An investigation of the factors that contribute to the mental health and wellbeing of autistic adults

Autistic people experience increased rates of mental health conditions and symptoms compared to their non-autistic peers; autistic women and trans people perhaps more so. However, there is not yet a consensus as to why this is the case. Through the lens of the neurodiversity paradigm, the present thesis aimed to develop an understanding of the factors that impact autistic people’s mental health, from the perspective of autistic people themselves. First, this thesis presents a systematic review and thematic synthesis of the perspectives of autistic females on what experiences have impacted their mental health and wellbeing. Findings suggested that the biological and psychological factors associated with being autistic interact with a variety of environmental and social factors, in turn shaping wellbeing and mental health outcomes. Second, an empirical mixed-methods study is presented, which investigated mental health experiences and the factors that contributed to mental health and wellbeing in mixed-gender samples. The qualitative phase consisted of semi-structured interviews with 20 autistic adults and the quantitative phase investigated key factors identified by interviewees in a sample of 236 autistic adults using standardised questionnaires. High levels of depressive and anxiety symptoms and low levels of wellbeing were reported. Autistic cisgender women reported higher levels of anxiety, while autistic trans people reported more depressive symptoms. Feelings of exclusion and isolation, childhood bullying, autism-related stigma and challenges related to the neurotypical environment were all found to predict mental health and wellbeing. Overall, the findings of the present thesis point to the need for community adaptations or interventions to create a more accessible and accepting society, as well as improvements in service provision for autistic adults.