A new patient walks into my office, looking like a lot of my patients do: exhausted, overwhelmed, and unsure whether I’m going to be just another doctor who doesn’t believe them.
They’ve already seen a dozen specialists. Some have said “it’s just anxiety.” Others didn’t even say that much.
They’ve been told their test results are normal—and therefore, they must be fine.
But they’re not fine. Their daily life is shaped by unpredictable crashes, pain flares, temperature regulation issues, difficulty tolerating food, brain fog, and more. Many have trouble standing up for more than a few minutes without symptoms. At each appointment, they’re patted on the head and sent home with nothing but a printout on mindfulness.
Eventually, they stop asking for help.
As an autistic physician supporting autistic patients, I witness firsthand the ways in which the healthcare system has failed autistic and other neurodivergent people. Many of my patients have spent years—often decades—battling not just their health conditions but also a system that invalidates, dismisses, and disbelieves their experiences. That harm adds up. Countless individuals are left struggling to access care that truly meets their needs.
When I discovered that the average life expectancy for autistic adults is 36 to 54 years , it shook me to my core. (See Premature mortality in autism spectrum disorder and Injury mortality in individuals with autism) The primary causes of these premature deaths—early cardiovascular disease and suicide—underscore a public health crisis that demands urgent attention. Equally alarming, adults with ADHD face a fourfold increase in the risk of early death compared to their neurotypical counterparts. These stark realities highlight the necessity of reimagining healthcare for neurodivergent people, by neurodivergent people.
In November 2021, I quit my job in traditional primary care and founded All Brains Belong VT, a 501(c)(3) nonprofit organization that is pioneering a new model for healthcare. We’re building a parallel model—one that integrates medical care with connection, community, employment support, and more. We also provide training to help workplaces and organizations design more neuroinclusive environments.
Most of the people who seek healthcare from All Brains Belong VT have been suffering for a long time, and have medical needs that went unmet by the traditional healthcare system. Among that group, 97% suffer from a constellation—a grouping or cluster—of intertwined medical problems. These conditions are known to be more common in autistic and ADHD people. Each of them is also known to be related to the others.
Some examples, among many, of what belongs to this grouping:
This pattern or grouping is nearly universal among the autistic and ADHD adults we serve. Yet the traditional healthcare system, with its siloed approach, often treats each condition in isolation. This fragmented care frequently leads to suboptimal outcomes, as standard treatments for one part of the constellation can actually worsen the other parts. Managing these conditions as a unified whole often results in a person making more improvements, faster.
The interconnectedness of these conditions requires a holistic approach to care. By zooming out and addressing the entire constellation, we can significantly improve health outcomes. At All Brains Belong VT, our neuroinclusive healthcare model is rooted in this understanding. Our work is guided by a simple but profound principle: everything is connected to everything.
This systems-based perspective has informed our clinical approach, allowing us to:
With support from OAR and the Autism Intervention Research Network on Physical Health (AIR-P), we developed the “Everything is Connected to Everything: Improving the Healthcare of Autistic and ADHD Adults” resource—a toolkit designed to empower both patients and primary care clinicians. This free resource, created with input from over 100 autistic and ADHD community members and a multidisciplinary task force of clinicians, offers:
Since its release in August 2023, more than 28,000 people have accessed these resources.
With additional support from OAR and AIR-P, we have created additional tools for both patients and clinicians:
This work isn’t about special accommodations. It’s about recognizing patterns that have always been there—and giving patients and clinicians tools to navigate them together.
It’s about reimagining healthcare for people who’ve been left out—and offering a way forward that’s practical, respectful, and grounded in trust.
We’re so grateful to OAR for believing in this work. Our hope is that these tools will make it easier for patients and clinicians to navigate these complex patterns together with more clarity, more connection, and more possibilities for healing.
Dr. Mel Houser is a family physician and founder and executive director of All Brains Belong VT, a nonprofit organization in Montpelier, VT, with a mission to support the health and belonging of people with all types of brains. All Brains Belong has pioneered an innovative model that integrates medical care with social connection, employment support, and community education. Dr. Houser provides neurodiversity training to healthcare practices and workplaces around the country about how to create environments where people with all types of brains can get their needs met and thrive.
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