“I wouldn’t know where to start”: Perspectives from clinicians, agency leaders, and autistic adults on improving community mental health services for autistic adults
Most autistic adults struggle with mental health problems, and traditional mental health services generally do not meet their needs. This study used qualitative methods to identify ways to improve community mental health services for autistic adults for treatment of their co-occurring psychiatric co...
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| Veröffentlicht in: | Autism : the international journal of research and practice 2020-05, Vol.24 (4), p.919-930 |
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| container_title | Autism : the international journal of research and practice |
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| creator | Maddox, Brenna B Crabbe, Samantha Beidas, Rinad S Brookman-Frazee, Lauren Cannuscio, Carolyn C Miller, Judith S Nicolaidis, Christina Mandell, David S |
| description | Most autistic adults struggle with mental health problems, and traditional mental
health services generally do not meet their needs. This study used qualitative
methods to identify ways to improve community mental health services for
autistic adults for treatment of their co-occurring psychiatric conditions. We
conducted semistructured, open-ended interviews with 22 autistic adults with
mental healthcare experience, 44 community mental health clinicians, and 11
community mental health agency leaders in the United States. The participants
identified clinician-, client-, and systems-level barriers and facilitators to
providing quality mental healthcare to autistic adults. Across all three
stakeholder groups, most of the reported barriers involved clinicians’ limited
knowledge, lack of experience, poor competence, and low confidence working with
autistic adults. All three groups also discussed the disconnect between the
community mental health and developmental disabilities systems, which can result
in autistic adults being turned away from services when they contact the mental
health division and disclose their autism diagnosis during the intake process.
Further efforts are needed to train clinicians to work more effectively with
autistic adults and to increase coordination between the mental health and
developmental disabilities systems.
Lay Abstract
Most autistic adults struggle with mental health problems, such as anxiety
and depression. However, they often have trouble finding effective mental
health treatment in their community. The goal of this study was to identify
ways to improve community mental health services for autistic adults. We
interviewed 22 autistic adults with mental healthcare experience, 44
community mental health clinicians (outpatient therapists, case managers,
and intake coordinators), and 11 community mental health agency leaders in
the United States. Our participants identified a variety of barriers to
providing quality mental healthcare to autistic adults. Across all three
groups, most of the reported barriers involved clinicians’ limited
knowledge, lack of experience, poor competence, and low confidence working
with autistic adults. All three groups also discussed the disconnect between
the community mental health and developmental disabilities systems and the
need to improve communication between these two systems. Further efforts are
needed to train clinicians and provide follow-up consultation to work more
effectively with auti |
| doi_str_mv | 10.1177/1362361319882227 |
| format | Article |
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health services generally do not meet their needs. This study used qualitative
methods to identify ways to improve community mental health services for
autistic adults for treatment of their co-occurring psychiatric conditions. We
conducted semistructured, open-ended interviews with 22 autistic adults with
mental healthcare experience, 44 community mental health clinicians, and 11
community mental health agency leaders in the United States. The participants
identified clinician-, client-, and systems-level barriers and facilitators to
providing quality mental healthcare to autistic adults. Across all three
stakeholder groups, most of the reported barriers involved clinicians’ limited
knowledge, lack of experience, poor competence, and low confidence working with
autistic adults. All three groups also discussed the disconnect between the
community mental health and developmental disabilities systems, which can result
in autistic adults being turned away from services when they contact the mental
health division and disclose their autism diagnosis during the intake process.
Further efforts are needed to train clinicians to work more effectively with
autistic adults and to increase coordination between the mental health and
developmental disabilities systems.
Lay Abstract
Most autistic adults struggle with mental health problems, such as anxiety
and depression. However, they often have trouble finding effective mental
health treatment in their community. The goal of this study was to identify
ways to improve community mental health services for autistic adults. We
interviewed 22 autistic adults with mental healthcare experience, 44
community mental health clinicians (outpatient therapists, case managers,
and intake coordinators), and 11 community mental health agency leaders in
the United States. Our participants identified a variety of barriers to
providing quality mental healthcare to autistic adults. Across all three
groups, most of the reported barriers involved clinicians’ limited
knowledge, lack of experience, poor competence, and low confidence working
with autistic adults. All three groups also discussed the disconnect between
the community mental health and developmental disabilities systems and the
need to improve communication between these two systems. Further efforts are
needed to train clinicians and provide follow-up consultation to work more
effectively with autistic adults. A common suggestion from all three groups
was to include autistic adults in creating and delivering the clinician
training. The autistic participants provided concrete recommendations for
clinicians, such as consider sensory issues, slow the pace, incorporate
special interests, use direct language, and set clear expectations. Our
findings also highlight a need for community education about co-occurring
psychiatric conditions with autism and available treatments, in order to
increase awareness about treatment options.</description><identifier>ISSN: 1362-3613</identifier><identifier>EISSN: 1461-7005</identifier><identifier>DOI: 10.1177/1362361319882227</identifier><identifier>PMID: 31674198</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adults ; Anxiety ; Autism ; Autistic adults ; Barriers ; Case management ; Clinical Experience ; College professors ; Community education ; Community Health Services ; Community mental health services ; Comorbidity ; Competence ; Coordination ; Coordinators ; Developmental disabilities ; Educational Needs ; Gorillas ; Health problems ; Health services ; Knowledge Level ; Leadership ; Medical diagnosis ; Mental depression ; Mental disorders ; Mental health ; Mental health care ; Mental health professionals ; Mental Health Programs ; Mental Health Workers ; Pervasive Developmental Disorders ; Program Improvement ; Psychotherapy ; Public Agencies ; Qualitative research ; Self Efficacy ; Therapists ; Treatment methods</subject><ispartof>Autism : the international journal of research and practice, 2020-05, Vol.24 (4), p.919-930</ispartof><rights>The Author(s) 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c484t-cd2d27919cc0846b0954ca33a7d173a30bb01bcd55e3886665237c0c3641585f3</citedby><cites>FETCH-LOGICAL-c484t-cd2d27919cc0846b0954ca33a7d173a30bb01bcd55e3886665237c0c3641585f3</cites><orcidid>0000-0002-9394-5956 ; 0000-0002-6228-0509</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1362361319882227$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1362361319882227$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>230,314,776,780,881,21798,27901,27902,30976,33751,43597,43598</link.rule.ids><backlink>$$Uhttp://eric.ed.gov/ERICWebPortal/detail?accno=EJ1255145$$DView record in ERIC$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31674198$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maddox, Brenna B</creatorcontrib><creatorcontrib>Crabbe, Samantha</creatorcontrib><creatorcontrib>Beidas, Rinad S</creatorcontrib><creatorcontrib>Brookman-Frazee, Lauren</creatorcontrib><creatorcontrib>Cannuscio, Carolyn C</creatorcontrib><creatorcontrib>Miller, Judith S</creatorcontrib><creatorcontrib>Nicolaidis, Christina</creatorcontrib><creatorcontrib>Mandell, David S</creatorcontrib><title>“I wouldn’t know where to start”: Perspectives from clinicians, agency leaders, and autistic adults on improving community mental health services for autistic adults</title><title>Autism : the international journal of research and practice</title><addtitle>Autism</addtitle><description>Most autistic adults struggle with mental health problems, and traditional mental
health services generally do not meet their needs. This study used qualitative
methods to identify ways to improve community mental health services for
autistic adults for treatment of their co-occurring psychiatric conditions. We
conducted semistructured, open-ended interviews with 22 autistic adults with
mental healthcare experience, 44 community mental health clinicians, and 11
community mental health agency leaders in the United States. The participants
identified clinician-, client-, and systems-level barriers and facilitators to
providing quality mental healthcare to autistic adults. Across all three
stakeholder groups, most of the reported barriers involved clinicians’ limited
knowledge, lack of experience, poor competence, and low confidence working with
autistic adults. All three groups also discussed the disconnect between the
community mental health and developmental disabilities systems, which can result
in autistic adults being turned away from services when they contact the mental
health division and disclose their autism diagnosis during the intake process.
Further efforts are needed to train clinicians to work more effectively with
autistic adults and to increase coordination between the mental health and
developmental disabilities systems.
Lay Abstract
Most autistic adults struggle with mental health problems, such as anxiety
and depression. However, they often have trouble finding effective mental
health treatment in their community. The goal of this study was to identify
ways to improve community mental health services for autistic adults. We
interviewed 22 autistic adults with mental healthcare experience, 44
community mental health clinicians (outpatient therapists, case managers,
and intake coordinators), and 11 community mental health agency leaders in
the United States. Our participants identified a variety of barriers to
providing quality mental healthcare to autistic adults. Across all three
groups, most of the reported barriers involved clinicians’ limited
knowledge, lack of experience, poor competence, and low confidence working
with autistic adults. All three groups also discussed the disconnect between
the community mental health and developmental disabilities systems and the
need to improve communication between these two systems. Further efforts are
needed to train clinicians and provide follow-up consultation to work more
effectively with autistic adults. A common suggestion from all three groups
was to include autistic adults in creating and delivering the clinician
training. The autistic participants provided concrete recommendations for
clinicians, such as consider sensory issues, slow the pace, incorporate
special interests, use direct language, and set clear expectations. Our
findings also highlight a need for community education about co-occurring
psychiatric conditions with autism and available treatments, in order to
increase awareness about treatment options.</description><subject>Adults</subject><subject>Anxiety</subject><subject>Autism</subject><subject>Autistic adults</subject><subject>Barriers</subject><subject>Case management</subject><subject>Clinical Experience</subject><subject>College professors</subject><subject>Community education</subject><subject>Community Health Services</subject><subject>Community mental health services</subject><subject>Comorbidity</subject><subject>Competence</subject><subject>Coordination</subject><subject>Coordinators</subject><subject>Developmental disabilities</subject><subject>Educational Needs</subject><subject>Gorillas</subject><subject>Health problems</subject><subject>Health services</subject><subject>Knowledge Level</subject><subject>Leadership</subject><subject>Medical diagnosis</subject><subject>Mental depression</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Mental health care</subject><subject>Mental health professionals</subject><subject>Mental Health Programs</subject><subject>Mental Health Workers</subject><subject>Pervasive Developmental Disorders</subject><subject>Program Improvement</subject><subject>Psychotherapy</subject><subject>Public Agencies</subject><subject>Qualitative research</subject><subject>Self Efficacy</subject><subject>Therapists</subject><subject>Treatment methods</subject><issn>1362-3613</issn><issn>1461-7005</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><sourceid>BHHNA</sourceid><recordid>eNp1kkuOEzEQhlsIxAwDezYgS2xY0OC33SyQ0GiAQSPBAtaW43YSD2472O5E2eUaSHACbpWT4ChDgEis_Pi_-qtKVU3zEMHnCAnxAhGOCUcEdVJijMWt5hRRjloBIbtd71Vud_pJcy_na1h_KUN3mxOCuKA16LT5ud18vwSrOPo-bDffCvgS4gqs5jZZUCLIRaey3fx4CT7alBfWFLe0GUxTHIDxLjjjdMjPgJ7ZYNbAW91Xrr5DD_RYXC7OAN2PvmQQA3DDIsWlCzNg4jCMwZU1GGwo2oO51b7MQbZp6cwuRUzHDvebO1Pts31wc541n99cfDp_1159eHt5_vqqNVTS0poe91h0qDMGSsonsGPUaEK06JEgmsDJBKKJ6RmzRErOOcNEGGgIp4hJNiVnzau972KcDLY3tcCkvVokN-i0VlE79a8S3FzN4lIJ1GEhYTV4emOQ4tfR5qIGl431Xgcbx6wwQYgz2UlR0SdH6HUcU6jtKUwhQ5RBJisF95RJMedkp4diEFS7TVDHm1BDHv_dxCHg9-gr8GgP2OTMQb54jzDbpa16u9dzHe6fqv6b8Bf1Acrl</recordid><startdate>20200501</startdate><enddate>20200501</enddate><creator>Maddox, Brenna B</creator><creator>Crabbe, Samantha</creator><creator>Beidas, Rinad S</creator><creator>Brookman-Frazee, Lauren</creator><creator>Cannuscio, Carolyn C</creator><creator>Miller, Judith S</creator><creator>Nicolaidis, Christina</creator><creator>Mandell, David S</creator><general>SAGE Publications</general><general>SAGE PUBLICATIONS, INC</general><scope>7SW</scope><scope>BJH</scope><scope>BNH</scope><scope>BNI</scope><scope>BNJ</scope><scope>BNO</scope><scope>ERI</scope><scope>PET</scope><scope>REK</scope><scope>WWN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7U3</scope><scope>BHHNA</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9394-5956</orcidid><orcidid>https://orcid.org/0000-0002-6228-0509</orcidid></search><sort><creationdate>20200501</creationdate><title>“I wouldn’t know where to start”: Perspectives from clinicians, agency leaders, and autistic adults on improving community mental health services for autistic adults</title><author>Maddox, Brenna B ; Crabbe, Samantha ; Beidas, Rinad S ; Brookman-Frazee, Lauren ; Cannuscio, Carolyn C ; Miller, Judith S ; Nicolaidis, Christina ; Mandell, David S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c484t-cd2d27919cc0846b0954ca33a7d173a30bb01bcd55e3886665237c0c3641585f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adults</topic><topic>Anxiety</topic><topic>Autism</topic><topic>Autistic adults</topic><topic>Barriers</topic><topic>Case management</topic><topic>Clinical Experience</topic><topic>College professors</topic><topic>Community education</topic><topic>Community Health Services</topic><topic>Community mental health services</topic><topic>Comorbidity</topic><topic>Competence</topic><topic>Coordination</topic><topic>Coordinators</topic><topic>Developmental disabilities</topic><topic>Educational Needs</topic><topic>Gorillas</topic><topic>Health problems</topic><topic>Health services</topic><topic>Knowledge Level</topic><topic>Leadership</topic><topic>Medical diagnosis</topic><topic>Mental depression</topic><topic>Mental disorders</topic><topic>Mental health</topic><topic>Mental health care</topic><topic>Mental health professionals</topic><topic>Mental Health Programs</topic><topic>Mental Health Workers</topic><topic>Pervasive Developmental Disorders</topic><topic>Program Improvement</topic><topic>Psychotherapy</topic><topic>Public Agencies</topic><topic>Qualitative research</topic><topic>Self Efficacy</topic><topic>Therapists</topic><topic>Treatment methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maddox, Brenna B</creatorcontrib><creatorcontrib>Crabbe, Samantha</creatorcontrib><creatorcontrib>Beidas, Rinad S</creatorcontrib><creatorcontrib>Brookman-Frazee, Lauren</creatorcontrib><creatorcontrib>Cannuscio, Carolyn C</creatorcontrib><creatorcontrib>Miller, Judith S</creatorcontrib><creatorcontrib>Nicolaidis, Christina</creatorcontrib><creatorcontrib>Mandell, David S</creatorcontrib><collection>ERIC</collection><collection>ERIC (Ovid)</collection><collection>ERIC</collection><collection>ERIC</collection><collection>ERIC (Legacy Platform)</collection><collection>ERIC( SilverPlatter )</collection><collection>ERIC</collection><collection>ERIC PlusText (Legacy Platform)</collection><collection>Education Resources Information Center (ERIC)</collection><collection>ERIC</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Social Services Abstracts</collection><collection>Sociological Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Autism : the international journal of research and practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maddox, Brenna B</au><au>Crabbe, Samantha</au><au>Beidas, Rinad S</au><au>Brookman-Frazee, Lauren</au><au>Cannuscio, Carolyn C</au><au>Miller, Judith S</au><au>Nicolaidis, Christina</au><au>Mandell, David S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><ericid>EJ1255145</ericid><atitle>“I wouldn’t know where to start”: Perspectives from clinicians, agency leaders, and autistic adults on improving community mental health services for autistic adults</atitle><jtitle>Autism : the international journal of research and practice</jtitle><addtitle>Autism</addtitle><date>2020-05-01</date><risdate>2020</risdate><volume>24</volume><issue>4</issue><spage>919</spage><epage>930</epage><pages>919-930</pages><issn>1362-3613</issn><eissn>1461-7005</eissn><abstract>Most autistic adults struggle with mental health problems, and traditional mental
health services generally do not meet their needs. This study used qualitative
methods to identify ways to improve community mental health services for
autistic adults for treatment of their co-occurring psychiatric conditions. We
conducted semistructured, open-ended interviews with 22 autistic adults with
mental healthcare experience, 44 community mental health clinicians, and 11
community mental health agency leaders in the United States. The participants
identified clinician-, client-, and systems-level barriers and facilitators to
providing quality mental healthcare to autistic adults. Across all three
stakeholder groups, most of the reported barriers involved clinicians’ limited
knowledge, lack of experience, poor competence, and low confidence working with
autistic adults. All three groups also discussed the disconnect between the
community mental health and developmental disabilities systems, which can result
in autistic adults being turned away from services when they contact the mental
health division and disclose their autism diagnosis during the intake process.
Further efforts are needed to train clinicians to work more effectively with
autistic adults and to increase coordination between the mental health and
developmental disabilities systems.
Lay Abstract
Most autistic adults struggle with mental health problems, such as anxiety
and depression. However, they often have trouble finding effective mental
health treatment in their community. The goal of this study was to identify
ways to improve community mental health services for autistic adults. We
interviewed 22 autistic adults with mental healthcare experience, 44
community mental health clinicians (outpatient therapists, case managers,
and intake coordinators), and 11 community mental health agency leaders in
the United States. Our participants identified a variety of barriers to
providing quality mental healthcare to autistic adults. Across all three
groups, most of the reported barriers involved clinicians’ limited
knowledge, lack of experience, poor competence, and low confidence working
with autistic adults. All three groups also discussed the disconnect between
the community mental health and developmental disabilities systems and the
need to improve communication between these two systems. Further efforts are
needed to train clinicians and provide follow-up consultation to work more
effectively with autistic adults. A common suggestion from all three groups
was to include autistic adults in creating and delivering the clinician
training. The autistic participants provided concrete recommendations for
clinicians, such as consider sensory issues, slow the pace, incorporate
special interests, use direct language, and set clear expectations. Our
findings also highlight a need for community education about co-occurring
psychiatric conditions with autism and available treatments, in order to
increase awareness about treatment options.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>31674198</pmid><doi>10.1177/1362361319882227</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-9394-5956</orcidid><orcidid>https://orcid.org/0000-0002-6228-0509</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1362-3613 |
| ispartof | Autism : the international journal of research and practice, 2020-05, Vol.24 (4), p.919-930 |
| issn | 1362-3613 1461-7005 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7192780 |
| source | Applied Social Sciences Index & Abstracts (ASSIA); SAGE Complete A-Z List; Sociological Abstracts |
| subjects | Adults Anxiety Autism Autistic adults Barriers Case management Clinical Experience College professors Community education Community Health Services Community mental health services Comorbidity Competence Coordination Coordinators Developmental disabilities Educational Needs Gorillas Health problems Health services Knowledge Level Leadership Medical diagnosis Mental depression Mental disorders Mental health Mental health care Mental health professionals Mental Health Programs Mental Health Workers Pervasive Developmental Disorders Program Improvement Psychotherapy Public Agencies Qualitative research Self Efficacy Therapists Treatment methods |
| title | “I wouldn’t know where to start”: Perspectives from clinicians, agency leaders, and autistic adults on improving community mental health services for autistic adults |
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