Woods Katherine, Dunn Rebecca, Smith Ian, Di Basilio Daniela
Faculty of Health and Medicine, Lancaster University, Lancaster, UK.
The Priory Cheadle Royal, Manchester, UK.
J Autism Dev Disord. 2025 Sep 27. doi: 10.1007/s10803-025-07050-0.
Autistic individuals and individuals with borderline personality disorder (BPD) are both more likely than the general population to require access to mental health services, specifically inpatient services. Both groups of individuals have reported difficulties when accessing inpatient services including stigma, lack of understanding and lack of adaptations. Recent research has suggested having diagnoses of both autism and BPD is becoming more common and that individuals with both diagnoses may be more at risk of suicidal thoughts and self-harm behaviours. The aim of this study is to understand the experiences of accessing inpatient mental health services for individuals with a diagnosis of autism and BPD.
Semi-structured interviews were conducted with participants. The data were analysed using reflexive thematic analysis.
Seven participants were interviewed. Six themes were developed: (i) Never fully understood, (ii) Intense need for care and connection, (iii) Prisoner or patient? When care and punishment are intertwined, (iv) Necessary evil, (v) System always wins, (vi) Responsible for own care.
Autistic individuals with BPD require personalised care that integrates both their diagnoses into their identities. To provide this, staff on inpatient wards need appropriate support including reflective spaces and clinical supervision. Inpatient systems also need to shift away from prioritising the needs of the system and towards prioritising the needs of the individual, including adaptations for autistic individuals.
自闭症患者和边缘型人格障碍（BPD）患者比普通人群更有可能需要获得心理健康服务，特别是住院服务。这两组人群在获得住院服务时都报告了困难，包括污名化、缺乏理解和缺乏适应性调整。最近的研究表明，同时患有自闭症和BPD的情况越来越普遍，且患有这两种疾病的个体可能更有自杀念头和自我伤害行为的风险。本研究的目的是了解被诊断患有自闭症和BPD的个体在获得住院心理健康服务方面的经历。
对参与者进行了半结构化访谈。使用反思性主题分析法对数据进行了分析。
对七名参与者进行了访谈。确定了六个主题：（i）从未被完全理解，（ii）对关爱和联系的强烈需求，（iii）囚犯还是患者？当护理与惩罚交织在一起时，（iv）必要之恶，（v）系统总是赢家，（vi）对自己的护理负责。
患有BPD的自闭症患者需要个性化护理，将他们的两种诊断融入其身份认同中。为了提供这种护理，住院病房的工作人员需要适当的支持，包括反思空间和临床监督。住院系统也需要从优先考虑系统需求转向优先考虑个体需求，包括为自闭症个体进行适应性调整。
