Acceptable access to health services for adults on the autism spectrum

Background: People with autism may experience higher rates of mental health difficulty, yet access to appropriate mental health support and services has been recognised as challenging.

Aims: This study aimed to explore whether components of the Theory of Planned Behaviour (TPB) could explain variance in IAPT clinicians’ intention to carry out interventions for mental health difficulties in people with High functioning autism (HFA) or Asperger’s syndrome (AS). It also explored the effect on intention of past experience of carrying out these interventions.

Method: There were two stages to the study. The first stage involved a qualitative elicitation study, which investigated attitudes, subjective norms and perceived behavioural control factors in carrying out the interventions. The second stage was a questionnaire-based study. The questionnaire was created following content analysis of the qualitative data, and was completed by clinicians currently working in Improving Access to Psychological Therapy (IAPT) services (n=88). The data were then analysed using multiple regression.

Results: The theory of planned behavioural model predicted 56.5% of the variance in intention to carry out interventions for mental health difficulties for people with (Autism Spectrum Conditions (ASCs). The most significant components in predicting intention were indirect attitude measures, direct measures of perceived behavioural control, and indirect subjective normative referents. Past experience of carrying out these interventions was significantly associated with intention when the individual had no experience of working with people with ASCs previously.

Conclusion: Further explorations of unaccounted variables impacting on intention to carry out interventions for mental health difficulties with people with ASCs could be valuable. Clinical implications include additional training for therapists in ASCs and development of adapted materials if part of the intervention. Future research could focus on therapy efficacy other than for cognitive behavioural therapy and in-depth accounts from therapists and service users with ASCs as to their therapeutic experiences.