Right. We've got ADHD education and employment, a bigger picture with doctor Jessica Eccles. And nearly a million young people in The UK are not in education, employment, or training. The conversation about them usually, is usually about motivation, about benefits, about skills. And our next speaker's a different question. Of the people who are out there, out of work in education, how many might be autistic and or have ADHD? And how many have ever been told, and what's the impact of that. She's a reader that's associate professor.

In brain body medicine at Brighton Sussex Medical School. She's a consultant psychiatrist in Sussex NHS Neurodevelopmental Service. She trained in medicine at Cambridge and Oxford, she chairs the Royal College of Psychiatrists Neurodevelopmental Psychiatry Special Interest Group. And to emphasize, because she's such an important person with so many important roles, she's speaking on her own behalf, which is a caveat that has to be put in. And she sits on the clinical reference group of the independent ADHD task force, which she just took back to.

Sat on. And you just heard from Professor Thapa. She's a pioneer in the links of brain and body. Her research has found that neurodivergent people are more than twice as likely to have hypermobile bendy joints. She's been honored twice by the Ehlers Danlos Society as a research pioneer. And she's co founded the neurodivergent brain body clinic, which as she describes, the first of its kind in the world. And today she's sharing some brand new findings from a study that ADHD UK have funded. And I have to say, we have funded some of the costs. Like we did not have to fund the time, which he put in at no cost. And so we essentially paid a fraction of the price that groundbreaking research really requires. And it's entirely her generosity.

And skills the reason that happened. And it's actually another good example of little going a long way in terms of donations. You can send your questions in through the q and a box, on her speaker page or go to globaladhd.com/live. And you'll see, if watching you're on the livestream, you'll see the questions beneath there. So anyway, without further ado, welcome Doctor Jessica Eccles.

Hello. Hope you can hear me. I'm just making sure that Chrome can share my screen, which I should have perhaps done before. And I also want to say that that this was... This work could not have been done without doctor Lisa Quatt who was a powerhouse behind showing that where there is a will, there is a way. We had an idea and she made it happen. And so thank you so much. I cannot say thank you enough to doctor Lisa Quatt who has been by my side doing so much important research in this space. So Henry Henry did a fabulous job of introducing myself... Of introducing me. And I just want to say thank you to all of the organizations that support me, BSMS.

And Sussex Partnership Foundation Trust, and all of the funders who have contributed to research, including now ADHD UK. So I wanted to start this off. I don't know whether this will actually play, but some of you with ADHD or other neurodivergent conditions may have heard of earworms. In the summer, in June, I went to Liverpool to talk to the Royal College of Psychiatrists along with Anita Thapar and Samuel Cortese about the importance of neurodivergence to psychiatrists. And I was due to go and give another very interesting talk and I was stuck with this earworm and I want to see if I can play it. Henry, if we can't hear the sound, let me know. Can you hear the sound?

Sadly, I don't think we can. Can't hear it. Don't worry. We can't hear it. If you... We we can't hear it, so we'll probably need to move on. Don't worry. Don't worry, Henry. So this is Neil Young in, I don't know, the eighties or the nineties.

Something called Farm Aid singing, hey, hey, my, my. And it is a song where he says, there is more to the picture that meets the eye. They give you this and you pay for that. When you are gone, you can't come back. And, Henry, I saw you on Good Morning Britain after the, you know, the great ADHD myth channel four documentary. And the presenters kind of ask you why we should take ADHD seriously. As Anita has said, ADHD are the neurodivergent conditions, not only do they cost money, they cost lives. And this talk is dedicated to Al and to Ted and to all of my patients and neurodivergent siblings, to all of the people who have fallen and fall through the cracks. Serendipity is a big thing. So here on the left is professor Hugo Critchley.

I met him in 2009 and he has changed my life. He has taught me about, neurodivergent as a whole. He came down from London, having been working in the Tourette's clinic And he helped set up a service in Sussex that looks at ADHD, autism, and Tourette's together. He also got me researching into hypermobility. It is wonderful to have been able to work with him and to continue to work with him. I want to say thank you to Jane Green from SEDS Connective who has been thinking about these things for a very, very long time and also for the conversations that we have had and for you inviting me to speak. So is medicine political? I get this a lot, you know. Shouldn't we keep health and politics separate?

Well, I would say if you have ever been ill or loved anyone who is ill, then we cannot possibly separate health, medicine, and politics. So we know and, you know, you're just discussing with Professor Feybar that there is this narrative and it continues about this idea of over diagnosis. Professor and I were writing an article, about misinformation. Over diagnosis isn't even an actual word really. It's got a very specific meaning in cancer. Things could be misdiagnosed or under diagnosed, but it seems to have caught light. And, the very day that this was published in The Guardian, West Streeting went on, Laura Kunsberg and said mental health conditions were overdiagnosed. In the meantime, professor and her team showed.

That the economic costs of ADHD are avoidable as when appropriately supported individuals with ADHD can thrive. But we know that the under recognition of neurodevelopmental conditions has severe consequences. And I will say now and I will say again, what do people mean when they use the word mild? Neurodivergent people have increased rates of suicide, substance use, chronic physical and mental illness, shortened life expectancy, educational and occupational exclusion and unemployment. And these translate into societal and economic costs that exceed those of cardiovascular disease and diabetes combined. That is an estimate of putting together Anita's 17,000,000,000 for ADHD and autistic is 30,000,000,000 for autism. So was... This is, after.

The prevalence renew, review, was announced. I was surprised to see myself mentioned, in this journalist article. West treating must stand up to the ADHD activist. I am scientist. I am a patient. And if believing a condition is real and wanting, to improve people's lives, outcomes, opportunities, and education, and employment is activism, then I am proud to be an ADHD activist. So the new narrative is that we have the prevalence review and we also have on, you know, mainstream television the idea that a condition such as ADHD which which hundreds and hundreds of thousands of articles have shown is real, is a myth.

Anita and I, along with Heidi Phillips, I'll tell you more about Heidi in a minute, we wrote a response to that. But Henry, you were there at the vanguard, you you you, you you stood up and said what we all needed to say before anyone else did. But we know that ADHD is real. I mean everything has so by is bio psycho social, but most importantly it responds to treatment and the treatment can be really effective. What we need is not to, try and pretend that conditions don't exist is we need equitable timely access to high quality assessments and treatment to reduce the risks of adverse outcomes. And, we, yeah. I mean, I'm I'm I'm practically speechless as you were on Great Morning Britain. Good Morning Britain. We.

We have the tools to do something about this. But we know that this this is just keeping going round in circles. And I found this, Ben Branson, he founded the hidden 20%. He listed all of the different articles. This was last week in which different perspectives on the prevalence, review, were cited. And you can see they're all, it's all different. We don't know what's going on. And as Anita says, until we have read the report, we cannot possibly... We can't, you know, hypothesize ahead of the of the report. But what I would like to say is that it is all the solution is all about education education education. So I, gave a talk a while back, to a group of people, psychiatrists.

Asked them if ADHD and autism detract from the core business of their work. This is what they said. This is what they said. After I gave the talk, more than, 85% of them answered that question differently. They said that it was their business. But look what they need. They need training. They need resources. So we need to upskill, the health and education sectors in the workforce to recognize what they are already seeing every day and allow neurodivergent people to thrive. So why is there more to the picture than meets the eye? Well, you've already said, that you know, the Melbourne review is focusing on the one million 18 to 24 year olds who are not in employment education and training. Interestingly.

1,000,000 is about the size of Glasgow. Last year, there was about the size of Manchester waiting for an ADHD and autism diagnosis in England alone. Now, it is 1.2 to 1,300,000 the town the size of Glasgow. So as I said, remember why this isn't so important and Anita just told us. So the big idea, there's more to the picture than meets the eye is this is the elephant in the room. Neurodevelopmental conditions ADHD is everywhere and we need to support people and we also must not forget that ADHD is not just a brain condition, it is a body condition and it has huge impacts on mental and physical health. So what did we do, Henry? Well, after, Henry, we looked into why people who were not in employment education and training.

Was there any reason, was there any association with possible ADHD or autism? And we thought, if we, you know, if we advertise this to people on my social media or anyone on this conference's social media, we'll get a load of people with ADHD. We need to try and have as unbiased a sample as possible. So we used a market research company called Prolific to find us 300 people across the age span, so 18 and above who were not in employment, education, and training, and we matched them to 300 people who who were. Were. So that was it to estimate the likely the frequency of likely often undiagnosed autism and ADHD in UK adults of working age and to examine whether neurodivergent traits.

Are associated with not being an employment education and training and whether there is any relationship to health burden and educational attainment. Many people, some commentators have said that conditions like ADHD are a sick note for life. We know that is not true. Henry is here talking to you with ADHD. I am here talking to you with ADHD, but why can it go wrong? So disabled people and those with long term health conditions are over represented amongst people not in employment education and training. But no one had really looked at the precise contribution of ND to this disparity. And also there are, you know, diagnostic biases. It is really hard to get an ADHD diagnosis. Really, really hard. So.

There are lots of people out there who may be undiagnosed and there are societal factors that influence that too. So what did we do? We took these 600 people, three hundred in, not in employment and 300 in employment. We matched them for age, sex at birth and ethnicity, and it was representative of The UK population. It's considerably harder to, we had to wait longer for the male replies and the female replies, but that's another story. We used some, ND screening tools, some views on accessibility factors and general health information. Lisa Quatt, she put this together. She did the ethics. She analyzed the data. She made these slides. I am just telling you. So, we, we we... They're the same age.

And they were... We we matched them so that they were generally the same, proportion of assigned female at birth and assigned male at birth. And as you can see, majority white but reflective of The UK population. And, as you would expect, a much higher level of, education in those in education and employment and training right down to GCSEs. So I think we've got to go right back to the very beginning. We do not... Sticking plasters now, they may they may be a sell, but we need to get to the root cause. So what did we find? That the not in employment and education group had higher physical health problems. They had greater numbers of mental health conditions. And although the diagnostic rates of of ADHD or autism were identical.

In both groups in terms of what they already knew about themselves, what they had had diagnosed seven percent, we found that if you screened likely autism, which is just a screening tool that has limitations, you were twice as likely to not be in employment education and training. You know, that was actually sixty six percent of those samples. And then if we look at ADHD, one and a half times more likely to to not not be in employment education or training. But both groups, the same very low diagnosis rate in the beginning. So this is what I think is absolutely imperative for ministers, government, for policy makers, for education makers to understand is there is a dual mediation. So a mediation is a process.

So how does the presence of neurodivergent traits lead to not being an employment education and training? It is through two pathways. It is through a pathway of educational failure as in not just the... Not the failure of the individual, but the failure of the education system, and it is in overall health burden. So neurodevelopmental conditions, physical and mental health factors, difficulties with education combined to mean that people are not in employment education or training. And so this is a multi system problem. We need joined up solutions. So what was interesting is, we asked, you know, to what extent is your current place of employment or education enabled you to manage your sensory environment, authentically express yourself.

And you can see that that there is, you know, we need, well, accommodations is one word. Lisa did a, doctor Lisa Quat. She did a good, look into the latest literature on this. Reasonable adjustments are in fact equitable requirements. So for those not in education and employment and training, to what extent did your previous place of employment enable you to manage your sensory environment or conditions or to authentically express yourself. And you can see this is like not at all. Tiny, tiny, tiny amount. But when Henry and I were talking about this, most people, the majority of the workforce, are working in jobs where accommodations are not straightforward. They are people serving food. They are people.

Working in shops. They are people on delivery drivers, on bikes, making reasonable adjustments for the sensory environment. We have to be more creative. So, you can see that accessibility is massively important. And, therefore, more detail this paper is available as a preprint. It has not yet been peer reviewed, but it is in the process. And what we need is to understand the intersection and the fact that these factors are converging. ADHD, autism, physical, mental health, educational difficulties. So, we need making unidentified neurodivergent makes asking for support difficult. Sensory executive functioning and social differences are often not effectively supported.

There is inequality and lack of support for neurodivergent people starts in primary school. It starts in secondary school. In fact, it could even start before. Remember sure start? What happened to sure start? Myself, Helen Minnis, professor Helen Minnis, and, doctor and Claire Jameson in... From the University of Glasgow working on a paper called the Vantage Point. How can we intervene as early as possible? I'm talking before even primary school to make sure that we enable people to thrive. So again, some thoughts on the word mild. This has been banded about by journalists, by, certain doctors. There is no such thing as mild ADHD. It is not in the classification system.

Children children grow up to be children. You see ADHD error there. Children grow up to be adults. And what may appear mild or, not particularly troublesome in childhood is, a whole other level to what it is to experience psychosis, mania, substance misuse in adulthood. So we need to remember that children grow up to be adults and that they have problems, but there are different problems throughout the lifespan. And not being able to be in school is far more than school based anxiety or difficulty paying attention. It is often physical health related too. And Jane Green from SEDS Connective has done some fantastic work in this space. But mild doesn't exist with ADHD. It isn't an actual term.

And functional impairment is required for a diagnosis. So we need an integrated approach because, ADHD neurodevelopmental conditions, they co occur more often than they appear in isolation. They are at least twenty percent, if not more, of our general psychiatry clinics. It overlaps, you know, in psychosis and severe mental illness, neurodevelopmental conditions are associated with greater complexity, service use, educational and employment difficulties. Neurodivergent people are particularly vulnerable to mental and physical health problems and complexity arises because neurodevelopmental conditions, trauma, physical health and mental illness coexist. We need to think about the whole person and not just ADHD or.

This person is not working. We need to look at the whole thing together. So this is the elephant. This elephant could be neurodevelopment and it could be physical health too. And, we need integrated pathways and mandatory transdiagnostic neurodevelopmental training across psychiatry, medic... Medicine, education, health. So So I'm not going to dwell on this, but this is a typical case in our NHS service. If people who are, you know, many psychiatric diagnosis, physical health problems in and out of hospital, we want to intervene before this is the case. We're just publishing. I've finished the proofs yesterday. Eighty percent of people attending our mental health liaison service in a psychiatric crisis were likely autistic, hypermobile.

And worst quality of life. Israel Hussein, a pediatrician doing research under my supervision. She has shown that of children attending the children's accident and emergency department with mental health problems, nearly seventy five percent of them are likely neurodivergent. We need to intervene early. We have shown, you know, neurodivergent and psychosis ten years earlier, age of onset, twice as much, hospital stays in acute, service use. Neurodivergent and sensory processing seem to be driving the relationship between hypermobility and bipolar. And, we are doing research that shows that autism and ADHD in the presence of physical health problems combine.

To lead to the likelihood of self harm in the ALSBAT birth cohort, a phenomenal number of children, kind of six thousand. The same thing with eating disorder. Big thank you to professor Janet Treasure and also to Israel. And no one talks about Tourette's. Hello, Tourette's Action if you are watching. But we showed in our neurodivergent brain body clinic that obsessive compulsive features associated with tics were present in almost all of our ADHD and autistic patients, and they were the greatest predictor of emotional difficulties and suicidality. So the elephant. I'm not going to dwell on hypermobility, you can check out BendyBrain YouTube and other webinars, but this is a physical reason why people with neurodevelopmental.

Conditions are more likely to experience physical and mental health problems. We've shown that the neurodivergent group are more likely to be hypermobile and that hypermobility explains the link between physical and mental health problems. Neurodivergent people more likely to experience emotional problems like dysregulation, but this is traits And this is because of a sense of uncertainty about where you are in space, and this is double in hypermobile people. This is the elephant. The elephant is what Henry talked about on Great... On Good Morning Britain. People are dying earlier. Life expectancy is less. Risk of suicide is higher. This is complex. We need serious solutions to serious problems, but we have them in reach. ADHD medicine.

Is one of the most effective interventions in medicine, reducing criminality, criminal convictions, suicide, traffic accidents, all sorts of things by about twenty percent. And again, let us think about needs and mild. Yes. We need our needs met, labels to get access to medication. Do not think that it has to be one thing or the other. It can be both and. Do not exclude people on the basis of a neurodevelopmental condition. Do not let people think that and just because you have a neurodevelopmental condition, you can't have a mental health or a physical health problem or vice versa. So this is what we need is training and resources. This is our postcards from the coal face.

Psychiatry, medicine, and education face a choice between continuing to ignore this or fully integrating neurodevelopmental understanding into everyday practice. Recognizing recognizing and diagnosing neurodevelopmental conditions is not a niche task but likely a core responsibility of every psychiatrist possibly every interested doctor possibly every teacher And this is essential for delivering personalized effective and economically sustainable care. The solutions are in reach on Monday. I was delighted to be taking part in initiative by the Royal College to credential for the first time ever a group of psychiatrists, pediatricians, and general practitioners in ADHD, autism, Tourette's, and fetal alcohol syndrome combined.

This has never been done before. This is funded by NHS England. Thank you. And this is what Heidi, has written about it. We need more clinicians who understand the bigger picture. And this is what makes today feel so exciting. This isn't just about creating specialists. It's about creating specialists who can think more widely than single conditions. You can take that knowledge back into their own fields, share it with colleagues, and help shift the way we understand and support neurodivergent people. The solutions solutions are in reach in Sussex and Surrey. We are piloting a cost effective alternative to Right to Choose where.

GPs with extended special interest of providing primary care ADHD assessments with support from specialist services at a fraction of the cost that, that may be incurred elsewhere. We need integration between pediatrics and cams, between ADHD and autism, between young people services and, adult services, between health, between education, between general psychiatry, and between, specialist neurodevelopmental services. And we need this to start from the very beginning. We need early intervention. And why might we be getting this done? Well, by conversations with film director, Nigel Cole, we showed that hypermobility which is a common physical feature associated with ADHD, not AD and, autism is linked to creativity.

Because of neurodevelopmental characteristics. And, we have a paper out about this in a matter of weeks, but creativity, they give you this and you pay for that. We need to balance the strengths and the challenges. There is more to the picture than meets the eye. Who am I? I am a patient in doctor's clothing. And where there is art, there is hope. Without research, it is guesswork. So thank you to everyone along the way, particularly Rebecca Dew and Lisa Quatt and Jane Green. All of these people, Helen Minnis, Rishka Gajwani, Oliver Dale, Connor Davidson, autism champion, Ulrich Muller Sedgwick, ADHD champion, and to the support of Anita Thapar and and to Henry and to Heidi Phillips. Thank you very much. But one final disclosure.

Of interest, this is from my slides, to Liverpool. I have a lot of physical health problems. I am powered by Gaviscon and ADHD medicine, which unfortunately, my tea got into. So lest we forget our siblings who have, not had the support that that we have and, the solutions are in reach. Invest to save money and lives. We need resources and training. Thank you very much. Please find me on YouTube and Linktree and reach out to SEDS Connective ADHD UK and ADHD Aware for support. Thank you.

Well, thank you. That was amazing. And and I think it shows what a sort of powerhouse and force you offer changing good within ADHD and to the the wider community. It's like a bit... It is a big deal. And I'd like... We obviously converse quite a lot, and I I really know how much energy and work and how... And often actually how difficult it can be for you and how you push so hard for change. And I I think you're extraordinary.

Oh, thank you, Henry. But I think it shows, doesn't it? That where there's a will, there's a way. And we need people to to join forces and to show what can be done. So we we needed, you know, ADHD UK kindly funded that study, and we were able to use the resources within our our medical school to make it happen. But we need... As I said, MQ, a former funder of mine. I was an MQ versus arthritis fellow. Without research, it's just guesswork. We know this, but we need the research to prove it. But will anyone listen? That is unfortunately the the the question, isn't it?

It is. And I think that the fact the decisions that have been made with a vacuum of research like, really where we look at... Significant to look at part of the cutting of ADHD services, not providing service to needs, blocking, recognizing solely the cost of providing the service and not the benefit, in the moral and economic benefit to individuals and the country. And this is because the research hasn't been done. It's a huge frustration. But willingness to make decisions in that vacuum is one of the things that are very, very sad and difficult. And thank you for mentioning me on Good Morning Britain pushing back against the ADHD myth show. And, of course, thank you to everyone who, well, people will have noticed. But.

Doctor. Eccles is very, very powerful in putting out statements that journalist community to to push back against the narrative and actually a lot in the background too. So the others along as well, she did a fantastic job on it. It's it's one of those unsung things I'm trying to think now that you can get what you you can put in. So thank you. So... And...

Oh, we've had a whole lot questions. Your mic is coming in and out, by the way. Yeah. No. I think I've got... There's building work. I'm just gonna try and plug in some headphones, so give me one second.

Okay. Well, as you do that, I'll attempt to give you what it will be your potentially favorite question. It's the most upvoted, and I have confidence that you will be pleased to be answering it. My son is very Bendy, hypermobile, and has ADHD. And his GP has not heard of the link and neither had I. What should we be telling doctors?

Yes. Headphones don't work. EDS UK GP toolkit, Go on BendyBrain Linktree and there are loads of resources. It exists. Unfortunately, it takes a while for things to catch up. I'm just going to close the window because there's a lot of building work outside.

If she does that, I'll also like... Let's we've got the the... So Jessica, we've got the most equal upvoted comment. Yes. It is I love doctor Eccles' passion, good humor and knowledge. Heart, heart, heart. Thank you. She has encapsulated how I feel about ADHD. Please tell her she is amazing.

Aw. You are amazing.

John, Donna, Amy, n.

And I think the thing is, Henry, is we... I mean, I never went into this field because I I didn't know I had ADHD when I started researching hypermobility and how it affected anxiety. But I I have seen my patients how important proper understanding, getting a decent diagnosis and explanation for their difficulties, how transformative that can be. And it's also... It's like a butterfly flaps it or swings in China. It is a ripple effect. Every person who gets better understanding and support this, like, cascades in families, in institutions. And I do think that this is an example of what we consider a paradigm shift. One day, we will look back and we will think, what the hell? Why didn't we understand what, being.

You know, thinking differently and having a different body meant? We see ADHD and, autism, you know, in literature. Shakespeare describes it, my one of my favorite childhood stories and Green Gables, clearly ADHD. And Sherlock Holmes, if you read Sherlock Holmes, he was written as hypermobile. He had a long thin face. He had long thin fingers and soft skin. He had addiction problems and And he... Yeah. It's always been there. You just need to know how to look for it.

We've got a slightly relevant question. Before we do that, and this is putting you on the spot and we'll move on quickly, but like, were mentioned in Shakespeare? That's new to me. Well.

If you if you think of the closing scene of Withnal and I, which is an excellent film, where he talks the soliloquy from Hamlet. He talks about, you know, how he has lost all of his pleasure. Man, you know, pleases not me nor woman neither. Wherefore I know not I have lost all my mirth. But he talks about then in the same passage about the overhanging firmament of stars, know, what, what piece of work is a man and it is, the entire huge and, you know, difficulties with sleep. Shakespeare is constantly talking about difficulties with sleep. You know, anyone who, has ADHD knows about difficulties with sleep. The the whole of human experience is encapsulated, I think, in that passage.

You've done... That was a good reference, like a double cultural reference. And... It's both modern and Modern. That that was solid.... To sweep back, there is more.

In heaven and hell than dreamt of in our philosophy. And there is so much more to neurodevelopment and ADHD than people think.

So you look, you get it all at the globaladhd conference. Not only do you get groundbreaking crowd into people talking about their research, you also get culture. And that's... Honestly, beautifully segues. We have a question very recently posted just as you were speaking. What are the best strategies for overcoming cultural and social stigma when trying to accept a new ADHD diagnosis?

I think it's a really interesting question. Because speak about, you know, having ADHD as, someone in a position of privilege. I sound like I, you know, went to the right schools and did all the right things. I, I think the cultural difficulties are immense. So I want to use an analogy. A few years ago, I was thinking of doing a research project. I wanted to be funded with the Wellcome Trust about anxiety. And so I spoke to a global mental health professor in Ethiopia, and I said, I want to do a research project about hypermobility and anxiety. And he said, oh, hypermobility. Do you mean mass migration? So obviously, we were slightly on the wrong foot.

It has a different associate political term. But he was explaining to me about the groundbreaking research he had done, translating and validating the p h q nine, a depression scale. And in Aramaic, there isn't really... And that's one of the widest spoken languages in Africa. There isn't really language for anxiety and, that doesn't mean to say it doesn't exist. But I had a little look into it and there is a 98% treatment gap in, mental health in Ethiopia. And I was thinking, do people do people really need me to worry about hypermobility and anxiety when, only two percent of the population have access to, mental health treatment. And there is an analogy there with ADHD.

I think culturally some people think, you know, this is, you know, children who can't pay attention in school shouldn't they be better disciplined. This is not actually, you know, we've got far worse problems, you know, we haven't got, you the know, the political unrest, famine, genocide, all of these things. But, actually, if we think, if we look beyond what we see, though, you know, more to the picture than meets the eye, actually, we could identify people who are going to need support earlier on. So I think it's because ADHD isn't taken seriously, and it's a mental health problem. As you said, I think on, Great Morning Britain, Henry, no one would be having the great menopause myth or the great migraine myth. It just goes to show.

That, there is real stigma around what conditions are considered to be mental health conditions. And I fear that that stigma can also be cultural. We need better role models, and we need we need people to be less afraid of, of of coming out at work in higher institutions and saying, I am neurodivergent, and this is how I'm supported. And we need... Well, I don't say we need because it's putting a lot of responsibility, but we need some non stereotypical presentations.

It is. And it's the... It does show the important representation. You obviously doing that, being out there and talking publicly about yourself is a big deal and very important. People are extremely grateful to you. You've got multiple comments. And for example, this one, which I'll answer with a question. Firstly, thank you so much. You have inspired me, both professionally and personally. As an NHS therapist, I've helped hundreds of people through sharing your work and helping them to make all the connections between their brains and their bodies, and how to thrive despite the continuing lack of access understanding.

I've been trying so hard for a long time to get an ND pathway set up for accessing primary care therapy and to face barrier after barrier. Do you have any advice about how we can be making systemic change?

Yes. Thank you so much. And I think this is where so much is needed. I was contacted, I think, Times Radio last week saying someone had interviewed Alan Melbourne about the Melbourne review, which has not yet been published. And that the idea was going to be, rapid access to online counseling and, possibly coaching. And I thought to myself, well, we have actually not for young people, but for 18 year olds and plus. We already have in this, in the NHS in England. We have rapid access to talking therapies, for, conditions like, depression and anxiety. But what we need is them to be to be, to be.

Adapted for neurodivergent because one size doesn't fit all. And we also need to though bust the myth because there is a big thing on the internet that says, you know, if you have ADHD or if you're autistic, CBT won't work for you. That is not necessarily the case at all. It needs to be personalized and with you in mind. And I think this is so true of, of everything of like pain management of physiotherapy. I am laboring under a number of physical health problems and orthopedic problems at the moment and body doubling and, you know, accountability and trying to incorporate things into a routine, trying to understand the role of sensory things is so so important, but the change... We're doing innovative change here in Sussex. We really are.

It needs to come from the very top. It needs to come from, you know, it needs to come from the politicians who need to be informed of, of what's actually going on, and it needs to trickle down into commissioning. But at the moment, in NHS England, for example, which is going to go into the Department of Health and Social Care, autism is an entirely separate strand to ADHD. Autism is in an entirely separate strand to, mental health. This is not related as well to education. We need joined up solutions. We need creative solutions, and they are all there, but the change has to come both from the top and also from the bottom. And it reminds me in some ways of the.

Fierce important work that people in the AIDS and HIV community did back in the eighties. The science went crazy fast, but the feet on the street and the people really made it happen too. So we need both from the top and from the bottom. So thank you to all of the grassroots organizations, Heads Connected, ADHD UK, ADHD Aware, and we need change at the top.

Recently post question and now I've voted to nearly the top. What do you think needs to be done first to tackle NEET in neurodiverse individuals?

I think, well, we need a multipronged approach, but we need to start young. We need to start before people go to school. We need to realize what their sensory needs are. I saw... My mother has ADHD diagnosed at 72. I showed her... She says in BendyBrain episode five about the impact of her neuro... Of getting an ADHD diagnosis. She said she rocked all the time. I saw like a picture on Instagram, which thinks I have a neurodivergent child. I don't have any children. A... A chair that you could... That lets you rock. I... If he... She said if she'd had that sort of thing in school, things would have been much different, much easier. We need to make both personalized accommodations, but we also need universal design to make schools sensory.

Sensory safe spaces. And we need... This needs to start before school. This this needs... And this is this is what I said. What happened to SureStop?

If if you... You know, your comments on how schools are designed if you... We did a panel from on the built environment on the schools. So if you... If you've got an area... Well, if it's an area of passion, I highly recommend that panel. It was just done yesterday. We have another comment. Such brilliant data to share. Real this all is. Thank you for sharing, doctor Jessica. The... Yes, and and the point on starting early, we had a charity meeting between seven charities. We did the leaders meeting yesterday. And one of the charities said that one of our goals is to talk about every adult diagnosis is a failed child diagnosis. That we missed people in school.

And should have got to them. And I listened to it and thought, that is a narrative that we are so far away from.

No. And and also unfortunately... Important and correct. But also, neurodevelopmental conditions, autism and ADHD, they can cause you to come unstuck in later life too. And there are so many people who are only in their fifties, their sixties, sometimes their seventies or eighties learning really who they are. And, we know that ninety percent of, autistic adults 50 are undiagnosed. It'll be the same for for ADHD, but that understanding can be transformative. But there are these transitions in life going to primary school, going to secondary school, going to university, having a job, becoming a parent, but also retiring. So imagine what happens when you retire, and we need we need to support or or as.

Doctor Heidi Phillips was telling me and the others at the neurodevelopmental credential learning day, what happens when you're when you're, like, partner who is, you know, Heidi was talking about, you know, how they are very complimentary in terms of skills. What happens to the... When when someone who is scaffolding you your whole life dies? We need we need support for older people and recognition of neurodevelopmental conditions in older people too.

Certainly, one of the things we see, essentially, is a bump in terms of ADHD diagnosis. People have been in a job which has given them the structure.

Yes. Maybe a secretary even.

Yeah. And this idea that in retirement, you just do nothing and and their busy brain is.

Yes. And lack... And their autistic brain lack of structure and routine and work could have been a special interest, or an intense interest. It is it is, we we absolutely have to go full full on in supporting the young people, but we mustn't forget people as they get older too.

One of the oldest people I know to get a diagnosis was a psychiatrist, And I met them in their mid seventies. And obviously ADHD just hadn't been a big discussion. They hadn't had that awareness. And to your point earlier, they had huge support from their wife. Their wife had passed and they'd realized quite how much they were really struggling.

I think I think this is the thing that people think psychiatrists know a lot about ADHD because they're psychiatrists. It features very little in the curriculum, very little. And there are very... Because neurodevelopmental services and ADHD services are generally seen as a part, especially adult services, not the same for child services. Adult services are seen because it's completely apart from mainstream services. It's perfectly possible to have got through an entire career in psychiatry without really knowing much about ADHD or autism at all. And this is why we need things to change. And the college really are changing that with the neurodevelopmental credential.

With the National Autism Training Program, and the National ADHD Foundation Program. For the credential, which only has 32 places, they closed admissions early when more than 200 GPs, pediatricians, and psychiatrists had applied to learn about this. The appetite is there.

Yeah. Exactly. The people there wanted to. Our last question is we're about to run out of time. If the funding was there, where would you put screening first? Schools, job centers.

GP surgeries, or another? That's not on the spot. Like, you're only... But screening screening, there are problems with screening. I wouldn't use screening to rule out or rule anything out, only to rule it in. I would start with the GP. The GP sees everyone across the entire lifespan. They see the baby when it is, I don't know, six weeks old. They see it before they go to school and the GP... I'm not saying this should be GP's responsibility without resources and training, but they are ideally placed to observe someone across the lifespan. But we need it joined up. It's not either or, Henry. It's both and. We need it everywhere.

Doctor Jessica Eccles, you you are amazing. You've been amazing. Very sadly have to say goodbye. I really can't thank you enough for all your work, everything you you do. Yeah. Thank you so hugely, hugely, for your time.

Thank you. Check us out on BendyBrain YouTube.

Thank you very much.

Thank you very much indeed. And well done, Henry. Good marathon. Bye bye. Bye bye.

She's extraordinary. She's an absolutely wonderful person and an extraordinary advocate for people with ADHD both in research and in public discourse. And I can't tell you how hard she works on this, the energy she puts in and the difference she makes. And it was wonderful seeing those comments come in from people celebrating her and what she's done. And I think just wonderful. The.