Why is there a need to increase understanding and skills when supporting autistic people with co-occurring mental health concerns?
With up to 70% of autistic people saying that they experience at least one mental health condition and 40% experiencing two or more, indications are that a high number of mental health referrals to local Child Adolescent and Mental Health Services (CAMHS) and Adult Mental Health Service (AMHS) teams relate to neurodivergent people (diagnosed or undiagnosed).
Increasing number of referrals to mental health services
One CAMHS practitioner on the Understanding Autism and Mental Health course estimated that up to 60% of referrals to their team related to autistic and neurodivergent children and young people.
Many children and young people (CYP) were being referred for more than one concern, including disordered eating, obsessive compulsive routines, depression and suicidal thoughts and behaviours. The concern expressed by the CAMHS practitioner was that current mental health services were not designed with the neurodivergent client in mind, making it difficult for many autistic CYP to access any type of meaningful therapy.
An Adult Mental Health Practitioners simply said, “We aren’t commissioned to provide mental health support to autistic adults. Because they have an Autism diagnosis, they must be seen by the Learning Disability Team. There is currently no Autism and Mental Health Pathway in our area.”
Lack of adjustments in schools
One Headteacher of a specialist school shared,
“Most autistic pupils experience sensory differences. Without adjustments to the environment and the way we organise the school day, many pupils experience sensory overstimulation and anxiety. This is often related to navigating the myriad of unexpected demands, changes and level of uncertainty around school spaces, academic expectations and relationships.”
Increase in adults seeking autism assessments
A General Practitioner on the course reflected, “There has been a significant increase in the number of adults seeking autism assessments, many with long histories of mental health difficulties. These requests usually follow an assessment relating to one or more their children. As they go through these processes, they recognise many of the traits in themselves.
We are often supporting neurodivergent families, rather than one autistic child or young person.
What have autistic people told us about their experiences?
A neurodivergent practitioner was reassured but also shocked that so many of the stories shared by autistic people on the course resonated with her own experience when growing up undiagnosed on the spectrum.
This young woman endured an endless cycle of misunderstandings, first at school, then with mental health services. She struggled to get into school, self-harmed and made multiple suicide attempts.
A mental health section led to a difficult hospital admission, culminating in a misdiagnosis of Borderline-Personality-Disorder (BPD), the use of restraint when experiencing melt downs, being over-medicated and a decade of revolving door experiences with inpatient and outpatient services. On the fifth hospital admission a new psychiatrist suggested that she might be on the autistic spectrum.
A fuller autism assessment and diagnosis followed, leading to a better, “inside out,” understanding of the young woman’s individual support needs including what environmental and treatment adjustments would be most helpful.
The practitioner described this as a life- saving diagnosis, with an improved understanding of why she experienced things in the way she did. Armed with this new self-awareness and access to the right environmental, communication and sensory supports the young woman went on to complete her education, graduating with a degree in Psychology.
These experiences are sadly shared by so many autistic and neurodivergent people across the United Kingdom and Internationally when seeking mental health support.
What is helpful?
As part of the Understanding Autism and Mental Health course we take an “Inside Out,” look at many of the barriers experienced by autistic people when seeking support and go on to share what autistic people and families have found helpful when thinking about their neurodevelopmental profile and preferences.
Here are a few of the topics covered in this two-day on-line training course (also Module 1 in the BPS Approved Certificate and Diploma in Autism and Mental Health).
- Reasons behind the high rates of co-occurring mental health conditions amongst autistic people.
- What autistic people have said about their experiences.
- Barriers to services
- The types of co-occurring mental health issues autistic people may experience.
- Access to the latest evidence base and research
What you will take away:
- An inside out model for supporting autistic people
- Knowledge, awareness, and skills for supporting autistic people with co-occurring mental health conditions (with access to resources and tools).
- An understanding of the role of special interests and self-stimulatory movements
- Two resource packs focused on integrating SPINS and STIMS into your practice
What are your experiences?
We would love to hear from you. Please share your own experiences, observations and reflections on the following:
- What have autistic and neurodivergent people shared with you about their experiences of seeking mental health support locally?
- Is there an Autism and Mental Health pathway in your area?
- Are autistic people seen by your local mental health team for mental health support?
- How do assessment services seek to identify mental health support needs amongst autistic people in your area?
- What post diagnostic mental health support is available for autistic and neurodivergent people in your area?
Please respond in the post or send to hello@ncamh.co.uk