‘It’s not fair, this isn’t what an autistic person should go through’: Experiences of autistic adults on inpatient mental health wards

When an autistic person requires inpatient mental health support, they should be supported in mainstream services with reasonable adjustments. However, there is a lack of research into how autistic service users find their admissions to mental health wards. Ten United Kingdom-based autistic adults took part in semi-structured interviews to explore their experiences of being a mental health inpatient. These results were analysed using reflexive thematic analysis (RTA) and four themes were developed: ‘I’m not mental health, I’m not autism, I’m just me’, ‘All the noise. All the people. All the unpredictability’, ‘You work out how to survive’, and ‘It’s the usual set up, all the decisions had been made’. Results highlighted a negative overall appraisal of inpatient admissions, with specific difficulties in a lack of nuanced autism understanding, sensory environments, unpredictability and a felt sense of powerlessness. Findings indicate further autism training is required for staff working on inpatient wards, as well as changes to sensory environments that could benefit neurodivergent populations. These changes should detail how to put in place reasonable adjustments throughout a person’s admission. Decisions around these factors should be made in collaboration with experts-by-experience to ensure effective intervention. Lay Abstract: At times, autistic adults who experience mental health difficulties may need to be supported in inpatient mental health care to manage risks to themselves and others. When this is the case, these adults should be able to access mainstream mental health services, and those supporting them should put in place reasonable adjustments to support their autistic needs. The researcher interviewed 10 UK-based autistic adults who had spent time in NHS England inpatient mental health wards to find out about their experiences. All participants found their time on mental health wards difficult, and there were some common reasons for this, including: autism needs not being recognised or understood, the environment of the ward not fitting their needs, and feeling as though they had no power to make changes in their care. This suggests that changes need to be made to how inpatient mental health care is delivered to autistic service users.