NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, UK; Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, UK; and National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK
Matilda Minchin
Division of Psychiatry, University College London, UK
Gráinne Brady
Division of Psychiatry, University College London, UK
Nafiso Ahmed
NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, UK
Jennie Parker
NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, UK; and School of Health and Psychological Sciences, City, University of London, UK
Beverley Chipp
NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, UK
Rachel R. Olive
NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, UK
Robin Jackson
Lancaster and Morecambe Child and Adolescent Mental Health Services, Lancashire and South Cumbria NHS Foundation Trust, Morecambe, UK; and University of Wolverhampton, UK
Amanda Timmerman
Department of Clinical, Educational and Health Psychology, University College London, UK
NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, UK
Alan Simpson
National Institute for Health and Care Research (NIHR) Mental Health Policy Research Unit, King's College London, UK
Sonia Johnson
NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, UK; and Camden and Islington NHS Foundation Trust, London, UK
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.
