TY - JOUR
T1 - Approaches to improving mental healthcare for autistic people
T2 - Systematic review
AU - Loizou, Sofia
AU - Pemovska, Tamara
AU - Stefanidou, Theodora
AU - Foye, Una
AU - Cooper, Ruth
AU - Kular, Ariana
AU - Greenburgh, Anna
AU - Baldwin, Helen
AU - Griffiths, Jessica
AU - Saunders, Katherine R.K.
AU - Barnett, Phoebe
AU - Minchin, Matilda
AU - Brady, Gráinne
AU - Ahmed, Nafiso
AU - Parker, Jennie
AU - Chipp, Beverley
AU - Olive, Rachel R.
AU - Jackson, Robin
AU - Timmerman, Amanda
AU - Sapiets, Suzi
AU - Driskell, Eva
AU - Parsons, Bethany
AU - Spain, Debbie
AU - Totsika, Vaso
AU - Mandy, Will
AU - Pender, Richard
AU - Clery, Philippa
AU - Trevillion, Kylee
AU - Lloyd-Evans, Brynmor
AU - Simpson, Alan
AU - Johnson, Sonia
N1 - Publisher Copyright:
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of Royal College of Psychiatrists.
PY - 2024/8/1
Y1 - 2024/8/1
N2 - Background Autistic people have a high likelihood of developing mental health difficulties but a low chance of receiving effective mental healthcare. Therefore, there is a need to identify and examine strategies to improve mental healthcare for autistic people. Aims To identify strategies that have been implemented to improve access, experiences of care and mental health outcomes for autistic adults, and to examine evidence on their acceptability, feasibility and effectiveness. Method A co-produced systematic review was conducted. MEDLINE, PsycINFO, CINHAL, medRxiv and PsyArXiv were searched. We included all study designs reporting acceptability or feasibility outcomes and empirical quantitative study designs reporting effectiveness outcomes. Data were synthesised using a narrative approach. Results A total of 30 articles were identified. These included 16 studies of adapted mental health interventions, eight studies of service improvements and six studies of bespoke mental health interventions developed for autistic people. There was no conclusive evidence on effectiveness. However, most bespoke and adapted approaches appeared to be feasible and acceptable. Identified adaptations appeared to be acceptable and feasible, including increasing knowledge and detection of autism, providing environmental adjustments and communication accommodations, accommodating individual differences and modifying the structure and content of interventions. Conclusion Many identified strategies are feasible and acceptable, and can be readily implemented in services with the potential to make mental healthcare more suitable for autistic people, but important research gaps remain. Future research should address these and investigate a co-produced package of service improvement measures.
AB - Background Autistic people have a high likelihood of developing mental health difficulties but a low chance of receiving effective mental healthcare. Therefore, there is a need to identify and examine strategies to improve mental healthcare for autistic people. Aims To identify strategies that have been implemented to improve access, experiences of care and mental health outcomes for autistic adults, and to examine evidence on their acceptability, feasibility and effectiveness. Method A co-produced systematic review was conducted. MEDLINE, PsycINFO, CINHAL, medRxiv and PsyArXiv were searched. We included all study designs reporting acceptability or feasibility outcomes and empirical quantitative study designs reporting effectiveness outcomes. Data were synthesised using a narrative approach. Results A total of 30 articles were identified. These included 16 studies of adapted mental health interventions, eight studies of service improvements and six studies of bespoke mental health interventions developed for autistic people. There was no conclusive evidence on effectiveness. However, most bespoke and adapted approaches appeared to be feasible and acceptable. Identified adaptations appeared to be acceptable and feasible, including increasing knowledge and detection of autism, providing environmental adjustments and communication accommodations, accommodating individual differences and modifying the structure and content of interventions. Conclusion Many identified strategies are feasible and acceptable, and can be readily implemented in services with the potential to make mental healthcare more suitable for autistic people, but important research gaps remain. Future research should address these and investigate a co-produced package of service improvement measures.
KW - adaptations
KW - adults
KW - Autism spectrum condition
KW - mental health
KW - mental healthcare
UR - http://www.scopus.com/inward/record.url?scp=85202158120&partnerID=8YFLogxK
U2 - 10.1192/bjo.2024.707
DO - 10.1192/bjo.2024.707
M3 - Review article
AN - SCOPUS:85202158120
SN - 2056-4724
VL - 10
JO - BJPsych Open
JF - BJPsych Open
IS - 4
M1 - e128
ER -