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Approaches to improving mental health care for autistic children and young people: a systematic review and meta-analysis.

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Author information

Affiliations

  • 1. NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK.
      Authors
    • Pemovska T 1
    • Appleton R 1
    • Stefanidou T 1
    • Kular A 1
    • Greenburgh A 1
    • Barnett P 1
    • Baldwin H 1
    • Ahmed N 1
    • Lloyd-Evans B 1
    • Johnson S 1
    (10 authors)
  • 2. NIHR Mental Health Policy Research Unit, King's College London, London, UK.
      Authors
    • Loizou S 2
    • Cooper R 2
    • Griffiths J 2
    • Foye U 2
    • Saunders KRK 2
    • Simpson A 2
    (6 authors)
  • 3. NHS England, London, UK.
      Authors
    • Spain D 3
    (1 author)
  • 4. Division of Psychiatry, University College London, London, UK.
      Authors
    • Minchin M 4
    • Brady G 4
    • Totsika V 4
    • Clery P 4
    (4 authors)
  • 5. Lancaster and Morecambe Child and Adolescent Mental Health Services, Lancashire and South Cumbria NHS Foundation Trust, Morecambe, UK.
      Authors
    • Jackson R 5
    (1 author)
    • Show all (9)

ORCIDs linked to this article

Show all (6)

Psychological Medicine, 17 May 2024, 54(10):2313-2343
https://doi.org/10.1017/s0033291724001089 PMID: 38757186 

Review

This article is based on a previously available preprint.

Abstract 

Autistic children and young people (CYP) experience mental health difficulties but face many barriers to accessing and benefiting from mental health care. There is a need to explore strategies in mental health care for autistic CYP to guide clinical practice and future research and support their mental health needs. Our aim was to identify strategies used to improve mental health care for autistic CYP and examine evidence on their acceptability, feasibility, and effectiveness. A systematic review and meta-analysis were carried out. All study designs reporting acceptability/feasibility outcomes and empirical quantitative studies reporting effectiveness outcomes for strategies tested within mental health care were eligible. We conducted a narrative synthesis and separate meta-analyses by informant (self, parent, and clinician). Fifty-seven papers were included, with most investigating cognitive behavioral therapy (CBT)-based interventions for anxiety and several exploring service-level strategies, such as autism screening tools, clinician training, and adaptations regarding organization of services. Most papers described caregiver involvement in therapy and reported adaptations to communication and intervention content; a few reported environmental adjustments. In the meta-analyses, parent- and clinician-reported outcomes, but not self-reported outcomes, showed with moderate certainty that CBT for anxiety was an effective treatment compared to any comparison condition in reducing anxiety symptoms in autistic individuals. The certainty of evidence for effectiveness, synthesized narratively, ranged from low to moderate. Evidence for feasibility and acceptability tended to be positive. Many identified strategies are simple, reasonable adjustments that can be implemented in services to enhance mental health care for autistic individuals. Notable research gaps persist, however.

Full text links 

Read article at publisher's site: https://doi.org/10.1017/s0033291724001089

Read article for free, from open access legal sources, via Unpaywall: https://www.cambridge.org/core/services/aop-cambridge-core/content/view/0B8C35C61254ADFFD8DBCFF7B8BF4BF7/S0033291724001089a.pdf/div-class-title-approaches-to-improving-mental-health-care-for-autistic-children-and-young-people-a-systematic-review-and-meta-analysis-div.pdfUnpaywall

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