Mel Houser, MD is Executive Director of All Brains Belong VT.
As an Autistic ADHD physician supporting Autistic and ADHD patients, I witness firsthand the ways in which the healthcare system has failed 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 gaslights their experiences. This broken system has perpetuated harm and left countless individuals struggling to access care that truly meets their needs.
When I discovered that the average life expectancy for Autistic adults is 36-54 years,¹˒² it shook me to my core. The primary causes of these premature deaths—early cardiovascular disease and suicide³—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.⁴ These stark realities highlight the necessity of reimagining healthcare for 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 – for neurodivergent people, by neurodivergent people. We integrate medical care into community connection – that is, connecting with other people who share similar health journeys. We also support our patients to navigate other broken systems, like school and work. At the same time, we provide trainings for workplaces and a range of different types of organizations about how to adapt environments and systems so that people whose brains work in all kinds of ways can get their needs met and thrive.
Understanding the Constellation of Conditions
Many of the people who seek healthcare from All Brains Belong 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 – or a grouping or cluster – of intertwined medical problems. Each of these conditions is known to be more common in Autistic and ADHD people. Each of these conditions is known to be related to others of these conditions. Some examples of what belongs to this grouping:
Hypermobility (including Hypermobility Spectrum Disorder and hypermobile Ehlers-Danlos Syndrome)
Dysautonomia (including a sub-type called POTS - Postural Orthostatic Tachycardia Syndrome)
Mast Cell Dysfunction
Sleep Disorders (including obstructive sleep apnea, restless leg syndrome and others)
Pain Syndromes (including fibromyalgia, endometriosis, migraine and others)
Post-infectious chronic illness (including Long COVID)
Digestive conditions (including Irritable Bowel Syndrome)
Many others
In my medical practice, we call this pattern “All the Things.” 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.
A Holistic Approach to Complex Needs
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:
Recognize patterns across conditions.
Avoid interventions that may inadvertently worsen other aspects of a patient’s health.
Empowering Both Patients and Clinicians
With support from the Organization for Autism Research (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:
Patient education materials in accessible formats (text, graphics, video).
Resources for clinicians on identifying and managing intertwined conditions, including a 16-page evidence-based management guide.
A pre-written letter that patients can share with their primary care providers to introduce these tools
Since its release in August 2023, more than 20,000 people have accessed these resources. Our hope is that these tools will make it easier for patients and clinicians to navigate these complex patterns together.
Join Our Upcoming Webinar
We are excited to announce our 2nd Annual “Everything is Connected to Everything” webinar on this topic, taking place on January 14, 2025 6pm ET (plus recorded). During this webinar, we will:
Explore the constellation of medical problems commonly experienced by Autistic and ADHD individuals.
Discuss strategies for holistic care that address the interconnectedness of these conditions.
Share insights from both clinical practice and lived expertise
Click here to register. Tickets are available by donation. 100% of donations support All Brains Belong’s free community and education programs.
Our hope is that our resources will make it easier for patients and clinicians to navigate these complex patterns together – which will allow Autistic and ADHD people to live longer, healthier lives.
References
Guan J, Li G. Injury mortality in individuals with autism. American Journal of Public Health. 2017;107(5):791-793.
Hirvikoski T, Mittendorfer-Rutz E, Boman M, Larsson H, Lichtenstein P, Bölte S. Premature mortality in autism spectrum disorder. British Journal of Psychiatry. 2016;208(3):232-8.
South M, Costa AP, McMorris C. Death by suicide among people with autism: beyond zebrafish. 2021;4(1):e2034018.
Barkley RA, Fischer M, Smallish L, Fletcher K. ADHD in adults: increased mortality risk and the critical role of age of onset, persistent symptoms, and associated risks. Journal of Attention Disorders. 2008;12(4):349-354.