Mental health project ECHO autism: increasing access to community mental health services for autistic individuals
Open accessAbstract
Despite the high prevalence of co-occurring autism spectrum disorders and mental health condition(s), there exist substantial barriers to mental health treatment for autistic individuals. These barriers are exacerbated by a lack of mental health provider training and self-efficacy in providing adapted services to autistic individuals. One method which has been effective in mitigating similar service gaps is the Extension for Community Healthcare Outcomes (Project ECHO) Autism model, a tele-mentoring platform that connects primary care physicians to autism spectrum disorder experts to improve physicians’ knowledge, self-efficacy, and practice. This study developed and implemented a pilot mental health version of Project ECHO Autism designed to increase mental health provider knowledge, self-efficacy, and problem-solving. Community mental health providers ( N = 51) participated in the 6-month Project ECHO Autism including mental health–focused didactics and provider case presentations. Analysis of pre- and post-measures revealed improvements in all domains, including significant increases in provider knowledge of autism spectrum disorders, self-efficacy, and problem-solving. Participants additionally reported high satisfaction with their experience. Taken together, preliminary results indicate that Project ECHO Autism may be a feasible, accessible, and effective method for increasing mental health provider competence and ultimately increasing access to services for autistic individuals who have co-occurring mental health diagnoses. Lay abstract Although many autistic individuals have additional mental health conditions, most have a hard time getting services from mental health providers. One reason why these services can be hard to access is that many mental health providers do not feel confident in their ability to provide services to autistic individuals. To share autism expertise with local community providers and boost their confidence in working with autistic individuals, we created a mental health version of the Extension for Community Healthcare Outcomes (Project ECHO) Autism virtual teleconsultation program. In this pilot study, we recruited 51 community mental health providers to participate in Project ECHO Autism. During each biweekly session, providers received information from autism experts about how to tailor mental health interventions (e.g. attention-deficit hyperactivity disorder or anxiety interventions) for use with autistic individuals. They also had the opportunity to ask questions and get advice on their current cases. At the end of the 6-month study, mental health providers showed improvements in their confidence, in their knowledge of autism, and in their problem-solving skills. Nearly half (45%) of these providers participated from rural counties, suggesting that the Project ECHO Autism teleconsultation model was able to reach mental health providers who might not have been able to get training otherwise. This study supports the feasibility of using Project ECHO Autism to share autism knowledge with mental health providers, consequently expanding mental health service options for autistic individuals with co-occurring mental health conditions.
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Clinicians may struggle to distinguish autistic traits from symptoms of mental health conditions because of similarities in external presentation.
“Clinicians may struggle to distinguish autistic traits from symptoms of mental health conditions because of similarities in external presentation,8,12–14”
From Approaches to improving mental healthcare for autistic people: Systematic review (2024) · cites this paper as [13]
The “Barriers to treating co-occurring ASD and mental health condition(s)” section reports that clinicians lack autism-specific training and find working with autistic clients challenging. It does not say they struggle to distinguish autistic traits from mental health symptoms because the two look similar in their external presentation. (LLM, conf=0.82)
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- Authors
- Dreiling, N. G., Cook, M. L., Lamarche, E., & Klinger, L. G.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Dreiling, Nicole Ginn
- Venue
- Autism
- Publisher
- SAGE Publications
- Published
- 2021-07-03
- Volume
- 26
- Issue
- 2
- Pages
- 434-445
- ISSN
- 1362-3613 (ISSN-L)
- 1461-7005
- PMC
- PMC8814946
- OpenAlex
- W3182706474
- Cited by
- 41
- References
- 42
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 7 · 2023: 8 · 2022: 4
- FWCI
- 4.12
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Autism (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNM’s Digital Repository (University of New Mexico) (submittedVersion)
- UNC Libraries
- Funders
- North Carolina Department of Health and Human Services
- medical foundation of north carolina (Innovations Grant)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Keywords
- autism spectrum disorder, access to mental health care, community mental health providers, teleconsultation, telementoring, provider self-efficacy, health professionals' knowledge, rural mental health services, attention deficit hyperactivity disorder, anxiety intervention, barriers to mental health care, provider training, feasibility and acceptability
- MeSH terms
- Autism Spectrum Disorder, Autistic Disorder, Community Health Services, Community Mental Health Services, Humans, Mental Health, Pilot Projects
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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