High Rates of Co-occurring Mental Conditions Found Among Children and Adults with ASD
Drexel University’s Life Course Outcomes Research Program, part of the A.J. Drexel Autism Institute, has just released its annual National Autism Indicators Report. The goal of this report series is to present the program’s findings in “an open-access, online format to speed the delivery of information to decision-makers while maintaining high standards of scientific credibility.”
This year’s National Autism Indicators Report focuses on mental health care for children and adults on the spectrum. The aim of this research is to highlight areas of practice and policy that need improvement. The report’s principal finding shows that co-occurring mental health conditions are common in children and adults with autism spectrum disorder (ASD). For instance, the research demonstrated that 74% of children with ASD had at least one mental health condition as reported by parents. These conditions include behavioral or conduct problems, ADHD, anxiety, and depression. The report detailed that adults on the spectrum also suffer from anxiety, ADHD, and depression. However, psychoses and schizophrenia were additionally associated with adults with autism, but not with children.
Adverse childhood experiences (ACEs) were examined in great detail in the report, showing that these experiences are associated with mental health challenges into adulthood. The researchers reported that 61% of children with autism experienced at least one ACE, while 12% experienced at least four. The most common ACE was trouble covering basic needs such as food and housing. This ACE type was more common for children with ASD than in their peers with or without special health care needs. Other ACEs covered included divorced or separated parents, living with someone with a mental illness, living with someone with a drug or alcohol problem, a parent who served time in jail, violence in the home, being treated unfairly due to race or ethnicity, violence in the neighborhood, or a parent who died. Most ACEs were more common in Black children on the spectrum than in children of other races or ethnicity.
Treatment of mental health conditions was another topic closely investigated. The report demonstrated that 45% of children with autism received treatment or counseling from a mental health professional in the past year. Treatment was most common in children with depression. Approximately 80% of kids suffering with depression received treatment or counseling within the past year. Unfortunately, the report showed that one in five parents of children with autism revealed that it was very difficult or impossible to access needed services. In addition, 12% reported that their child needed mental health care and was not able to receive it in the past year.
The report concludes with recommendations to improve mental health care research and policy. The report’s authors call for:
- Mental health parity, requiring mental health services to be covered to the same degree as, or in parity with, medical and surgical services.
- Equitable access to care, treatment effectiveness, and treatment relevance in all racialized communities.
- Including more people with autism in mental health research, as they are currently under-represented.
- Access to more telehealth services, which will remove access barriers like travel and provider availability.
- Portability, or the ability for licensed professionals to provide services in a state other than the one for which they are licensed.
- Integrating mental and behavioral health into primary care, in an effort for primary care physicians to have expertise in managing complex mental health concerns, especially for individuals with autism.
- Connecting systems of care so that services and programs are not isolated from each other and can offer better support.
- Better mental health crisis care, which relies upon crisis call centers, mobile crisis teams, and crisis receiving and stabilizing programs.
- Additional provider training highlighting the intersection of autism and mental health.
