Don't ask me what's the matter, ask me what matters: Acute mental health facility experiences of people living with autism spectrum conditions.

P Maloret,T Scott

doi:10.1111/jpm.12438

Abstract

Background This qualitative study explored how mental health inpatients with autistic spectrum conditions (ASCs) experience and cope with anxiety when admitted to an acute mental health inpatient facility in the United Kingdom. Anxiety is a common characteristic for people who live with ASCs and whilst a plethora of studies on anxiety in this population is published which correlate anxiety with mental health service experience, little is known about the actual triggers of anxiety and its manifestations. This study adds to a body of evidence which considers anxiety experienced by people with autism. The rationale for this study includes the need to heighten mental health practitioners' understanding, of the responses, motivations to engage and support required to overcome fears and anxieties when admitted to a mental health inpatient unit. Method The study used a qualitative naturalistic research design, to explore the emotional and psychological experiences of being a mental health inpatient living with an ASC. During 2015-2017. audio-recorded semistructured interviews captured the experiences of 20 adults from the east of England who were former psychiatric inpatients with an established diagnosis of ASC. Interpretative phenomenological analysis enabled the identification of broad themes which explained in rich detail, participant reflections regarding the situations and events within the acute care mental health facility that triggered their anxiety, manifestations of anxiety and responses to their anxiety. Findings Broad response patterns were identified that could be associated with their anxiety that is isolating themselves from others, including patients and staff, ceasing to eat and sleep adequately and all too often self-harming or exhibiting aggressive and violent responses. Conclusions The anxiety caused by the physical environment appears to be overlooked by mental health practitioners so attention to anxiety-inducing encounters is needed when planning acute care mental health service improvement and research is required to clearly understand the experiences of this vulnerable group.

Highlights

According to the National Autistic Society (2017) an Autistic Spectrum Condition (ASC) is a lifelong developmental disability that affects how people perceive the world and interact with others
Growing numbers of people living with an autistic spectrum condition find themselves in mental health inpatient units within the UK
It is largely the opinion of the participants of the study that the services in which they find themselves are woefully ill-equipped to deal with their different needs and that frontline staff in mental health units could learn from mistakes made in the past and gain greater awareness and knowledge of how the core features of autism coexist with mental health issues

Summary

Introduction

According to the National Autistic Society (2017) an Autistic Spectrum Condition (ASC) is a lifelong developmental disability that affects how people perceive the world and interact with others. Howlin (2005) notes that the mere thought of an inpatient admission for a person with ASC can cause an acute escalation of the severity of their mental health condition, the desire for sameness can be seriously compromised when someone with ASC is placed in unfamiliar surroundings. This qualitative study explored how mental health inpatients with autistic spectrum conditions experience and cope with anxiety when admitted to an acute mental health inpatient facility in the UK. Findings Broad response patterns were identified that could be associated with their anxiety i.e. isolating themselves from others, including patients and staff, ceasing to eat and sleep adequately and all too often self-harming or exhibiting aggressive and violent responses

Objectives

Methods

Findings

Discussion

Conclusion