scholarly journals The importance and availability of adjustments to improve access for autistic adults who need mental and physical healthcare: findings from UK surveys

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043336
Author(s):  
Samuel Brice ◽  
Jacqui Rodgers ◽  
Barry Ingham ◽  
David Mason ◽  
Colin Wilson ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Physical Health ◽  
Response Rate ◽  
Autism Spectrum ◽  
Healthcare Provision ◽  
Healthcare Settings ◽  
Autistic People ◽  
Autistic Adults ◽  
Mental And Physical Health

Objectives To investigate autistic people’s views on the importance and availability of adjustments to mental and physical healthcare provision. To explore whether specific categories of adjustments can be identified and to identify any differences in their importance and availability between mental and physical healthcare. Design Data from two studies, both employing a cross-sectional survey design. Setting UK-based autistic adults registered with the Adult Autism Spectrum Cohort-UK were contacted by post or online. In both studies, recruitment was staged over a 12-month period. Non-responders were sent a single reminder letter 2 weeks after initial contact. Participants 537 autistic adults completed a survey about mental health services (51% response rate), 407 completed the physical health survey (49% response rate). Within these samples, 221 participants completed both surveys. Primary outcome measures Each study developed a bespoke survey to explore participants’ views on mental and physical health services, respectively. Both included an identical list of adjustments that participants rated based on importance and availability. Results Three factors of important adjustments were identified: sensory environment, clinical and service context, and clinician knowledge and communication. Adjustments across healthcare settings were widely rated as being important yet rarely available. One significant difference between the importance of adjustments available through mental and physical health services was identified. Participants reported that having access to a clinician who is willing to adapt their approach to suit the person’s preferences was significantly more important for participants attending mental health settings (p=0.001). Conclusions Autistic people reported the limited availability of important adjustments in current healthcare provision. To address unmet need and tackle the health inequalities faced by autistic people attending physical and mental healthcare settings, healthcare providers should offer adjustments relating to the three identified factors. Future research should focus on identifying and addressing service provider barriers to implementation.

A blind spot in mental healthcare? Psychotherapists lack education and expertise for the support of adults on the autism spectrum

Autism ◽  
2021 ◽  
pp. 136236132110579
Author(s):  
Silke Lipinski ◽  
Katharina Boegl ◽  
Elisabeth S Blanke ◽  
Ulrike Suenkel ◽  
Isabel Dziobek
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Mental Health Services ◽  
Health Services ◽  
Research Group ◽  
Autism Spectrum ◽  
Major Barrier ◽  
Autism Research ◽  
Autistic Adults ◽  
Lack Of Knowledge

Most adults on the autism spectrum have co-occurring mental health conditions, creating a high demand for mental health services – including psychotherapy – in autistic adults. However, autistic adults have difficulties accessing mental health services. The most-reported barriers to accessing treatment are therapists’ lack of knowledge and expertise surrounding autism, as well as unwillingness to treat autistic individuals. This study was conducted by a participatory autism research group and examined 498 adult-patient psychotherapists on knowledge about autism and self-perceived competency to diagnose and treat autistic patients without intellectual disability compared to patients with other diagnoses. Psychotherapists rated their education about autism in formal training, and competency in the diagnosis and treatment of patients with autism, lowest compared to patients with all other diagnoses surveyed in the study, including those with comparable prevalence rates. Many therapists had misconceptions and outdated beliefs about autism. Few had completed additional training on autism, but the majority were interested in receiving it. Greater knowledge about autism was positively linked to openness to accept autistic patients. The results point to an alarming gap in knowledge necessary for adequate mental health care for individuals with autism. Lay abstract Most autistic adults experience mental health problems. There is a great demand for psychotherapeutic support that addresses the specific needs of autistic individuals. However, people with autism encounter difficulties trying to access diagnostic and therapeutic services. This study was conducted by a participatory autism research group: a group in which autistic individuals and scientists collaborate. The group developed a questionnaire for psychotherapists in Germany to assess their knowledge about autism. Psychotherapists also rated their ability to diagnose and treat autistic patients without intellectual disability, and patients with other psychological diagnoses. Many of the 498 psychotherapists that responded reported little knowledge and outdated beliefs about autism, as well as little training on treating patients with autism. Their expertise about other psychological conditions was more comprehensive. However, many psychotherapists were interested in professional training on autism. Those with more knowledge were also more open to treating autistic patients. In conclusion, psychotherapists’ lack of knowledge and expertise seem to be a major barrier for adults with autism to receiving helpful psychotherapeutic support. The results demonstrate the need for an advancement in autism education during psychotherapists’ training and in continuous education.

scholarly journals The Mental and Physical Health Profiles of Older Adults Who Endorse Elevated Autistic Traits

2020 ◽  
Author(s):  
Gavin R Stewart ◽  
Anne Corbett ◽  
Clive Ballard ◽  
Byron Creese ◽  
Dag Aarsland ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Health ◽  
Autistic Traits ◽  
Autism Spectrum ◽  
Psychiatric Diagnoses ◽  
Depression And Anxiety ◽  
Dimensional Approach ◽  
Autistic People ◽  
Polygenic Scores ◽  
Mental And Physical Health

Abstract Objectives The mental and physical health profile of autistic people has been studied in adolescence and adulthood, with elevated rates of most conditions being reported. However, this has been little studied taking a dimensional approach to autistic traits and in older age. Methods A total of 20,220 adults aged 50–81 years from the PROTECT study reported whether they experienced persistent sociocommunicative traits characteristic of autism. Approximately 1%, 276 individuals, were identified as endorsing elevated autistic traits in childhood and currently, henceforth the “Autism Spectrum Trait” (AST) group. An age- and gender-matched comparison group was formed of 10,495 individuals who did not endorse any autistic behavioral traits, henceforth the “Control Older Adults” (COA) group. Differences between AST and COA groups were explored in self-reported psychiatric diagnoses, self-reported symptoms of current depression and anxiety, and self-reported physical health diagnoses. Associations were also examined between autistic traits and health across the whole sample. Results The AST group reported significantly elevated rates of psychiatric diagnoses compared to the COA group. Additionally, the AST group showed significantly higher self-reported symptoms of current depression and anxiety than the COA group. However, few differences were observed in individual physical health conditions, and no differences in total co-occurring physical diagnoses between groups. Similar associations between autistic traits and health were also found taking a dimensional approach across the whole sample. Discussion These findings suggest that older adults with elevated autistic traits may be at greater risk of poorer mental, but not physical, health in later life. Future studies should incorporate polygenic scores to elucidate the possible genetic links between the propensity to autism/high autistic traits and to psychiatric conditions, and to explore whether those with elevated autistic traits experience particular barriers to mental health care.

scholarly journals ‘Something needs to change’: Mental health experiences of young autistic adults in England

Autism ◽  
2018 ◽  
Vol 23 (2) ◽  
pp. 477-493 ◽  
Author(s):  
Laura Crane ◽  
Fern Adams ◽  
Georgia Harper ◽  
Jack Welch ◽  
Elizabeth Pellicano
Keyword(s):  
Mental Health ◽  
Help Seeking ◽  
Online Survey ◽  
Mental Health Problems ◽  
Health Problems ◽  
Autism Spectrum ◽  
Health Needs ◽  
Mental Health Needs ◽  
Autistic People ◽  
Autistic Adults

There is a high incidence and prevalence of mental health problems among young people, with several barriers to help-seeking noted in this group. High rates of mental health problems have also been reported in children and adults on the autism spectrum. Taken together, young autistic people may be a particularly vulnerable group when it comes to mental health. Yet, there has been remarkably little work on the mental health needs and experiences of young autistic adults (16–25 years). Adopting a community-based participatory research (CBPR) approach – in which academic researchers and young autistic adults collaborated in an equitable research partnership – we explored young autistic people’s experiences of mental health problems and their perspectives on the support they sought, if any, for these problems. A total of 130 young autistic adults took part in the research: 109 completed an online survey and 21 took part in detailed interviews. The results highlight how young autistic people find it difficult to evaluate their mental health, experience high levels of stigma and often face severe obstacles when trying to access mental health support. The findings also demonstrate how listening to – and learning from – young autistic people is crucial in ensuring that their mental health needs are met.

Examining Post-Migration Social Determinants as Predictors of Mental and Physical Health of Recent Syrian Refugees in Canada: Implications for Counselling, Practice, and Research

2020 ◽  
Vol 54 (4) ◽  
pp. 778-802
Author(s):  
Ben C. H. Kuo ◽  
Lais Granemann ◽  
Avideh Najibzadeh ◽  
Riham Al-Saadi ◽  
Monira Dali ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Physical Health ◽  
Perceived Stress ◽  
Social Determinants ◽  
Perceived Control ◽  
Syrian Refugees ◽  
Physical Health Outcomes ◽  
Health Model ◽  
Mental And Physical Health

In response to the increasing number of Syrian refugees being resettled in Canada and worldwide, the present study set out to explore and examine critical post-migration predictors of mental health and physical health of adult Syrian refugees (n = 235) living in Windsor, Ontario. Using survey data collected from the national SyRIA-lth project and grounded in the Social Determinants of Health model, this study tested demographic, contextual, and psychosocial predictors in two regression models of mental health and physical health, respectively. The results showed that both predictive models were significant in explaining Syrian refugees’ mental and physical health outcomes, as hypothesized. Specifically, age, gender, satisfaction of health services, perceived control, and perceived stress predicted mental health in significant ways, whereas age, satisfaction of health services, and perceived stress predicted physical health in significant ways as well. Implications for practice and research with Syrian refugees, given the identified risk and protective factors of health, are considered.

The impact of economic crisis on mental and physical health in Italy

2017 ◽  
Vol 14 (02) ◽  
pp. 103-110
Author(s):  
S. Tomassi ◽  
M. Ruggeri
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Economic Crisis ◽  
Social Determinants ◽  
Great Recession ◽  
Economic Recession ◽  
Behavioural Disorders ◽  
Economic Activities ◽  
The Impact ◽  
Mental And Physical Health

Summary Background: The global crisis that began in 2007 has been the most prolonged economic recession since 1929. It has caused worldwide tangible costs in terms of cuts in employment and income, which have been widely recognised also as major social determinants of mental health (1, 2). The so-called “Great Recession” has disproportionately affected the most vulnerable part of society of the whole Eurozone (3). Across Europe, an increase in suicides and deaths rates due to mental and behavioural disorders was reported among those who lost their jobs, houses and economic activities as a consequence of the crisis.

Camouflaging in non-autistic adults is associated with poorer mental health

2019 ◽  
Author(s):  
Mark Somerville ◽  
Sarah E. MacPherson ◽  
Sue Fletcher-Watson
Keyword(s):  
Mental Health ◽  
Executive Function ◽  
Autistic Traits ◽  
Self Report ◽  
Linear Regression Models ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Autistic People ◽  
Autistic Adults ◽  
The Relationship

Camouflaging is a frequently reported behaviour in autistic people, which entails the use of strategies to compensate for and mask autistic traits in social situations. Camouflaging is associated with poor mental health in autistic people. This study examined the manifestation of camouflaging in a non-autistic sample, examining the relationship between autistic traits, camouflaging, and mental health. In addition, the role of executive functions as a mechanism underpinning camouflaging was explored. Sixty-three non-autistic adults completed standardised self-report questionnaires which measured: autistic traits, mental health symptoms, and camouflaging behaviours. In addition, a subset (n=51) completed three tests of executive function measuring inhibition, working memory, and set-shifting. Multiple linear regression models were used to analyse data. Results indicated that autistic traits are not associated with mental health symptoms when controlling for camouflaging, and camouflaging predicted increased mental health symptoms. Camouflaging did not correlate with any measure of executive function. These findings have implications for understanding the relationship between autistic traits and mental health in non-autistic people and add to the growing development of theory and knowledge about the mechanism and effects of camouflaging.

Mental health correlates and potential childhood predictors for the wish to be of the opposite sex in young autistic adults

Autism ◽  
2021 ◽  
pp. 136236132110240
Author(s):  
Jung-Chi Chang ◽  
Meng-Chuan Lai ◽  
Yueh-Ming Tai ◽  
Susan Shur-Fen Gau
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Typically Developing ◽  
Item Endorsement ◽  
Opposite Sex ◽  
Autistic Adults

Cross-sectional research has demonstrated the overrepresentation of gender dysphoria in children and adults with autism spectrum disorder. However, the predictors and underlying mechanisms of this co-occurrence remain unclear. This follow-up study aimed to explore baseline (childhood/adolescence) predictors for the follow-up (adulthood) self-reported wish to be of the opposite sex and to investigate its mental health correlates in a sample of 88 autistic individuals as compared with 42 typically developing controls. An item on the Adult Self-Report Inventory-4, “I wish I was the opposite sex,” was used. We compared mental health symptoms between adults with and without this item endorsement. We used prediction models to explore family and autism-related predictors in childhood/adolescence to endorse this item in adulthood. There were more adults endorsing the item in the autism spectrum disorder group compared with the typically developing group. Autistic adults who endorsed the item experienced more mental health challenges, more bullying victimization, more suicidal ideations, and worse quality of life. Lower parent-reported family support and more stereotyped/repetitive behaviors during childhood/adolescence predicted the self-reported wish to be of the opposite sex in adulthood in autistic individuals. It is necessary to raise more attention to gender development and related mental health impact in autistic individuals. Lay abstract Autistic people/people with autism spectrum disorder are more likely to experience gender dysphoria. However, the possible longitudinal predictors and underlying mechanisms of this co-occurrence are unclear. To fill this knowledge gap, we assessed 88 people with autism spectrum disorder and 42 typically developing individuals at their average ages of 13.0 (baseline, childhood/adolescence) and 20.2 years old (follow-up, adulthood). At follow-up, their endorsement on the item “I wish I was the opposite sex” was used to evaluate gender dysphoric symptoms. We compared mental health symptoms between adults with and without this item endorsement at the follow-up assessment. We explored parent-reported family and autism characteristics-related predictors in childhood/adolescence to this item endorsement in adulthood. We found that more autistic adults reported the wish to be of the opposite sex than did typically developing individuals. Autistic adults who endorsed this item experienced more mental health challenges, more school bullying and cyberbullying, more suicidal ideation, and worse quality of life. Moreover, parent-reported lower family support and more stereotyped/repetitive behaviors during childhood/adolescence predicted the self-reported wish to be of the opposite sex in adulthood in autistic individuals. More attention and support should be provided to autistic people regarding gender development and related mental health and quality of life impact, especially during the transition period to young adulthood.

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