For some autistic people, NHS treatment for anxiety and depression is not available.

Research has found that autistic people suffering from anxiety and depression do not receive the same quality of mental health care as the general population because their varying treatment needs are not being adequately met.

According to the NHS, up to 27 per cent of autistic people suffer from anxiety and 23 per cent develop depression, compared with 5.9 per cent and 3.3 per cent respectively in the general population.

However, they are much less likely to receive talk therapy on the NHS. Talk therapy will be significantly less effective for those who use it, according to a University College London (UCL) study of more than two million people who have used talk therapy services, including 8,761 autistic adults.

The study found that adults with autism were 25 percent less likely to have improved symptoms than the general population and 34 percent more likely to have worsened symptoms.

However, the researchers said the treatments in their current form are still useful for many autistic people.

“Our analysis suggests that therapy delivered in primary care settings may be beneficial for autistic people suffering from depression, anxiety, or both,” said lead researcher Céline El Baw.

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“However, we found that not only were treatment outcomes worse for autistic people, but the autistic population was significantly underrepresented in services. Although this study was unable to examine why this might be the case, we suspect that it reflects the specific barriers that autistic people face in accessing therapy, as well as the lack of adequate accommodations for neurodiversity, including differences in thinking styles, sensory sensitivities, or need for predictability. . »

Katie Long, who has autism, said there is no one-size-fits-all approach to therapy, adding that individual needs must be taken into account.

“I used to use NHS talk therapy, but cognitive behavioral therapy didn’t really help me. It was too educational,” the social worker said. I.

A UCL study found that adults with autism are two to five times less likely than the general population to attend NHS Talking Therapy for Anxiety, a free service offering cognitive behavioral therapy (CBT), counseling and guided self-help, which includes face-to-face meetings. face-to-face classes individually, in groups or online. This service was previously called Improving Access to Psychological Therapies (IAPT).

These treatments, along with antidepressants, are the standard treatment for depression and anxiety in the population.

It is unknown whether medications are less effective in autistic people than in the general population, as this appears to be the case.

Ms El Baw said: “People with autism may need more detailed and predictable information about what to expect from treatment, who will deliver it and what type of information is expected from them.” visual material than non-autistic people and less spontaneous verbal communication.

“The sensory environment can also influence how autistic people experience therapy, as they may be especially sensitive to background noise or room lighting when therapy is done in person. Therefore, this must be taken into account when providing services to autistic people.”

She advocates for making mental health care more accessible to people with autism by adapting it and making it more accessible.

“Not adapted to our needs”

“I think the key point will be that talk therapy is primarily designed by neurotypical people for neurotypical people,” says Katie Long, a social worker from Cardigan in West Wales.

“And when people don’t have a lot of experience working with autistic people, they’re not prepared to meet their needs.

“I know that being autistic means I think differently and probably react to situations differently, and there have been many instances in my life where people have misinterpreted that.

“I used to use NHS talk therapy, but cognitive behavioral therapy didn’t really help me. It was too educational. I’m not saying this won’t work for some autistic people. I just felt like it required a lot of thinking and I didn’t want to think too much, it was distracting.

“An autistic person with severe anxiety and possibly depression needs time to trust this person. So if someone is only offered short-term therapy, maybe six or even twelve sessions, it takes time to trust that person and get used to it, and then it stops. The logic would be: “Why would you do this, it will end?”

“That doesn’t mean it never works, because I think these things can be helpful for some people, but they’re not autism-friendly. There is no one size fits all. It’s about looking at the person and thinking about what he or she needs.”

Researchers say autistic people are likely underrepresented in mental health care for a number of reasons, but associated stigma plays a key role.

Anushka Pattenden, evidence and research manager at the National Autistic Society, who was not involved in the study, said: “Action needs to be taken now to ensure healthcare is as effective for autistic people.” It is important that mental health professionals are trained to recognize and understand autism, be flexible in their approach, and engage autistic people in discussions about the treatment and adjustments they need.”

Dr James Cusack, chief executive of the research organization Autistica and a government adviser on autism, said part of the problem was that due to great difficulty accessing services, many autistic people had already recovered from depression and anxiety by the time they came forward. to them. Talk therapy is very good. that it is much more difficult to treat.

In addition to special interests, behaviors, and/or sensory sensitivities, autism is characterized by specific experiences of social communication and interaction.

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Many autistic people need conditions that provide equal access to healthcare, employment and local government support.

It is estimated that between 1 and 3 per cent of the UK population have autism, although a recent UCL study suggests this figure could be twice as high as previously thought.

The researchers noted a number of limitations in their study, including that the comparison group also included undiagnosed adults.

The National Health Service stated: “Improving the mental health of autistic people remains a priority and we welcome these results from UCL, which show that our NHS talk therapy for depression and anxiety reduces symptoms in autistic adults.”

“More work needs to be done to reduce inequalities in outcomes for autistic people in talk therapy services. That’s why we’re working with the National Autistic Society to provide staff with guidance on how to overcome barriers and improve access for autistic people. We encourage anyone struggling with their mental health to contact the NHS Talk Therapy service online or see their GP.

Dr Conor Davidson, autism advocate at the Royal College of Psychiatrists, said: “Talk therapy plays an important role in the care of autistic people struggling with anxiety and depression, particularly when appropriate adjustments are made to suit the autism. “This research should not discourage autistic people from seeking help or dissuading doctors from providing therapy.

“Although this study shows that autistic people, on average, did not benefit as much from talk therapy as others, it does not show whether reasonable adjustments were made to the therapy they received.”

Professor Camila Hawthorne, President of the Royal College of General Practitioners, said: “Patients with autism and related conditions have special health needs, including in relation to access to care, and GPs and our teams will strive to meet these where possible.

“When it comes to talk therapy and other mental health services in England, most can now be accessed through self-referral, so it is important that these systems are also designed to take into account the needs of people with autism, including any potential barriers to their access . access care and services that can benefit their health.

“Interventions such as talk therapy and cognitive behavioral therapy have been shown to benefit some patients, and it is important that no one feels they do not have access to these treatments.”