Shortage of Community Mental Health Clinicians Trained to Treat Autistic Adults

Background: Autistic adults with co-occurring psychiatric conditions often do not have access to quality mental health services in their communities, in large part because few community mental health clinicians are trained to work with autistic adults. Improving access to quality mental health services will require increasing clinicians’ knowledge about and confidence in adapting their clinical practice for this population. Little is known about how to best train community mental health clinicians to effectively treat autistic adults with co-occurring psychiatric conditions.

Objectives: To gather information about community mental health clinicians’ knowledge of, skills in, and confidence in treating autistic adults, in order to inform a training program for clinicians working with this population.

Methods: One hundred community mental health clinicians who work with adults in an urban setting completed an online survey (see Table 1 for demographic information). The survey was described as designed to elicit clinicians’ opinions of outpatient therapy methods, without specific mention of autism, in hopes that clinicians with a wide range of experiences with autistic clients (i.e., even those with little to no experience) would participate. Participants answered questions about their clinical experience with autistic adults and their prior autism training. Participants also completed a measure of their confidence in working with autistic adults, using an adapted version of the Therapist Confidence Scale-Intellectual Disabilities (TCS-ID).

Results: Most respondents (70%) indicated that they had no autistic adults on their current caseload, although 60% reported some experience providing mental health services to an autistic adult. Most participants (76%) had not received any formal training (e.g., CE workshop, graduate school coursework) in working with autistic adults. Almost all (96%) respondents indicated that they would likely attend such a training if it were offered through their agency. On average, clinicians reported feeling only “slightly knowledgeable” about treating autistic adults. On a scale ranging from 1 (not at all confident) to 5 (extremely confident), clinicians reported significantly less confidence treating autistic adults (M = 2.65, SD = 1.00), than treating adults without autism (M = 3.71, SD = .76), t(99) = -9.98, p < .001.

Conclusions: This study highlights the need for training to increase community mental health clinicians’ knowledge and confidence related to working with autistic adults. Better understanding the current landscape of community mental health services for autistic adults is crucial for future development of provider training programs. Most clinicians expressed a desire for more training in mental health interventions for autistic adults. However, one challenge is that most clinicians do not currently have an autistic adult on their caseload, which could limit the real-time practice of skills learned in a training program.