it was wrong to support independent living or to close abusive asylums. It means it was wrong to not provide proper care in the community. The only thing that the Tories wanted to liberate was the public finances from the burden of the sick.
Today, when care home staff beat patients, they do not do it because they have succumbed to neurodiversity propaganda that they should respect differences in brain wiring. Quite the opposite: they do it thinking that their charges are inferior, less human than them.
You will see proponents of the neurodiversity approach at the forefront of campaigns against all these abuses and shortcomings in support and care. You will also see proponents of the neurodiversity approach parenting autistic and otherwise neurodivergent offspring, including those with very high needs - perhaps disproportionately so, given the established hereditary factors in many of these conditions.
So in making out that the neurodiversity approach overlooks the needs of more severely disabled people, Nick misunderstands - or misrepresents - what the neurodiversity approach actually is.
There is an anti-neurodiversity lobby which caricatures the neurodiversity approach as asserting that everyone with an atypical brain is a happy genius without a care. Not so. Those advocates who support the neurodiversity approach understand full well that many neurologically-atypical people are severely disabled. They ask people to consider that differences in neurology occur naturally, and in many cases are not in themselves impairments.
Humanity is neurologically diverse. Some people’s neurology is impaired. Others have an atypical neurology which while not faulty, puts them at odds with social norms and environments to the extent that they are disabled. It may not be just their neurology that is disabling them, but those social norms and environments - or, more precisely, the interaction between their neurology and the world around them. Perhaps when, as Cohen cites, an autistic man is fired from twenty jobs, there is something wrong with the jobs rather than just with the man.
Brain science is still at an early stage. There is a lot that we still do not understand about how the human brain works. The categories and terms that we currently use to label people’s neurology may not last more than a few more years. In this context, to declare that the majority of autistic people are disabled *by their autism* is at the very least unjustifiably presumptive.
Cohen recycles the argument that there are small number of autistic people who are doing fine, and who claim to speak on behalf of all autistic people, including those much more severely disabled than themselves.
If that were true, it would be bad. Perhaps you can find a handful of tweets that suggest that a few people do think this way. You can find some cheesy ‘awareness’ campaigns that lionise eccentric geniuses and promote ‘inspiration porn’ in a ludicrous attempt to suggest that we can all be like that. And those employers portrayed as ‘enlightened’ because they seek out autistic people to employ are very clearly pursuing only those autistic people whose productivity exceeds their support needs.
But these are not the neurodiversity movement. They are not even part of the neurodiversity movement that Cohen describes. He and the autistic person he quotes aim their criticism at autistic self-advocates, at the growing movement of people who are demanding, and helping others to demand, acceptance and the removal of discrimination and hostility.
Autistic UK, an organisation of autistic people which promotes the neurodiversity approach, is part of the neurodiversity movement. It states explicitly that it does not claim to speak for all autistic people, but to facilitate autistic people to advocate for themselves. Numerous autistic advocates express the views of themselves and their co-thinkers, not claiming to speak for all autistic people, only to be denounced by the anti-neurodiversity lobby for doing just that. This does not happen to people in other circumstances. When Nick writes his opinions about journalism, no-one accuses him of erroneously claiming to speak for all journalists. Even when royals say the ‘royal we’ that Nick quotes, they are not claiming to speak for every royal and are not accused of doing so.
Nick goes wrong in his very first sentence, ‘Arguments are won by people who can speak’. That would probably have been news to Stephen Hawking, who won plenty of scientific arguments without the ability to speak.
There are means of communication other than speaking, especially if people who don’t speak are facilitated to communicate and if people listen. I recommend that Nick reads ‘The Reason I Jump’, written by Naoki Higashida when he was thirteen years old. Naoki is autistic and does not speak.
In reality, arguments are won by those whose voices are amplified by the power and resources they hold or are given. Sometimes, thankfully, the strength of their argument is a factor too.
Nick goes on to argue that those autistic people who ‘can study, work, live, love and marry’ are ‘the few’. That is not so. A lot of autistic people can - and do - at least one of these things. If the numerous and substantial barriers that our society puts in their way were removed, more would be able to.
He quotes a source who implies that if an autistic person is a lawyer or a professor then they do not struggle. This misses one of the key aspects of autism: the ‘spiky functional profile’. Rather than being exclusively ‘high-functioning’ or ‘low-functioning’, most autistic people function at different levels in different areas. Just because someone can practise law or lecture in a university, that does not mean that they can make friends easily, or know what sort of behaviour is socially acceptable or not, or travel independently, or even get out of bed in the morning without help. The suggestion of a linear gradient, where some people’s autism is severe and others’ is mild obscures the needs of apparently high-functioning autistic people and the strengths of the seemingly low-functioning.
I have purposefully not commented on the particular legal cases to which Nick refers. I do not know the details nor have I heard all the evidence and argument. Perhaps Nick has. Hopefully, he is not one of the many people who pronounce and take sides in such cases without doing so.
Parenting autistic children, or learning-disabled children, or mentally-unwell children is hard. It continues to be hard when they become adults. These parents deserve so much more support and resources and understanding than they get. Many of the parents of those who died in care have persistently and admirably fought for justice for their dead (adult) children. Their fight for justice has been against not the neurodiversity movement but the healthcare system.
However, it would not be right for parents to have unquestioned rights over their children. A small minority of parents abuse their children. Research suggests that disabled children are more likely to be neglected and abused but less likely to be subject to child protection. Some parents are unable to provide for their children’s needs - itself a damning indictment of our society. Some parents subject their children to ‘treatments’ which are harmful, others do not arrange for them to have treatments (or vaccinations) that might benefit them. This is not to condemn those parents, but to illustrate that ‘parent knows best’ can not be automatically assumed.
Sadly, in writing about very important matters, Nick Cohen throws several different and complex issues into the pot, stirs them, and creates a concoction that is muddled and unhelpful.
Looking at Language
Like Nick, I don’t want to condemn people who get language wrong. I understand why a lot of people don’t feel confident as to whether ‘is autistic’ or ‘has autism’ is better; whether ‘disabilities’ are their conditions or the barriers they face in society; what is an ‘impairment’ and what is a ‘difference’.
But in the UK, it is widely known that ‘handicapped’ is not a good word to use. This is not because disabled people do not experience ‘handicaps’ in life, but because, although it replaced even worse words - such as those Nick mentions - it carries negative connotations. The word originated in the handicapping of horses in races, and went on to be associated with beggars holding a cap in their hand. Nick’s argument that ‘handicapped’ is considered ‘politically incorrect’ because people deny that impaired people face any difficulties is simply wrong, as shown by the fact that it was superseded by ‘disabled’ (at least thirty years ago). Come on, Nick, you’re a journalist: look it up.
Despite decrying others for doing so, Nick himself focuses on language. He concludes that austerity can hide behind ‘politically correct’ terminology because of ‘how we talk about mental health’. He does not say who he means by (the royal?) ‘we’. Different parts of society talk about mental health in different ways. His strapline, though, blames ‘the weasel words of disability rights’. So, not the bigoted words of disabled people as inferior or incapable; not the money-first words of productivity and balancing books; not the conformist words of narrow normality; not the pathological words where every difference is a medical flaw; not the patronising words of ‘inspiring’ disabled people doing things that other disabled people never could. No, the words of disability rights, of disabled people demanding equality.
Nick writes with some compassion in places, but ultimately points the blame in the wrong direction and comes down on the wrong side.