Approaches to improving mental health care for autistic children and young people: a systematic review and meta-analysis

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Pemovska, T., Loizou, S., Appleton, R., Spain, D., Stefanidou, T., Kular, A., Cooper, R., Greenburgh, A., Griffiths, J., Barnett, P., Foye, U., Baldwin, H., Minchin, M., Brady, G., Saunders, K. R. K., Ahmed, N., Jackson, R., Olive, R. R., Parker, J.,..., & Johnson, S. (2024). Approaches to improving mental health care for autistic children and young people: a systematic review and meta-analysis. Psychological Medicine, 54(10), 2313-2343. https://doi.org/10.1017/s0033291724001089

Publication date: 17 May 2024 Added to AutiHub: 6 Jul 2026 Type: Article Article language: English
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Authors

Publication authors
31
Publication authors identified as autistic
1 / 31 (3.2%)
  1. Tamara Pemovska
  2. Sofia Loizou
  3. Rebecca Appleton
  4. Debbie Spain
  5. Theodora Stefanidou
  6. Ariana Kular
  7. Ruth Cooper
  8. Anna Greenburgh
  9. Jessica Griffiths
  10. Phoebe Barnett
  11. Una Foye
  1. Helen Baldwin
  2. Matilda Minchin
  3. Gráinne Brady
  4. Katherine R. K. Saunders
  5. Nafiso Ahmed
  6. Robin Jackson
  7. Rachel Rowan Olive
  8. Jennie Parker
  9. Amanda Timmerman *
  10. Suzi J. Sapiets
  11. Eva Driskell
  1. Beverley Chipp
  2. Bethany Parsons
  3. Vasiliki Totsika
  4. Will Mandy
  5. Richard Pender
  6. Philippa Clery
  7. Brynmor Lloyd‐Evans
  8. Alan Simpson
  9. Sonia Johnson

Abstract

Autistic children and young people (CYP) experience mental health difficulties but face many barriers to accessing and benefiting from mental health care. There is a need to explore strategies in mental health care for autistic CYP to guide clinical practice and future research and support their mental health needs. Our aim was to identify strategies used to improve mental health care for autistic CYP and examine evidence on their acceptability, feasibility, and effectiveness. A systematic review and meta-analysis were carried out. All study designs reporting acceptability/feasibility outcomes and empirical quantitative studies reporting effectiveness outcomes for strategies tested within mental health care were eligible. We conducted a narrative synthesis and separate meta-analyses by informant (self, parent, and clinician). Fifty-seven papers were included, with most investigating cognitive behavioral therapy (CBT)-based interventions for anxiety and several exploring service-level strategies, such as autism screening tools, clinician training, and adaptations regarding organization of services. Most papers described caregiver involvement in therapy and reported adaptations to communication and intervention content; a few reported environmental adjustments. In the meta-analyses, parent- and clinician-reported outcomes, but not self-reported outcomes, showed with moderate certainty that CBT for anxiety was an effective treatment compared to any comparison condition in reducing anxiety symptoms in autistic individuals. The certainty of evidence for effectiveness, synthesized narratively, ranged from low to moderate. Evidence for feasibility and acceptability tended to be positive. Many identified strategies are simple, reasonable adjustments that can be implemented in services to enhance mental health care for autistic individuals. Notable research gaps persist, however.

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Cited references
127
Total cited references integrated for this publication.
Cited references with an identified autistic author
5 / 127 (3.9%)
Cited author occurrences identified as autistic
13 / 768 (1.7%)
Among occurrences linked to AutiHub author records: 13 / 199 (6.5%). Distinct cited authors identified as autistic: 13 / 630 (2.1%).
Cited author occurrences linked to AutiHub author records
199 / 768 (25.9%)
Distinct linked cited authors: 144 / 630 (22.9%)
Linked cited-author occurrences not identified as autistic
186 / 199 (93.5%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 186 / 768 (24.2%). Distinct linked cited authors not identified as autistic: 131 / 144 (91.0%).
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