Loizou Sofia, Pemovska Tamara, Stefanidou Theodora, Foye Una, Cooper Ruth, Kular Ariana, Greenburgh Anna, Baldwin Helen, Griffiths Jessica, Saunders Katherine R K, Barnett Phoebe, Minchin Matilda, Brady Gráinne, Ahmed Nafiso, Parker Jennie, Chipp Beverley, Olive Rachel R, Jackson Robin, Timmerman Amanda, Sapiets Suzi, Driskell Eva, Parsons Bethany, Spain Debbie, Totsika Vaso, Mandy Will, Pender Richard, Clery Philippa, Trevillion Kylee, Lloyd-Evans Brynmor, Simpson Alan, Johnson Sonia
National Institute for Health and Care Research (NIHR) Mental Health Policy Research Unit, King's College London, UK.
NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, UK.
BJPsych Open. 2024 Aug 1;10(4):e128. doi: 10.1192/bjo.2024.707.
Autistic people have a high likelihood of developing mental health difficulties but a low chance of receiving effective mental healthcare. Therefore, there is a need to identify and examine strategies to improve mental healthcare for autistic people.
To identify strategies that have been implemented to improve access, experiences of care and mental health outcomes for autistic adults, and to examine evidence on their acceptability, feasibility and effectiveness.
A co-produced systematic review was conducted. MEDLINE, PsycINFO, CINHAL, medRxiv and PsyArXiv were searched. We included all study designs reporting acceptability or feasibility outcomes and empirical quantitative study designs reporting effectiveness outcomes. Data were synthesised using a narrative approach.
A total of 30 articles were identified. These included 16 studies of adapted mental health interventions, eight studies of service improvements and six studies of bespoke mental health interventions developed for autistic people. There was no conclusive evidence on effectiveness. However, most bespoke and adapted approaches appeared to be feasible and acceptable. Identified adaptations appeared to be acceptable and feasible, including increasing knowledge and detection of autism, providing environmental adjustments and communication accommodations, accommodating individual differences and modifying the structure and content of interventions.
Many identified strategies are feasible and acceptable, and can be readily implemented in services with the potential to make mental healthcare more suitable for autistic people, but important research gaps remain. Future research should address these and investigate a co-produced package of service improvement measures.
自闭症患者出现心理健康问题的可能性很高，但获得有效心理保健的机会却很低。因此，有必要确定并研究改善自闭症患者心理保健的策略。
确定为改善自闭症成年人获得心理保健的机会、就医体验和心理健康结果而实施的策略，并研究这些策略在可接受性、可行性和有效性方面的证据。
进行了一项联合产出的系统评价。检索了MEDLINE、PsycINFO、CINHAL、medRxiv和PsyArXiv。我们纳入了所有报告可接受性或可行性结果的研究设计，以及报告有效性结果的实证定量研究设计。采用叙述性方法对数据进行综合分析。
共识别出30篇文章。其中包括16项针对自闭症患者调整后的心理健康干预研究、8项服务改进研究以及6项专门为自闭症患者开发的心理健康干预研究。关于有效性没有确凿证据。然而，大多数专门定制和调整后的方法似乎是可行且可接受的。已识别出的调整措施似乎是可接受且可行的，包括增加对自闭症的认识和检测、提供环境调整和沟通便利、适应个体差异以及修改干预措施的结构和内容。
许多已识别出的策略是可行且可接受的，并且可以在服务中轻松实施，有可能使心理保健更适合自闭症患者，但仍存在重要的研究空白。未来的研究应解决这些问题，并研究一套联合产出的服务改进措施。
