Advancing health-care equity for autistic people: mental health as a key priority

Added on 08/04/2025

Type de contenu

Journal article of the type Commentary ( ; english)

Daniel Wechsler, Will Mandy, Meng-Chuan Lai, Brian Boyd, Matthew Goodwin, Gauri Divan, Virginia Carter Leno
Advancing health-care equity for autistic people: mental health as a key priority published in the journal "The Lancet" Preprint, 3 pages , doi: 10.1016/s0140-6736(25)00667-1

- 4% of authors cited in the bibliography of this resource have publicly identified as autistic (5 out of 137 authors).
- 20% of references cited in this resource contain at least one author who has publicly identified as autistic (4 out of 20 references).

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Summary/Presentation

[First lines]

Autistic people make up a substantial proportion of society, with global prevalence estimated at around 1%. This amounts to approximately 80 million people worldwide, with the majority living in low-income and middle-income countries (LMICs). The risk of poor mental health is substantially elevated in autistic people, with mental health problems typically emerging early in life.  Estimates of lifetime prevalence in autistic adults are around 40% for both anxiety and depressive disorders. The prevalence of other psychiatric disorders is also substantially raised, and autistic people are three times more likely to die by suicide.

Despite being at increased risk of mental health difficulties, autistic people have poor access to appropriate and evidenced-based care. These health-care disparities likely contribute to heightened rates of mental ill health and poor quality of life. In this Comment, we draw on a range of expertise among the authors—including causal models of mental health in autistic populations, delivery of clinical care for autistic people (including those in LMICs), supporting autistic people with minoritised identities, and lived experience of barriers to receiving appropriate mental health care as an autistic person—and suggest actions required to redress health-care inequities that prevent autistic people from receiving the mental health supports they need.

For your information:

(1) References in blue are resources listed on our site.

(2) Authors listed in this bibliography whose names are in color have published other resources referenced on the site. Clicking on the name allows you to see the list of resources they have published and shared on the site.

(3) Authors whose names are followed by an asterisk have publicly disclosed being autistic.

  • T. Cullingham, U. Rennard, C. Creswell, et al. (2024). "The process of co-design for a new anxiety intervention for autistic children". JCPP Adv, e12255, Article e12255.

  • J. Zeidan, E. Fombonne, J. Scorah, A. Ibrahim, M. Durkin, S. Saxena, A. Yusuf, A. Shih, M. Elsabbagh (2022). "Global prevalence of autism: A systematic review update". Autism Research, 15(5). doi:10.1002/aur.2696

  • M. Hollocks, J. Wei Lerh, I. Magiati, R. Meiser-Stedman, T. Brugha (2019). "Anxiety and depression in adults with autism spectrum disorder: a systematic review and meta-analysis". Psychol. Med., 49(4). doi:10.1017/s0033291718002283

  • D. Santomauro, D. Hedley, E. Sahin, T. Brugha, M. Naghavi, T. Vos, H. Whiteford, A. Ferrari, M. Stokes (2024). "The global burden of suicide mortality among people on the autism spectrum: A systematic review, meta-analysis, and extension of estimates from the Global Burden of Disease Study 2021". Psychiatry Research, 341. doi:10.1016/j.psychres.2024.116150

  • D. Adams, K. Young (2021). "A Systematic Review of the Perceived Barriers and Facilitators to Accessing Psychological Treatment for Mental Health Problems in Individuals on the Autism Spectrum". Rev J Autism Dev Disord, 8(4). doi:10.1007/s40489-020-00226-7

  • J. Brede, E. Cage, J. Trott, L. Palmer, A. Smith, L. Serpell, W. Mandy, A. Russell (2022). "'We Have to Try to Find a Way, a Clinical Bridge' - autistic adults' experience of accessing and receiving support for mental health difficulties: A systematic review and thematic meta-synthesis". Clinical Psychology Review, 93. doi:10.1016/j.cpr.2022.102131

  • M. Lai, A. Amestoy, S. Bishop, H. Brown*, M. Giwa Onaiwu*, A. Halladay, C. Harrop, E. Hotez, M. Huerta, A. Kelly, D. Miller, C. Wu Nordahl, A. Ratto, C. Saulnier, P. Siper, K. Sohl, L. Zwaigenbaum, S. Goldman (2023). "Improving autism identification and support for individuals assigned female at birth: clinical suggestions and research priorities". The Lancet Child & Adolescent Health, 7(12). doi:10.1016/s2352-4642(23)00221-3

  • C. El Baou, G. Bell, R. Saunders, J. Buckman, W. Mandy, D. Dagnan, E. O'Nions, R. Pender, H. Clements, S. Pilling, M. Richards, A. John, J. Stott (2023). "Effectiveness of primary care psychological therapy services for treating depression and anxiety in autistic adults in England: a retrospective, matched, observational cohort study of national health-care records". The Lancet Psychiatry, 10(12). doi:10.1016/s2215-0366(23)00291-2

  • L. Clarke, L. Fung (2022). "The impact of autism-related training programs on physician knowledge, self-efficacy, and practice behavior: A systematic review". Autism, 26(7). doi:10.1177/13623613221102016

  • Z. Li, C. Hutchings-Hay, S. Byford, K. Tchanturia (2024). "A qualitative evaluation of the pathway for eating disorders and autism developed from clinical experience (PEACE): clinicians' perspective". Front Psychiatry, 15, Article 1332441.

  • A. Linden, L. Best, F. Elise, D. Roberts, A. Branagan, Y. Boon Ernest Tay, L. Crane, J. Cusack*, B. Davidson, I. Davidson, C. Hearst*, W. Mandy, D. Rai, E. Smith, K. Gurusamy (2023). "Benefits and harms of interventions to improve anxiety, depression, and other mental health outcomes for autistic people: A systematic review and network meta-analysis of randomised controlled trials". Autism, 27(1). doi:10.1177/13623613221117931

  • M. Knapp, E. Cyhlarova, N. Salehi, et al. (2024). "The economic case for prioritising autism in policy and reform". (Source)

  • M. Palmer, V. Carter Leno, V. Hallett, J. Mueller, L. Breese, A. Pickles, V. Slonims, S. Scott, T. Charman, E. Simonoff (2023). "Effects of a Parenting Intervention for Emotional and Behavioral Problems in Young Autistic Children Under Conditions of Enhanced Uncertainty: Two-Year Follow-up of a Pilot Randomized Controlled Trial Cohort (ASTAR) During the United Kingdom COVID-19 Pandemic". Journal of the American Academy of Child & Adolescent Psychiatry, 62(5). doi:10.1016/j.jaac.2022.09.436

  • G. Divan, S. Bhavnani, K. Leadbitter, C. Ellis, J. Dasgupta, A. Abubakar, M. Elsabbagh, S. Usman Hamdani, C. Servili, V. Patel, J. Green (2021). "Annual Research Review: Achieving universal health coverage for young children with autism spectrum disorder in low‐ and middle‐income countries: a review of reviews". Child Psychology Psychiatry, 62(5). doi:10.1111/jcpp.13404

  • L. Naithani, P. Sangwan, S. Guha Roy, S. Menon, Z. Azar, S. Lakhera, D. Kumar, M. Kakra Abhilashi, R. Roy, V. Vajaratkar, C. Taylor, V. Patel, J. Green, G. Divan (2022). "From engagement to competency: The pathway to making disability naïve frontline workers competent in the delivery of an evidence-based autism intervention in New Delhi, India". Front. Psychiatry, 13. doi:10.3389/fpsyt.2022.903341

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