The importance and availability of adjustments to improve access for autistic adults who need mental and physical healthcare: findings from UK surveys

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Brice, S., Rodgers, J., Ingham, B., Mason, D., Wilson, C., Freeston, M., Le Couteur, A., & Parr, J. R. (2021). The importance and availability of adjustments to improve access for autistic adults who need mental and physical healthcare: findings from UK surveys. BMJ Open, 11(3), e043336. https://doi.org/10.1136/bmjopen-2020-043336

Publication date: 1 Mar 2021 Added to AutiHub: 18 Sep 2026 Type: Article Article language: English
Publisher source (DOI) Full text OpenAlex source

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Authors

Publication authors
8
Publication authors identified as autistic
1 / 8 (12.5%)
  1. Samuel Brice
  2. Jacqui Rodgers
  3. Barry Ingham
  4. David Mason *
  1. Colin Wilson
  2. Mark Freeston
  3. Ann Le Couteur
  4. Jeremy R. Parr

Abstract

Objectives To investigate autistic people’s views on the importance and availability of adjustments to mental and physical healthcare provision. To explore whether specific categories of adjustments can be identified and to identify any differences in their importance and availability between mental and physical healthcare. Design Data from two studies, both employing a cross-sectional survey design. Setting UK-based autistic adults registered with the Adult Autism Spectrum Cohort-UK were contacted by post or online. In both studies, recruitment was staged over a 12-month period. Non-responders were sent a single reminder letter 2 weeks after initial contact. Participants 537 autistic adults completed a survey about mental health services (51% response rate), 407 completed the physical health survey (49% response rate). Within these samples, 221 participants completed both surveys. Primary outcome measures Each study developed a bespoke survey to explore participants’ views on mental and physical health services, respectively. Both included an identical list of adjustments that participants rated based on importance and availability. Results Three factors of important adjustments were identified: sensory environment, clinical and service context, and clinician knowledge and communication. Adjustments across healthcare settings were widely rated as being important yet rarely available. One significant difference between the importance of adjustments available through mental and physical health services was identified. Participants reported that having access to a clinician who is willing to adapt their approach to suit the person’s preferences was significantly more important for participants attending mental health settings (p=0.001). Conclusions Autistic people reported the limited availability of important adjustments in current healthcare provision. To address unmet need and tackle the health inequalities faced by autistic people attending physical and mental healthcare settings, healthcare providers should offer adjustments relating to the three identified factors. Future research should focus on identifying and addressing service provider barriers to implementation.

Bibliography cited by this reference

Cited references are imported from external metadata sources when they are available. The list may be partial.

Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 01:01.

Cited references
42
With a DOI
32
Without a DOI, from raw bibliography text
9
6 / 42 (14.3%) cited references include at least one author identified as autistic.
References with data to complete
8 / 42 (19.0%)
References with detected author names
34 / 42 (81.0%)
Without detected author names
8
Without a structured title
8
Without a stable identifier
8
References with raw author names still to review
8
References with external metadata lookup issues
1
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
154
From DOI or external metadata
154
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
10
81 / 154 (52.6%) names are linked to an author already present in AutiHub. 73 / 154 (47.4%) names are not yet linked.
Names linked to a person identified as autistic
19 / 154 (12.3%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 19 / 81 (23.5%). Distinct people identified as autistic: 13 / 134 (9.7%).
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