September 2025 – Written for Ability Beyond Borders (www.abilitybeyondborders.org)

For neurodivergent individuals such as those diagnosed with Autism or ADHD, access to healthcare to the same standard as others can be a complicated issue. For example, someone may encounter issues with communicating their needs to medical professionals, or they may require extra support with the sensory aspects of healthcare.

The following are some examples of barriers to healthcare for neurodivergent people:

• Difficulty with spoken communication – e.g. explaining symptoms or processing instructions
• Difficulty understanding why they need treatment
• Overwhelming healthcare environments – e.g. someone may have a low tolerance for pain, may dislike being touched or encounter issues with bright lights or loud noises
• Lack of understanding of neurodivergence and neurodivergent experiences by healthcare providers
• Lack of understanding of how to adapt care to suit neurodivergent people better
• Fear and anxiety around medical consultations or procedures

In an international 2019 study of 507 Autistic adults, some of the most prevalent barriers to healthcare included difficulty deciding whether symptoms required a visit to a General Practitioner (72%), not feeling understood by medical professionals (56%), experiencing issues with making appointments over the phone (62%), the environment of the waiting room (51%) and problems communicating with a doctor (53%). This study goes into great detail about the barriers faced by Autistic people in the British healthcare system, exploring a wide range of areas such as anxiety and communication. Only 3% of Autistic people reported not experiencing anxiety about going to see a doctor, compared with 33% of non-Autistic people. As well as this, many Autistic respondents reported difficulties with summarising their medical issues, and 66% noted that they felt the need to “tell the whole story and not leave anything out”. Only 12% of the non-Autistic respondents reported this. Autistic respondents also stated that organisation and planning around healthcare was also a major barrier. 59% reported difficulties with making appointments in advance, 58% reported challenges with prioritising their health issues, and 56% found it difficult to change their habits or lifestyle. 30% also reported arriving for a healthcare appointment on the wrong day, and 45% reported forgetting about one entirely (Doherty et al, 2022).

Sensory Barriers

For many neurodivergent people, sensory barriers can play a major role in them being put off from receiving treatment. In a 2022 study of 62 Autistic adults in Sweden, participants gave their opinions on the sensory barriers faced by Autistic adults in healthcare settings. Barriers experienced by the participants included:

• Light levels – Autistic participants perceived healthcare environments as being particularly stressful when lighting levels were outside of their control, such as in waiting environments or rooms shared with other patients.
• Auditory barriers – “Autistic participants identified auditory inputs as one of the greatest stressors in medical settings”. Some examples of specific causes of stress include the sounds of TVs, ticking clocks, alarms and phones. Many comments were made by the respondents about the need for sound insulation between rooms, as well as sound-absorbing materials within the rooms.
• Proximity to others – Close proximity to others can be very offputting for Autistic people. In the study, odours, movement and other input from nearby people contributed to a sense of unpredictability and stress. Some expressed a desire to wait in a separate room or outside. Some suggestions made by participants included the use of armchairs rather than couches, making sure seats didn’t face each other and dividing rooms into smaller sections (Strömberg et al, 2022, p. 71).
• Tactile sensitivities – “Some Autistic participants found the tactile feeling of blankets in patient rooms bothersome”.
• Smell – Participants in the study mentioned olfactory (smell-based) concerns less often than auditory and visual inputs, but it was still a concern as a source of “emotional adversity or sensory overstimulation”.
• Pain – “Atypical perception or expression of pain” was also among the barriers the survey participants thought healthcare providers should be aware of (Strömberg et al, 2022, p. 73). An autistic person may have a low pain tolerance or express pain in an unusual way, which may complicate their healthcare experience.

Doherty et al’s study also provides further examples of sensory issues faced by Autistic people. Some examples provided by the study include:

• Issues with being touched during examination (experienced by 25% of respondents), or primarily with unexpected touch (32%) (Doherty et al, 2022, p. 5).
• Sensory issues may also cause issues with communication. In Doherty et al’s study, sensory issues were reported to be a barrier to communication for 31% of respondents (Doherty et al, 2022, p. 5).
• Preference for written communication – 41% of Autistic respondents reported that it is easier for them to communicate in writing, and 30% expressed a desire to avoid face-to-face communication (Doherty et al, 2022, p. 3).
• Difficulties with unpredictability – Autistic respondents reported more significant difficulties around unpredictability compared to non-Autistic participants, such as finding it problematic to not know what would happen during the consultation (63%compared to 16%), not knowing which doctor they would be seen by (58% vs 24%) and the length of the consultation (40% vs 85%) (Doherty et al, 2022, pp. 3-5)
• Support needs – 21% of Autistic adults reported “needing a support person to come with me”. (Doherty et al, 2022, p. 5)

Another study (Raymaker et al, 2017) of 209 Autistic people highlighted the following barriers:

• Difficulty following up on care (23% of respondents) – e.g. going to the pharmacy, taking prescription drugs at the correct time or making follow-up appointment
• Worrying that interacting with the healthcare system will cause high stress levels or meltdown (26% of respondents)
• “Frustration or anger keeps me from getting primary care” (23% of respondents)
• Problems understanding the healthcare system or finding it difficult to progress through (27% of respondents)
• Finding it difficult to process information quickly enough to participate in a real-time discussion about healthcare (32% of respondents)
• Feeling that your own behaviours are misunderstood by healthcare providers or staff members (20% of respondents)(Raymaker et al, 2017, p. 18)

Barriers to healthcare for individuals diagnosed with ADHD

Alongside Autistic people, those diagnosed with ADHD are also presented with a variety of barriers to healthcare. Some examples of barriers faced by those diagnosed with ADHD include:

• Struggling with the bureaucratic process of accessing healthcare (e.g. finding it stressful to collect medications every month, and having problems with remembering appointments)
• Healthcare professionals not having an adequate understanding of adult ADHD (Cambridgeshire & Peterborough Insight, no date).
• Stigma – significant societal stigma around ADHD still persists. Someone may place this stigma upon themselves (e.g. by viewing themselves as “lacking discipline or motivation”), which may deter them from seeking care.

Psychiatric Healthcare

Neurodivergent people are much more likely to experience mental health issues that they may need treatment for. Some of the barriers faced by the Autistic community in accessing physical healthcare also exist in a psychiatric context, but some are different. For example, neurodivergent people, who are more susceptible to mental health issues, may need to access diagnoses and mental health support which may have uniquely long waiting times. For example, the UK’s Child and Adolescent Mental Health Service (CAMHS) is notorious for its very lengthy wait times, with many vulnerable young people having to wait months or even over a year to access treatment (Rethink Mental Illness, no date).

Barriers that may be faced by neurodivergent people in accessing mental healthcare are as follows:

• Potentially complex pathways to receiving the appropriate support
• Healthcare professionals lacking the appropriate support, knowledge and confidence in taking someone’s neurodivergence into account when providing care
• A psychiatric care provider requiring service users to “self-report” symptoms, which may not be easy for Autistic people who struggle to articulate how they feel and may therefore not receive the care they need.
• Difficulties recognising the symptoms of mental health issues

(Cambridgeshire & Peterborough Insight, no date)

Community views on healthcare barriers

The following are quotes from forum users who are members of the Autistic community (minor edits have been made for clarity).

On not feeling like you are being taken seriously:

“I often feel the need to hide that I am autistic because doctors, nurses, and other medical staff tend to stop listening to me and refuse to take me at my word if I disclose. It is frustrating to feel like I have no say or autonomy, I would very much like an emphasis on treating autistic patients with the same amount of respect as a neurotypical patient.”

On sensory differences and communication issues:

“I react differently to pain, lights, sounds, and need to know what’s happening so I ask questions. Nurses sometimes can’t deal with that and assume I’m being rude or noncompliant. I also understand things differently, so we aren’t communicating on the same page. These problems have led me to getting hurt by nurses, but they didn’t believe that they hurt me. Nurses also use a ton of pleasantries and small talk and it’s confusing, especially if I’m overwhelmed”

On “symptom-centric” rather than person-centered care, as well as the experience of meltdown:

“Women aren’t taken seriously and healthcare in the US treats the symptom not the patient. Few months ago I had a meltdown in an urgent care office and it was one of the worst experiences I had. I just cry and go non verbal but nobody in the office knew how to handle it and made things much worse. I avoid dealing with anything healthcare related as much as possible.”

Conclusion

Healthcare systems are supposed to provide equitable care, yet evidence from around the world makes it clear that access to healthcare is often still made difficult for many neurodivergent people. From communication challenges and sensory sensitivities to gaps in professional understanding, these barriers to healthcare are not isolated incidents but systemic failures that place neurodivergent people at a significant disadvantage compared to their peers. To overcome these challenges, the world’s healthcare systems need to make efforts to avoid “one-size-fits-all” approaches and listen to the needs of the neurodivergent community to promote truly inclusive environments.

Healthcare providers should take concrete steps to address these barriers, such as by making an effort to accommodate different communication styles (e.g. written communication), incorporating sensory-aware design into healthcare environments and ensuring that neurodivergent experiences are respected rather than dismissed. Although progress is being made, true healthcare equity cannot be achieved until these shifts in the approaches of healthcare providers occur fully.

References

Cambridgeshire Insight – https://cambridgeshireinsight.org.uk/mentalhealthneedsassessment/mental-health-needs-assessment-chapter-two/inequalities-in-mental-health-and-mental-health-services/equality-and-diversity/adhd-and-autism/barriers/

Doherty et al. (2022) – https://bmjopen.bmj.com/content/bmjopen/12/2/e056904.full.pdf

Raymaker et al. (2017) – https://pmc.ncbi.nlm.nih.gov/articles/PMC5362353/pdf/nihms819405.pdf

Reddit – AutismInWomen – https://www.reddit.com/r/AutismInWomen/comments/1aj2szy/navigating_healthcare_as_an_anxious_autistic/

Reddit – AutisticAdults – https://www.reddit.com/r/AutisticAdults/comments/1f9dk5f/what_problems_with_health_care_do_you_have_im_a/

Rethink (2024) – https://rethink.org/news-and-stories/news-and-views/2024/the-hidden-toll-of-camhs-waiting-lists-on-young-people-s-mental-health/

Strömberg et al. (2022) – https://www.liebertpub.com/doi/pdf/10.1089/aut.2020.0074