The mental health crisis among persons with autism


I strongly suspect that many reasonably knowledgable disability advocates have little or no appreciation of the extent to which persons with developmental disabilities, especially individuals with autism are vulnerable to mental illness. A recently published study in the Journal of Autism and Developmental Disorders illustrates the extent to which the prevalence of mental illness among young adults with autism represents an epidemic with serious implications for the medical and mental health communities – and for anyone involved in ministry in the autism community.

A team of Canadian investigators reviewed the demographics, clinical profiles, and health service use patterns of young adults in Ontario between the ages of 18–24 years with autism spectrum disorders (ASD), other developmental disabilities (other DD), and those without ASD or other DD (non-DD) using administrative health data. Some of the key findings from the study include:

  • 52% of young adults with autism had a psychiatric diagnosis, compared to 39% of persons with other DD and 19% of the non-DD population.
  • Young adults with autism were 2.34 times more likely to see a psychiatrist than peers with other DD, and twelve times more likely to see a psychiatrist than peers without developmental disabilities.
  • Young adults with autism are 4.58 times more likely to access psychiatric services through an emergency room and experience rates of psychiatric hospitalization more than ten times higher than those reported among their non-DD peers.

This study echoes earlier research we’ve reported on in this blog, including a studyreporting that adults with autism and no intellectual disability are over nine times more likely to commit suicide when compared to their age-matched peers, another study of 10-14 year-olds with autism in which 70% of kids with autism were found to have at least one mental health disorder such as anxiety, ADHD or depression and 41% had at least two comorbid mental health disorders and a report that kids with autism were 28 times more likely to experience suicidal ideation than age-matched peers without autism.

It is important to note in looking at the Canadian data that rates of mental illness are elevated in general among persons with intellectual and other developmental disabilities. In that study, mental illness was roughly twice as common and use of psychiatric services was five times more common among persons with non-autistic developmental disabilities compared to the general population.

What are the most important take home points here for pastors and disability ministry leaders?

Mental health ministry is inseparable from special needs ministry with children and teens or any ministry serving adults with intellectual or developmental disabilities. Many of the strategies used in promoting emotional regulation and self control among children and adults who struggle in those areas represent mental health-based interventions.

Children and adults of typical intelligence with autism spectrum disorders will be more appropriately served by mental health inclusion ministry. When our Key Ministry team was in the process of developing a mental health inclusion model, we sought to develop a model that would account for the challenges persons with autism face in attending church associated with their primary condition (sensory processing, social isolation and expectations for social communication), challenges linked with the mental health conditions arising from associated mental health conditions (stigma and the reluctance to self-identify, anxiety, executive functioning deficits) and a challenge common to both types of conditions – overcoming negative experiences of church in the past. An effective inclusion ministry has to be prepared to help overcome all of the obstacles they’re likely to encounter across all of the activities essential to the life and mission of the local church.

We need to fully appreciate the unique struggles and challenges experienced by children and adults at all points along the autism spectrum. The condition that has spurred the development of much special needs ministry in recent years (children and adults with profound language delays, intellectual disability and stereotypic behavior) is fundamentally different than the experience of persons with restricted interests and behaviors and social communication deficits but normal to high intelligence. Our models of ministry to this point have failed to recognize the unique needs – and unique gifting of persons at the high end of the spectrum.

Perhaps one of the reasons the church has struggled to effectively minister with many persons with autism spectrum disorders is that we don’t do a very good job of welcoming and including children and adults with mental health-related challenges common among persons with autism?