Turn Awareness Into Action for Autism and Mental Health

This May marks the 76th observance of Mental Health Awareness Month in the United States. This year’s theme, “Turn Awareness Into Action,” challenges us to be moved by stories and statistics. It begs us to ask the question, “What can I do to respond to the mental health needs of my community?” This is a question that I often consider in the context of my work with children and adolescents on the autism spectrum.

Autism Associated With a Higher Risk of Some Mental Health Concerns

A diagnosis of autism spectrum disorder (ASD) is associated with increased risk for a host of mental health concerns. According to the American Psychiatric Association (APA), approximately 70% of individuals diagnosed with ASD have at least one co-occurring mental health condition, most commonly anxiety disorders and depression. The APA also reported that rates of suicide attempts and completions are higher among autistic adolescents and young adults compared to that of the general population. Some recent research also suggests that individuals on the autism spectrum may have an increased risk of developing severe, chronic psychiatric disorders, like bipolar disorder and psychosis. However, estimates of the prevalence of these conditions in the autism community has varied widely across studies due to differences in how data was collected.

There are a number of reasons why people on the autism spectrum might be susceptible to mental health challenges. Two areas identified by research are high rates of adverse childhood experiences, and limited access to needed services.

Autistic children have been found to be at heightened risk of adverse childhood experiences, or ACEs. These are traumatic events or aspects of the environment that may undermine a child’s sense of safety and stability, such as parental separation, housing instability, food insecurity, etc. In many families of autistic children, at least one parent has had to reduce or quit working to support their child, which can result in financial strain. Due to differences in social interaction and communication skills, children on the autism spectrum are more likely to experience bullying or exploitation than typically developing peers. Additionally, parents of autistic children express heightened concerns about their child’s safety in the community, which may be due to issues like elopement and impulsivity contributing to a higher risk of injury. ACEs are strongly associated with a host of negative outcomes, including chronic mental health and substance abuse problems.

Mental Health Needs Not Always Being Met for Our Autistic Population

People on the autism spectrum also report having higher rates of unmet service needs than individuals without a diagnosis of ASD. Studies have found that, for children on the autism spectrum, access to a primary care medical home can have a buffering effect against some of the negative outcomes associated with ACEs. Specifically, having a “medical home” that provides comprehensive, well-coordinated, family-centered care increases the likelihood of an autistic child having improved health and wellness, as well as decreased financial burdens on the family. However, based on national survey data, children on the autism spectrum are less likely to receive this kind of care than children with other special heath care needs. Autistic adolescents are also more likely to have unmet specialty mental health care needs than non-autistic peers. Additionally, the quality of mental health care for autistic adolescents tends to be poorer, due to a lack of evidence-based psychotherapies that are adapted to suit their unique needs and communication styles.  

What Can Help: Better Knowledge and Resources 

These statistics highlight the need, but what can we do in response? I believe parents of children on the autism spectrum can be empowered when they learn about autism and mental health, think preventatively, and are knowledgeable about resources. At the Autism Center, we offer classes to parents and caregivers on a range of topics, including anxiety, attention-deficit/hyperactivity disorder (ADHD), sleep problems, and mental health service options. Regarding prevention, Seattle Children’s Odessa Brown Children’s Clinic (OBCC) is a primary care medical home that offers integrated behavioral health and autism-specific therapies. Both OBCC and the Autism Center offer family support navigating resources to address a range of needs, including physical and mental health services, special education, disability supports and other autism and general community resources. Located in our Magnuson office in North Seattle is Psychiatric Urgent Care, which offers same-day visits for children and adolescents who need urgent mental health support. The Autism Center offers certain specialty mental health services, including a therapy group for autistic adolescents with anxiety disorders and their parents.

Our understanding of the mental health needs of children and youth with autism is constantly improving, and the number of therapists and clinics serving autistic clients is slowly growing in our state. Groups such as the Washington INCLUDE Collaborative are actively working to improve training and support for clinical providers in this area. Nevertheless, more work is needed to improve access to resources and mental health parity. One way that we can all respond is by making our voices heard.

More Information and Resources for Support and Advocacy

• Autism and Mental Health (Autism Speaks)
• Autism Society (search for “mental health” to find a variety of articles and resources)
• Mental Health Referral Service for Children and Teens
• Washington State Medical Home Partnerships Project