A Mixed-Method Study Exploring the Experiences of Adults with Autism and Co-existing Mental Health Disorder(s), and Professionals' Knowledge of Autism Spectrum Disorder (ASD)

  • Chelsea Courts

    Student thesis: Doctoral Thesis


    Adults with autism are at high risk of experiencing mental health difficulties. It is therefore surprising that very little is known about the needs and experiences of this population in relation to accessing adult mental health services. This study had three aims: (1) to explore the needs and experiences of adults with co-existing autism and mental health disorder, (2) to establish whether a Health Board’s adult mental health services met the needs of these service users, and (3) to evaluate the knowledge of ASD amongst mental health professionals working within adult mental health services.

    This study utilised a parallel mixed-method design, consisting of two-phases of data collection. The first phase involved semi-structured interviews with adults with co-existing autism and mental health disorder(s) to explore their needs and experiences of accessing adult mental health services (N = 20). The second phase involved an online questionnaire to establish professionals’ knowledge of ASD, as well as the confidence that professionals had in their ASD knowledge (N = 58).

    The qualitative interviews from Phase 1 were analysed using Interpretative Phenomenological Analysis (IPA). Five superordinate themes were identified relevant to the needs and experiences of service users with co-existing autism and mental health disorder(s): (1) Experience of Autism Diagnosis, (2) Staff Awareness of Autism, (3) Facilitating Communication, (4) Dissatisfaction, and (5) Making Accommodations. The quantitative findings from Phase 2 indicated that mental health professionals may not possess adequate levels of ASD knowledge. Additionally, ASD knowledge held by professionals who had undertaken ASD training was significantly higher than those who had not received training, indicating that providing ASD training could be a means to increasing professionals’ ASD knowledge.

    The current study contributed to knowledge in the following ways: (1) it explored the experiences of adults with co-existing autism and mental health disorder(s) and identified the service needs of this population, (2) it established the current level of ASD knowledge and ASD confidence held by mental health professionals working in an adult mental health service, and (3) it resulted in the development of a questionnaire that can measure individuals’ ASD knowledge and ASD confidence.

    Recommendations for practice generated from the findings of the current study include a need for a clear and consistent pathway for autism diagnosis. Staff working within adult mental health services need to be provided with autism training, with staff also needing to ensure that they ask service users about their communication preferences. Mental health services need to move away from a crisis-driven provision to a service that works proactively to prevent mental health decline. A need for the Crisis Team to modify the way they currently provide support to the current population was evident as well as a need for healthcare environments to be accessible to adults with autism. Recommendations for future research are also provided within this thesis.
    Date of AwardNov 2021
    Original languageEnglish
    SupervisorAnne Fothergill (Supervisor), Ruth Northway (Supervisor) & Catherine Purcell (Supervisor)

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