Autistic adults’ experiences of accessing and receiving mental health care and their priorities for improvements: a qualitative study

Autistic adults are disproportionately affected by mental health conditions yet face significant barriers in accessing support and receiving suitable care. To understand this disparity better, using qualitative methods, we investigated the experiences of autistic adults in accessing and receiving mental health care and their priorities for improvement. Thirteen autistic adults with experience of mental health services in England were purposively selected to participate in semi-structured interviews. Reflexive thematic analysis principles guided the analysis of interview transcripts. Participants felt that an understanding of autism was key for professionals to provide effective support, and reported this was often lacking, resulting in insufficient recognition for their autism-specific needs, feelings of neglect and inadequate treatment. Inconsistent services, including varying appointments and unfamiliar professionals exacerbated anxiety and hindered treatment benefits. A recurring theme of validation emerged as participants expressed a shared sense of not being believed or taken seriously within the context of mental health support. In terms of priorities for improving services, adaptability was a central focus, while better understanding and addressing the specific needs of autistic people was considered crucial. Participants - females in particular – emphasised the need for professionals to adopt more effective communication strategies as they felt that poor communication and misunderstandings often delayed autism diagnoses. To enhance mental health support for autistic adults and mitigate negative outcomes, increasing mental health professionals’ understanding of autism is vital. Further research is needed to understand the manifestations and risk factors of mental health conditions in autistic adults. Participants stressed that autistic people need to be directly involved in driving these priorities and guiding the enhancement and adaptation of mental health care to meet their needs.