Metrics details. Autism refers to a neurodevelopmental condition with characteristic impairments in social interaction and communication, restrictive and repetitive behaviors, as well as difficulties in sensory information processing and daily living skills. Even though symptoms persist from early childhood throughout the lifespan and often require long-term support, there is a lack of mental health services that sufficiently meet the needs of autistic adults.
Previous evidence suggested individual, professional and structural barriers to healthcare for autistic adults. Here, using a peer research approach, we sought to systematically investigate barriers and needs in mental healthcare of autistic adults in Germany at the three relevant levels individual, professional, structural and from three relevant perspectives autistic adults, relatives and healthcare providers , in order to obtain specific recommendations for optimized healthcare.
Maximum variation sampling was used to account for the complexity of the research field. Data analysis was performed using the codebook approach of thematic analysis. Themes were similarly reported across participants, emphasizing dissatisfaction in all stakeholders. We identified major barriers to mental healthcare for autistic adults in Germany that affect autistic adults, but are also of concern to relatives and healthcare providers. Our results point to specific and generic areas for improvement, independent of stakeholder perspectives, which could guide future development of needs- and evidence-based services, recommendations and guidelines of mental healthcare for people with autism across the lifespan.
Peer Review reports. Manifestations of autism include characteristic impairments in social interaction and communication, as well as restrictive and repetitive behaviors, including abnormalities in sensory information processing, and difficulties in critical domains of daily living [ 2 ]. Previous evidence showed increased rates of comorbid somatic diseases, such as epilepsy, diabetes, gastrointestinal, cardiovascular and respiratory diseases [ 3 , 4 , 5 ], and psychiatric conditions [ 4 , 5 ].
Furthermore, increased rates of premature mortality [ 4 ] and risk of committing suicide and dying by suicide [ 6 , 7 ] have been reported. As such, autistic adults often require a broad variety of medical as well as mental healthcare services, including social services like supported employment [ 8 ].
