NIHR Health Services Delivery Research 2377 national learning disability and autism demand signalling 33584

Background Over 80% of autistic adults and 50% of adults with learning disabilities (LD) struggle with their mental health. Talking therapy can help. In England, this is usually offered by NHS Talking Therapies services, but many autistic adults and adults with LD report difficult experiences in these services such as long waits, access processes not suited to their needs and finding therapy unhelpful. This can cause their mental health to deteriorate, leading to crises and harmful hospital admissions. Aim To address this inequity by creating new knowledge about NHS Talking Therapies for autistic adults and adults with LD and use this to increase access, improve experiences in, and outcomes of NHS Talking Therapies for these groups, so they can live happier, healthier lives. Methods We have unique access to a database of all 5 million adults who have been referred to NHS Talking Therapies since 2012. This includes 23,329 autistic adults & 24,664 adults with LD. We will analyse: -Inequities in access & outcomes faced by autistic adults and adults with LD in NHS Talking Therapies and the added effect of other aspects of their lives that can affect care (e.g., ethnicity or long-term health conditions). -What factors are linked to better NHS talking therapy experiences and whether better outcomes lead to fewer future mental health hospital admissions for these groups. -If having LD is accurately recorded in NHS Talking Therapies records. We will then explore in more depth the experience of those most involved (stakeholders), creating outputs to improve these services. We will: -Review all evidence on access to and experiences of mental health services for adults with LD and autistic adults. -Interview 15 autistic adults, 15 adults with LD, and 15 clinicians about their experiences and potential solutions to problems. -Run 6 stakeholder meetings (8 people in each) to collaboratively produce outputs and plans to improve services for autistic adults and adults with LD. Patient and public involvement (PPI) Mental health service improvement is autistic adults' top research priority and is a key priority for adults with LD. This inspired our project. We co-designed it with 2 PPI Leads (both autistic, one is a carer for an adult with LD). Our charity partners (Learning Disability England [LDE] and National Autistic Society [NAS]) will run 6-monthly PPI groups to ensure autistic adults and adults with LD are central to shaping plans, refining analyses, developing outputs & dissemination. PPI groups will be diverse (e.g., in ethnicity) and Equality, Diversity and Inclusion is central to our work and embedded in our aim to reduce inequities faced by these groups. Dissemination Outputs will include: -Guides created with and for adults with LD and autistic adults, outlining support they are entitled to in NHS Talking Therapies (including easy read versions). -Best-practice guidelines for clinicians/services working with these groups. -Recommendations on recording autism & LD in NHS Talking Therapies records. -Clinician training. -Plans for putting outputs into practice in pilot sites and nationally. We will work closely with key partners (NHS England, NHS Talking Therapies service leads, the Royal College of Psychiatrists), so that clinicians, services & policymakers hear about findings and that outputs reach practice. LDE & NAS will ensure autistic adults and adults with LD hear about this (via membership/social media).