Human Service Professional's Perspectives on Services for Autistic Adult Mental Health: A Community Engaged Study

Background and Purpose:

Autism research has been proposed as a “grand challenge” for social work, yet social workers often lack coherent roles, knowledge, and training related to autism. Additionally, Autistic adult mental health has been framed as a “crisis” requiring a coordinated response from social workers and other human service professionals.

While research has examined the barriers Autistic people and their communities face in accessing mental health support—and the barriers professionals face in providing it—few studies explore the strategies and adaptations that professionals use to address these barriers. This paper examines how human service professionals support Autistic adult mental health in practice. Drawing on their experiences, participants offer suggestions for change across ecological systems levels.

Methods:

Using a community-engaged research approach, 24 in-depth, semi-structured interviews were conducted with professionals supporting Autistic adults (e.g., social workers, speech-language pathologists, occupational therapists, psychiatrists, psychologists). Participants were recruited through selective and convenience sampling in partnership with a local grassroots autism community organization.

The sample was predominantly neurodivergent (54.1%, n = 13), majority women (75%, n = 18), with most holding a master’s degree (66.7%, n = 16). Interviews explored participants’ experiences supporting Autistic adults, barriers to Autistic adult mental health at the micro, mezzo, and macro levels, and the strategies they used to overcome them. Interviews were transcribed verbatim using NVivo Transcribe. Coding followed an abductive approach to thematic qualitative content analysis, organized through Ecological Systems Theory. In alignment with community-engaged scholarship and to enhance epistemological integrity, theme development incorporated feedback from the partner organization.

Findings:

Participants identified five key barriers to Autistic adult mental health across ecological levels: funding and cost, knowledge and training, diagnosis, trust, and ableism and stigma. Some expressed frustration with underfunded policies and organizations tasked with serving Autistic adults; others noted gaps in provider training, capacity, and inclusive practice. Most participants emphasized that these barriers are rooted in structural and individual stigma. They described a variety of strategies to mitigate these challenges while underscoring the need for broader systemic change.

Conclusions and Implications:

Findings underscore the importance of addressing barriers to Autistic adult mental health through systemic change, particularly at the macrosystem level. Enhancing funding and training for mental health professionals is essential. By addressing Autistic adult mental health at a systems level, social workers can foster more inclusive, affirming, and supportive environments across practice contexts.