How did you come to research?
I came to it because I’m passionate about improving outcomes for autistic adults, who represent the majority of people on the autism spectrum. Life expectancy for autistic people averages at just 54 years old, due to largely preventable health disparities. This includes a risk of suicide nine times higher than the general population. Improving these outcomes is no easy feat. It’ll require a combination of appropriate, accessible services provided by knowledgeable and compassionate people, as well as awareness-raising in wider society to tackle social stigma and increase acceptance of autistic people and the social advantages of neurodiversity.
Your PhD project explores the benefits of social prescribing and horticulture therapy for autistic adults. What role can social prescribing play in improving outcomes for autistic adults?
Social prescribing alone isn’t the answer, but it may be an option in a wider toolkit. It can offer the advantages of personalised and tailored solutions to wellbeing and small-scale, community-based activities outside of health service settings. The wide range of outcomes that can be achieved, such as emotional wellbeing, skills and employability and strengthened social connections, means that if done well, it may be a helpful response to the complex social issues that lead to poor outcomes faced by autistic adults. Importantly it can achieve this without focusing on changing the person but by helping people to identify their individual well-being goals, play to their strengths and navigate barriers. However it first needs to be accessible and inclusive at all levels, which should be informed by collaborative working involving autistic people as service users and providers.
What approaches have you employed in your research so far?
A mixed methods study aimed at gathering autistic people’s perspectives on well-being, accessing healthcare pathways, relationships with communities and views on social prescribing and other services. This will contribute to understanding the wellbeing priorities of autistic people and how social prescribing may need to be adapted to be made inclusive and achieve its potential benefits. I also plan to explore how the pandemic has impacted autistic people and ways in which social prescribing could respond to the widening health inequalities that have arisen as a result. I’ve been privileged to interview a diverse group of autistic adults from people in their 20s up to over 70, all with very different lived experience. They have demonstrated resilience and creativity around navigating adversity, including in roles as community leaders, and these strengths are crucial for services to recognise and build on going forward.
Have you identified any hurdles?
The studies have highlighted many barriers, including lack of staff training and understanding of autism, and inaccessible systems that prevent healthcare access at the very start of the pathway. This can lead to delays in seeking support and a lack of opportunity for services to recognise people’s full potential. Social prescribing can only be beneficial to autistic people and society if it can reach the right people in a timely way, and is accessible at all points of the pathway.
What do you consider the successes of your project so far?
This year I responded to Autistica’s funding call for projects to contribute to the development of a grant proposal in response to the NIHR’s call for social care in Spring 2022. During a review of the literature Autistica found that there were gaps in social care delivery and training which may affect outcomes for autistic adults. One of their recommendations was for projects to focus on social prescribing and personalised care, an area highlighted by the NIHR in the remit of the social care call. I decided to make this the focus of my application, which had a short turnaround time in Spring 2021 and involved getting to grips very quickly with the administrative processes of submitting a budgeted plan to the university. But, only a few weeks later, I was thrilled to hear that my application had been reviewed favourably and been successful.
What happens next?
I’m now planning to involve a group including autistic adults, carers and social care staff in the development of a proposal for the funding call. This will be based around a co-designed social prescribing solution for autistic adults with lower level support needs, to help prevent them from escalating. The solution will focus on building people’s connections to their local communities and developing independent, accessible resources before reaching a point of crisis. This exciting work will be co-produced with the autistic community in Devon and Cornwall and is due to start shortly.