Understanding Mental Health in Autistic Young People: Ask, Accept, Develop
By Dr Freya Spicer-White, Head of Neurodiversity Practice and Standards
Autistic young people often face more challenges with their mental health, including anxiety and depression. Research suggests that between 70-80% of Autistic people will experience some form of mental health problems in their lifetime.
This help sheet is designed to explain these difficulties in a way that’s quick and easy to understand and offers advice on how to support a young person using our three core concepts: Ask, Accept, and Develop.
Why Mental Health Matters
Just like physical health, mental health is very important. It impacts our daily lives and everything we do; how we think, feel, and act; our relationships with others and our self-esteem. For Autistic young people, the world can sometimes feel overwhelming, socially confusing, filled with too many intense sensory experiences and at times lonely, which can make mental health conditions, like anxiety and depression more likely to occur. Understanding this can help us provide better support.
Anxiety
What it is: Feeling very worried or scared about things that might happen or about everyday situations. Having physical sensations, like your heart racing or breathing quickly, when you feel anxious.
Why it happens: Autistic people might find some experiences more anxiety provoking, like social situations, changes in their routine, or sensory differences (like loud noises or bright lights).
How to help?
Ask: Always talk to the young person about what makes them feel anxious. Listen carefully and allow them time to process and describe their feelings. Use photos and/or written words to visually support your conversation.
Accept: Understand that their feelings are real. They might be describing something that you do not experience as anxiety-provoking. Do not minimise by saying things like ‘don’t be silly’ or ‘don’t worry’ as these comments will not be useful for an Autistic young person. It is always important to acknowledge and validate their experiences.
Develop: Help them to learn some calming techniques like:
- 7/11 breathing. Encourage and practice with them breathing in for the count of 7, and then breathing out for the count of 11. Repeat a few times.
- Muscle relaxation. Support the young person to go through the muscles in their body, section by section, tensing and relaxing. For example, tightly squeeze and make a fist, then let your hand go floppy.
Depression
What it is: Feeling low, hopeless, and/or losing interest in things you used to enjoy.
Why it happens: Autistic young people might feel isolated or misunderstood by others, leading to these feelings. They may feel like they do not fit in or they may feel like they are not as good as their peers. Some Autistic young people have a more ‘all or nothing’ thinking style, this means when things are tough, their thoughts may get stuck focusing on all the bad things.
How to help?
Ask: Check in with them about their feelings and thoughts. Be a supportive listener. When someone feels low, they maybe less likely to have the motivation to seek someone out so if you notice an Autistic young person you know is withdrawing, acting differently from usual and are maybe not engaging in their passions as much, take time to check-in with them. Think of create ways to use visuals to support your conversation.
Accept: Be accepting of their experiences and their emotions. Allow the young person to use their preferred communication for communicating with you; this could be through text messaging, through their artwork or in a conversation. Sometimes sitting side by side rather than face to face can feel more comfortable for an Autistic young person.
Develop: Think with the young person of some activities to include in their day. Research has shown that:
- Engaging in cardio-exercise improves mood so think about what exercise the young person might like to try, this could be sports, walking, dancing, gardening and more. Encourage and join them doing an exercise activity at least 3 times a week.
- Engaging in their passions improves wellbeing for Autistic young people. Think how you can start re-integrating their interests into their day. Small steps can have a big impact over time.
Remember, each Autistic young person is unique. What works for one may not work for another. Always approach the person with kindness, understanding, and patience.
Supporting an autistic young person with mental health challenges starts by you recognising something isn’t quite right for that young person. By asking, accepting, and helping them develop new skills, you can make a significant positive impact on their life. Remember, it’s about working together to find the best ways to manage these difficulties and ensuring they feel supported and valued. If you feel unsure of what to do or feel out of your depth, always seek advice and guidance from a trained mental health practitioner.