Undiagnosed character on British Medical drama ‘Casualty’

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Much-loved Casualty character Dylan Keogh (William Beck) was faced with a journey of self-exploration recently when colleague Patrick (Jamie Glover) told him he’s on the autistic spectrum.

In a population-based study by the University College London (UCL) in 2023, researchers estimated there may be between 150,000 and 500,000 people aged 20-49 in England who are autistic, but have not received a diagnosis.

This can be as a result of many things from lack of funding, to the situation never really being addressed before. For Dylan, this was the case.

Reflecting on his reaction to this storyline, actor William Beck told me that while he was looking forward to exploring this side of Dylan, he recognised the sensitivity surrounding putting a spotlight on an adult living with autism without previously receiving a diagnosis:

‘Inknew it was going to be very important to bear in mind that each individual is an individual first and foremost, and very, very rarely I think would people choose to define themselves by a diagnosis. Dylan, I would say, that would be particularly true of him and yet he was confronted by this obligation to examine this thing that he had probably put to the back of his mind.

Again, it’s about remembering that Dylan is Dylan. He’s a good doctor, he’s got to go to work and he’s got to get it done. This stuff, it’s like the weight of a storyline cooking away in the background. In our show, it sometimes bubbles away for a few episodes and then it gets examined. For this, it’s been bubbling away and it’s like there’s a monkey on his back – he’s got to feed it but he doesn’t want to.’

‘Then, when you get to the point where he takes the monkey off his back and wrestles with it, the answer is more complicated than you would’ve thought. The answer is far more nuanced and hopefully, that’s the bit people recognise. It’s not the specifics of saying well this is how it is for people, it’s saying first and foremost, it’s about you.’

He added: ‘We live in a society now where we are psychologically literate, and psychiatrically literate, literate in terms of mental health in a way that no generation before us has been. As such, we’re forced to confront things.

There’s a lot of talk in mental health about spectrums, and I think that’s the key to understanding it – a spectrum is infinite possibilities to satisfy some or I suppose none of those diagnostics – we’re all on there somewhere. The point is to hopefully offer those people who have come to that realisation later on, that we’re all on there somewhere.’

The storyline came to a conclusion when Dylan read the result of his autism test. For Will, he confirmed that he would be intrigued to look at this further, but knows it would all depend on timings as well.

‘I think it depends on what happens to him’, he told me.

‘There are, of course, situations where the storyline could be re-examined of itself but the way the storyline was introduced was really just a helper to the Patrick/Dylan story. That is where things of delicacy are best examined, as part of another storyline. Sometimes it gives you the chance to wear it lightly. I think there’s every opportunity for it to be re-examined but it would have to be at the right time.