Pressure on Diagnostic Services In recent years, adult autism diagnostic services have come under exceptional pressure. Referral rates have surged, far outpacing clinical capacity, and exposing systemic limitations in provision. The consequences are stark. An NHS-funded diagnostic service in Oxfordshire, for example, recently closed its waiting list after estimating that it could take until 2043 to process its backlog of over 2,000 patients. For individuals referred before 20

In recent decades, clinicians and researchers have become increasingly aware of a form of extreme social withdrawal lasting at least six months, known as hikikomori [ 1 ]. The term was coined in the late 1990s by Japanese psychiatrist Saitō Tamaki to describe individuals who withdraw almost entirely from social life, isolating themselves within their home – often in a single room – refusing school or work, and avoiding face-to-face relationships. While some remain connected t