The Mental Health Epidemic No One is Talking About

There is a mental health epidemic that few are aware of: the high co-occurrence of suicidal ideation and overall mental health struggles in autistic people. A recent study found that 70% of autistic individuals have at least 1 mental health diagnosis and 50% have 2 or more (Lai, et al., 2019). As for suicidal risk, a recent study found that suicide rates in autistic adults are 3 times higher than that of the general population (South, et al, 2021). Yet another recent study found that autistic people who are considered “high functioning,” a term many object to, are 9 times more likely to die by suicide than neurotypicals (Hirvikoski, et al., 2016). Additionally, another study showed that autistic children who have an IQ of 120 or higher are almost 6 times more likely to struggle with suicidal ideation than their same age peers (Casten, et al., 2023). Unfortunately, the mental health community is not stepping up to meet the mental health needs of autistic people. Cantor et al. (2020), reported after surveying more than 8,000 mental health clinics in the United States that only 43% would accept a referral for a child with an autism diagnosis. Of that 43%, only 12.7% had a therapist with any training or experience in treating autistic children, and only 4.3% had therapists using treatment interventions specifically designed for autistic children.

It is time to spread awareness and advocate for better supports from mental health professionals. In my work, I hear statements such as "I don't do autism," etc. from other professionals at least once every month or two. No one acts like this is a big deal and the concept of "competency" is used to justify this. While I agree that competency is very important, disabled people often go without mental healthcare because no one will see them. This is a crisis as again, co-occurring mental health diagnoses is very high in this population (not just for autistic people, but for those with intellectual disabilities as upwards of 35% of the IDD community have at least one mental health diagnosis (National Association for the Dually Diagnosed, N.D.)). I always ask people to reflect on statements like, "I don't do autism," by inserting ANY other minority group into that statement, "I don't do _____." We don't tolerate that kid of racism, sexism, homophobia, etc. why do we tolerate ableism like it isn't a big deal?

So please, spread the word about this mental health crisis. If you are a mental health professional who feels that they do not have the competency to treat disabled people, take a training, find a therapy resource, a supervisor, or consultant that can help you increase your competency and skills. Finally, make sure you are working to appreciate disabled people in your daily life as society benefits from neurodivergent minds!

References

Cantor, J., McBain, R. K., Kofner, A., Stein, B. D., & Hao Yu. (2020). Fewer than half of US mental health treatment facilities provide services for children with autism spectrum disorder. Health Affairs, 39(6), 968–974.  doi: 10.1377/hlthaff.2019.01557

 Casten LG, Thomas TR, Doobay AF, Foley-Nicpon M, Kramer S, Nickl-Jockschat T, Abel T, Assouline S, Michaelson JJ. (2023). The combination of autism and exceptional cognitive ability is associated with suicidal ideation. Neurobiol Learn Mem. 197:107698. doi: 10.1016/j.nlm.2022.107698.

Hirvikoski T, Mittendorfer-Rutz E, Boman M, Larsson H, Lichtenstein P, Bölte S. (2016). Premature mortality in autism spectrum disorder. Br J Psychiatry. 208(3):232-8. doi: 10.1192/bjp.bp.114.160192.

Lai, MC, Kassee, C, Besney, R, Bonato, S, Hull, L, Mandy, W, Szatmari, P, & Ameis, SH (2019). Prevalence of co-occurring mental health diagnoses in the autism population: A systematic review and meta-analysis. Lancet Psychiatry.

National Association for the Dually Diagnosed. (N.D.). What is an IDD/MI dual diagnosis? https://thenadd.org/idd-mi-diagnosis/

Penot, J., (2024). A Better Way to Help Adults With Autism. Psychology Today. https://www.psychologytoday.com/us/blog/the-forgotten-women/202410/a-better-way-to-help-adults-with-autism

South M, Costa AP, McMorris C. Death by Suicide Among People With Autism: Beyond Zebrafish (2021). JAMA Netw Open. 4(1):e2034018. doi:10.1001/jamanetworkopen.2020.34018