Autistic students’ poor mental health: staff training needed to improve outcomes

Autistic students commonly face mental health problems, which can be wide ranging and severe. These students face further problems in the form of stigmatising attitudes towards neurodiversity and support systems which are difficult to navigate. Identifying what works for support could help reduce the high drop-out rate for autistic students, with long term health and employment benefits.

Autistic people have worse mental health than non-autistic people, with higher rates of anxiety, depression, OCD, and eating disorders.

The transition to university can be a challenging time which exacerbates these issues for autistic students, who make up around 2.4% of students in the UK overall.
These challenges, along with worsened mental health, lead to higher non-completion rates for autistic students regardless of academic ability – something which is a problem for all higher education institutions.

There has been little research to date about the experiences of mental health and mental health support for autistic HE students which looks beyond a single point in time.
This research collected information on the current mental health and coping styles of autistic students at the University of Bristol four times across the academic year 2019-20, along with interviews regarding mental health support and experiences of university.

Using this data, along with insights from interviews with autistic students, we created a set of recommendations for supporting these potentially vulnerable individuals while they are in higher education.

“[Universities] should train people so they know how autistic people’s mental health is different, what we need that’s different”


Policy recommendations

Improve staff knowledge of autism
• Students repeatedly mentioned that university staff lacked autism knowledge, and that this led to stigmatising attitudes which negatively impacted their studies and mental health. It is crucial that staff have accurate information about autistic people, and the adaptations that can help them to thrive, particularly when academic and pastoral roles overlap.
Single point of contact for support
• The complexity of navigating multiple university and external support systems was a factor in successfully accessing support. A threshold approach, where students with specific or multiple needs are assigned a named contact to help them, should be considered.
Implement practical measures around key events
• Recommendations exist for increasing accessibility of key events but are not consistently followed. For example, ensuring proper implementation of Fresher’s Fair quiet hour, rather than it being used as extra set-up time, is crucial for enabling autistic and other disabled students to be fully involved in university life.

Key findings

The study surveyed twenty-two students, around 10% of autistic students known to the university, at four points across the academic year 2020-21. They completed quantitative measures capturing their current mental health, and behavioural measures of alcohol and drug use.

We conducted in-depth interviews with 12 of these students about their experiences of mental health and mental health support at university.

This is a good sample size for this type of research and the students represented a range of subjects, with a mix of ages, genders, and undergraduate/postgraduate status.

The survey results showed that:

• Autistic students had poor mental health, reaching clinical cut-off points for anxiety, social anxiety, depression, OCD, and ADHD
• They did not report harmful behaviours such as overconsumption of alcohol or heavy recreational drug use.
• Mental health, drinking, and drug use were stable across all timepoints.

They tended to use a roughly equal mix of proactive (e.g., asking for help) and avoidant (e.g., denial) coping strategies, in contrast to non-autistic people who tend to predominantly use proactive approach style strategies.

Network analysis revealed a connection between using more avoidant strategies and worse chronic mental health issues.

This may mean that traditional support reliant on students seeking help does not work for autistic students, who may instead benefit from regular, structured meetings with a key person where they are comfortable to raise issues they face.

Interviews revealed that while some aspects of university life were positive for autistic students, such as increased independence, making genuine friendships, and reasonable adjustments to assessment, others contributed to maintaining or worsening their mental health.

Examples given included lack of autism knowledge among staff, stigmatising attitudes, and complex support systems.

Anxiety score using GAD-7. A score of 10 upwards is considered ‘moderate’ anxiety

“I don’t really want my lecturers knowing ‘cause they start to talk to you differently”


Further information

Scott, M., & Sedgewick, F. (2021). ‘I have more control over my life’: A qualitative exploration of challenges, opportunities, and support needs among autistic university students. Autism & Developmental Language Impairments, 6,

Scott et al., Longitudinal analysis of mental health in autistic university students across an academic year, Journal of Autism and Developmental Disorders (in press)

Autism at University – being an autistic student, Elizabeth Blackwell Institute for Health Research blog post


This work was supported by the Elizabeth Blackwell Institute, University of Bristol, and the Wellcome Trust Institutional Strategic Support Fund.


Dr Felicity Sedgewick, Professor Melissa Allen, Professor Chris Jarrold (University of Bristol, United Kingdom), Dr Jenni Leppanen (King’s College London), Matthew Scott (University of Cardiff, United Kingdom)

Contact the researchers

Dr Felicity Sedgewick
Lecturer in Psychology of Education
University of Bristol

Elizabeth Blackwell Inst logo

Edit this page