The Social, Cultural and Discursive Construction of Autism as a Mental Health Condition and Disability: Different Perspectives

In Chap. 3, we outlined the clinical and medical position of autism, setting the context for the discursive and inquiring position we take throughout the book. In Chap. 2, we presented a more social constructionist argument for understanding how autism came to ‘be’, challenging the language of impairment and the social construct of normality. In so doing, we considered some of the critical models of disability for understanding how and where autism fits on the spectrum of disabling conditions. The clinical position, whereby autism has been constructed medically as a neurodevelopmental condition, a brain disease, potentially explained by psychobiology and genetics, characterized by impairments, and positioned on the clinical manual (DSM-5), strongly asserts that autism is a mental health condition, a disorder, a disability, requiring psychiatric input and treatments that are both pharmacological and talking/behaviour therapy based. Such positions based on the medical model, posit autism as the responsibility of psychiatry and mental health services more broadly, with such practitioners assuring diagnosis and treatment is done within the realm of clinical responsibility. Ostensibly, therefore, based on such psychiatric assertions, one could argue that autism is a mental disorder and thus constitutes a psychiatric disability. Indeed, this position is accepted by some, and the pathways of care, access to services and supports, and the way in which those diagnosed with autism are treated, are in some ways contingent on this prevailing view. However, there are many critics of the medical ideology of autism, and we have already included and alluded to various scholarly positions thus far in the book. We move forward through these debates here in this chapter.