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Progress on children’s mental health services is too slow, says commissioner for England

BMJ 2018; 363 doi: (Published 22 November 2018) Cite this as: BMJ 2018;363:k4953

Rapid Response:

Re: Progress on children’s mental health services is too slow, says commissioner for England

Dr Anand draws attention to the silence of the medico-political establishment, over many years, in failing to respond to Mr John Stone, as he has repeatedly drawn attention to the increasing incidence of ASD in those parts of the UK where figures are available. Despite the surprising inability of UK Public Health bodies, Her Majesty’s Government, and Local Authorities, to produce reliable, national, figures for ASD incidence, any reasonable person would likely conclude from the available figures, and from the experience of those in child care and education, that ASD incidence is rising significantly.

Those of us who qualified before1970 may not have encountered autism for our first 20 years of practice, despite interested awareness of the subject.

The veracity of the invaluable service that John Stone renders, and which the BMJ enables by allowing him a forum, is emphasised by what seems to be the collective turning away of those professionals who might seem best placed and motivated to demolish his case. Those whose roles at national and local level contribute to child care, and whose salaries rightly reflect that responsibility.

There is even more widespread concern in the USA about ASD.

An extensive but scattered literature of papers relating to incidence, variability, and aetiology posed problems for researchers until the recent publication of two books, which have collected the evidence.

In ‘Denial’ (1), the authors examine the attempts by corporate, media and professional groups in the USA, to expunge any notion of an “ASD epidemic”. The book examines the evidence for both sides.

JB Handley (2) had access to more recent papers and information, most of which is not made available by our public and professional media.

It is possible that many of those who remain silent in the face of John Stone's concerns will feel too uncomfortable to finish Handley’s book, unless they already agree that “All professions are conspiracies against the laity .“ (3)

Sixty copies of these two books were sent in recent months to Welsh Assembly members, senior doctors in Wales, and a scattering of journalists, including three BMJ editors.

Resulting, so far, in silent intellectual darkness, more befitting the bottom of an abandoned mine shaft than an attempt to stimulate discussion about a possible childhood epidemic . A silence familiar to John Stone, Dr Anand, and possibly to media and corporate PR experts who seem to know that the best way to diminish sources of possible discomfort or criticism is to pretend they do not exist.

1 Olmsted and Blaxill, Denial, Skyhorse, NY, 2017

2 JB Handley, How to End the Autism Epidemic. Chelsea Green Publishing, 2018

3 George Bernard Shaw, The Doctors Dilemma, (1911) act 1

Competing interests: No competing interests

30 November 2018
Noel Thomas
retired/ part time GP
BronyGarn, Maesteg, Wales CF34 9AL