"I wouldn't know where to start": Perspectives from clinicians, agency leaders, and autistic adults on improving community mental health services for autistic adults.
Brenna B Maddox, Samantha Crabbe, Rinad S Beidas and 5 others
PMID 31674198WHAT IT FOUND
Autistic adults, clinicians, and agency leaders described mental health care as hard to access because clinicians lacked autism knowledge, services were fragmented, and sessions felt impractical.
Autistic adults asked for clear, structured, sensory-aware therapy focused on current distress.
Key findings
01Twenty of 22 autistic adults described negative psychotherapy experiences, and the most common explanation was that the clinician did not understand autism.
02Forty-three of 44 clinicians could not recall learning anything about autistic adults in their educational programs.
03Autistic adults recommended practical, present-focused therapy and treatment of co-occurring conditions rather than changing core autistic traits.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study interviewed people who chose to take part. Their views may not represent autistic adults who did not seek or receive mental health services. All autistic participants could speak English well enough for an interview. The findings do not cover autistic adults who cannot use talk therapy in that way. The autistic sample had more college and graduate degrees and more adult diagnoses than expected. Their experiences may differ from many autistic adults. The study did not formally assess autism or co-occurring mental health conditions. Diagnoses and symptoms were based on participant reports. Agencies and clinicians were not randomly selected. The work was done in Philadelphia community mental health centers, and results may not apply to other systems or places. Clinician-reported client barriers were partly anticipated. Many clinicians had little or no experience working with autistic adults.
Declared interests
The supplied text does not include a conflict-of-interest declaration. The publication types list research support as N.I.H., Extramural.
The easy way to misread this
Do not read these recommendations as evidence that autism training improves mental health care. The study reports perspectives from autistic adults, clinicians, and agency leaders. It does not test a service change.