Buck Bond Group
How employers can better support neurodivergence in the workplace

How employers can better support neurodivergence in the workplace

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Amanda Cran, Principal and Healthcare Proposition Leader at Buck
Laura Brown, Senior Consultant at Buck

Neurodiversity; what is it?

Everyone is unique, and our brains work differently. Neurodiversity encompasses the range of differences in individual brain function and behavioural traits, regarded as part of the normal variation in the human population.

Neurological conditions, such as dyslexia, dyscalculia, attention deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD), to name a few, are now more commonly recognised. In recent years, many companies have come to better understand the skills neurodivergent employees can offer, including in pattern recognition, memory, and mathematics.

As a result of a better understanding of the value that neurodiverse employees offer, an increasing number of companies have revisited their HR processes and policies in order to access neurodiverse talent. Improvements in these areas have reportedly resulted in boosted productivity, increased innovation capabilities, and improved employee engagement.

Accessing diagnosis

Whilst neurodiversity is being more widely discussed in workplaces (as well as in the wider community), there continues to be a real battle with accessing diagnosis.

Parents or guardians with children exhibiting neurodiverse behaviours can feel a little lost in how to best navigate the NHS Children and Young People’s Mental Health Service (CYPMHS) which assesses and treats young people with emotional, behavioural, or mental health difficulties.  They may also face challenges in accessing support through the school, with many schools having little or no budget for support in this area. This has been exacerbated by the pandemic, with a c.3 year waiting list to get a child assessed, as well as significant variation as to accessibility of support available from area to area.

In addition to the challenges of diagnoses for children, there will be a number of adults remaining undiagnosed, not only due to accessibility of diagnosis, but additionally due to societal pressures; some may also be concerned about a potential impact on their career.

It’s also worth highlighting that, with regards to the diagnosis of some conditions, gender also plays a significant part, with a U.S. study* concluding that there’s only one female receiving an ASD diagnosis for every four males. Recent thinking suggests that this is because the diagnosis criteria were almost entirely developed using male presentation of symptoms and behaviours, and are therefore biased towards male diagnosis, rather than because gender impacts the likelihood of having ASD.

For those undiagnosed adults, this may have meant many years of constant feelings of anxiety, bouts of depression, and cycles of burnout, as well as challenges with sleep.

Whilst some industries have been trailblazers in adapting their workplace culture to attract neurodivergent talent, many are still grasping with what it means for their business, and how they can/should support.

So, how has the healthcare market developed in supporting neurodiversity?

Well, you could argue maybe not very much.

We’re increasingly seeing other hot topics such as gender dysphoria and women’s health appearing as headlines in supporting employee health and wellbeing; however, with an estimated one in seven of us (more than 15% of people in the U.K.) being neurodivergent, combined with the lack of accessible healthcare services for diganosis, it would suggest a growing demand on employers (and by extension, their employee benefit provider partners) to offer support, education, and benefits to better address employees’ individual needs, as well as those of their families, to reach their full potential, both from a wellbeing and career perspective.

While some providers state they will pay up to diagnosis, this is often not clear in their terms and conditions. Additionally, our experience has shown that if a GP referral letter makes any suggestion that the referral may result in a neurodivergent diagnosis, or the referral includes a full physiological or educational assessment, it’s likely the provider will decline the claim.

Some larger corporate clients have taken to supporting diganosis by incorporating a bespoke fund within their benefit design, but this comes with its own problems. Many providers don’t have a developed network of consultants they can recommend, which leaves the individual to navigate the system without support, unless their GP has specific experience in this area, and knowledge on how/where best to obtain a diganosis privately.

Even where a diagnosis is made, however, a private medical insurance (PMI) scheme will not usually cover any ongoing treatment or support – either under the standard “chronic conditions” exclusion applying to most policies, or under a specific exclusion for conditions of this nature.

Additionally, where a diagnosis has been made privately rather than via the NHS, and results in a requirement for ongoing consultations and drugs to manage the condition, it’s likely that the individual will also not receive any support via the NHS, leaving them to foot the bill for their ongoing needs, or go back to square one in waiting for an NHS diagnosis.

Where the market has perhaps become more understanding of the clinical needs of someone with a neurodivergent condition is in supporting the frequently co-existing mental health conditions such as anxiety and depression.

Is private healthcare the answer?

Arguably there appears to be a demand for PMI providers to look to support diganosis, particularly in supporting children, and certainly this is something they are looking at more closely.

In the meantime, however, when it comes to supporting employees in the workplace, there are many other ways that an employer can provide support, often within existing employee benefit programmes. These are often readily available resources; it’s just knowing where to find them.

  • Occupational health: What support can your occupational health (OH) provider offer? Quite often a good OH provider will have knowledge of the right specialists in this area, and some may partner with a specialist company that’s able to not only obtain assessments, but also think about adjustments that can be made to the working environment, and provide a management training programme.
  • Employee assistance programme: Your EAP will likely offer an online hub of varying information, which can include guidance to understanding and supporting colleagues with a neurodivergent condition. Support for managers is also usually available, which can assist in improving understanding and approach.
  • Group income protection: Your GIP provider may also provide manager guides, and partner with a specialist that can offer guidance in workplace adjustments.
  • Digital tools: Both healthcare and GIP providers offer value-add digital tools which can assist with management of mental health conditions. Additionally, mental health pathways can be inclusive and responsive to diverse populations and individual needs should anyone be struggling with a mental health or a substance misuse issue.
  • Charities: There are several U.K. charities with a focus on neurodiversity, offering information and support to better improve understanding. For example, the ADHD foundation offers an employer’s guide to ADHD in the workplace.

More than anything, companies need to recognise neurodiversity as a social category similar to ethnicity, sexual orientation, gender, or ability. This will allow them to create a culture of education and openness in order for employees to feel empowered and allow them, and the business, to reach their true potential.

* American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (5th edition). American Psychiatric Association: Washington, DC, USA.