A mixed-methods investigation of barriers and facilitators in mental healthcare services for adults with autism spectrum disorders in Germany

The project will employ a mixed-methods approach to assess current barriers and facilitators for adults with Autism Spectrum Disorders (ASD) with respect to mental healthcare in Germany. During the first project phase, current barriers or needs and facilitators will be assessed at three levels (at the individual level, at the structural or organizational level of the healthcare system, and at the professional level of clinicians or healthcare service providers) and from three stakeholder perspectives (i.e., participants with ASD, relatives/caregivers, clinicians). For this purpose, both qualitative data (i.e., semi-structured focus groups and one-on-one interviews) as well as quantitative data (i.e., online surveys and questionnaires) will be assessed. Furthermore, costs due to medical and non-medical service utilization of ASD will be estimated and compared to utilization costs of individuals without ASD. Results and emerging themes will be used to develop a concept suitable for providing improved and extended mental healthcare for adults with ASD. This concept aims to include individual ASD patient parameters in order to provide a stepped-care approach and will include recommendations for patients, relatives and professionals. During the second project phase, the developed concept and its potential implementation within the German healthcare system will be evaluated qualitatively and quantitatively, again by assessments in different stakeholder groups (i.e., participants with ASD, relatives and clinicians) and formally analyzed with respect to cost-effectiveness and implementation chances. Our research project aims to strengthen a participatory research approach by including patients, relatives and professionals at all project stages. This includes project employees as well as cooperation with relevant associations. The study has been approved by the Local Psychological Ethics Commission at the Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (date: 12/02/2020).