Autism and Mental Health: Recognition and Support Across Systems of Care

This workshop, presented at the Georgia Systems of Care Academy (sponsored by the Georgia Department of Behavioral Health and Developmental Disabilities), addresses the recognition and treatment of co-occurring mental health conditions in autistic children, youth, and adults by providers working across systems of care. Organized around a case of a young adult whose autism was correctly diagnosed but whose distress was repeatedly misread, it presents autism as a profile of dimensions — sensory reactivity, focused interests, need for predictability, social motivation, and masking — and shows how each dimension is routinely misinterpreted as a character or compliance problem. That misreading produces diagnostic overshadowing, in which treatable anxiety, depression, and ADHD are attributed to autism and left unaddressed despite elevated rates of each, including a three- to sevenfold increase in suicide risk. The workshop then covers neuroaffirming adaptations to therapeutic practice (environmental choice, in-session allowances, trust-building, and extended pacing), and reframes treatment around transdiagnostic pathways rather than autism itself: sensory processing, intolerance of uncertainty, alexithymia, emotion regulation, and sleep. Data from the presenter's research link intolerance of uncertainty to suicidal ideation severity and alexithymia to low positive affect and non-suicidal self-injury, with corresponding CBT, ACT, and parent-mediated targets.