A diagnosis can make a life intelligible without making it easier to live. In a Guardian letter responding to England’s review of mental-health, ADHD and autism services, Rebecca Hope Duncan describes asking for help at 17 and receiving an autism diagnosis at 51. Decades of treatment for anxiety, depression and trauma had addressed real problems without explaining the whole of her experience.
Recognition did not bring the support she needed. Her report also identified ADHD, but she is still waiting for an ADHD assessment and access to medication. The distinction matters: being told what may explain your difficulties is not the same as gaining access to care. “The diagnosis explained my life; it did not come with any help to live it,” she writes.
The review’s proposal to offer support according to need rather than diagnostic labels sounds welcome to Duncan. Her experience tests the promise from the other direction: she already has both a diagnosis and unmet needs. Changing eligibility rules will mean little if services cannot provide help afterward.
These are readers’ letters, not a clinical investigation. Other contributors debate prevention, social conditions and the boundaries of diagnosis; their medical claims should not be mistaken for established findings. The strongest companion account comes from a reader whose wife remains undiagnosed at 70, after growing up when recognition was far less available. Together, the accounts expose two distinct failures: people can spend decades without an explanation, and receiving one still may not lead to support.