Faculty Bibliography

LAY ABSTRACT/UNASSIGNED:Autistic children and adolescents experience high rates of co-occurring mental health conditions, including depression and suicidality, which are frequently identified by stakeholders as treatment priorities. Unfortunately, accessing community-based mental health care is often difficult for autistic youth and their families. The first obstacle families confront is finding a provider that offers mental health treatment to autistic youth within the many service systems involved in supporting the autism community. The mental health and developmental disability systems are two of the most commonly accessed, and previous work has shown there is often confusion over which of these systems is responsible for providing mental health care to autistic individuals. In this study, we conducted a telephone survey to determine the availability of outpatient mental health services for autistic youth with depressive symptoms or suicidal thoughts or behaviors in New York City across the state's mental health and developmental disability systems. Results showed that while a greater percentage of clinics in the mental health system compared with in the developmental disability system offered outpatient mental health services to autistic youth (47.1% vs 25.0%), many more did not offer care to autistic youth and there were very few options overall. Therefore, it is important that changes to policy are made to increase the availability of services and that mental health care providers' knowledge and confidence in working with autistic youth are improved.

Suicidal thoughts and behaviors (STB) and emergency department (ED) utilization are prevalent in autistic youth. The current study surveyed clinicians in a pediatric psychiatric ED to examine differences in attitudes on suicide-related care for autistic and non-autistic patient populations. While clinicians rated addressing STB in ASD as important and adaptations to care as necessary, less than half identified ASD as a suicide risk factor and confidence ratings were significantly lower for autistic patients. Previous ASD training predicted confidence and accounted for approximately 25% of the variance in confidence scores. Findings highlight the urgency to develop and disseminate ED clinician training, and address the lack of validated assessment tools, adapted suicide prevention practices, and evidence-based treatments for STB in autistic youth.

Objectives: The United States is among the most diverse nations worldwide, boasting a majority percentage of the population comprised of ethnic minorities. Despite this, there remains a longstanding and pervasive history of racism toward several minority ethnic groups. According to a 2019 report from the Pew Research Center, race relations in America have worsened in recent times. Racism is a social determinant of health. Experiences of racism significantly impact the identity and self-perception of children and adolescents. It is therefore critical to examine how the unique racial experience of prominent ethnic minority groups shapes their developing identities and to accurately inform best practices in mental health diagnosis and treatment.
Method(s): Presenters will review the historical context of racism in the United States for the following prominent minority groups: African American, Latinx, East Asian, and South Asian. Each presenter will expand on the experience of racism specific to each ethnic group, identify unique negative biases, and review how these dynamics of discrimination impact adolescent identity development. Presenters will also share clinical pearls for how to explore topics of racial discrimination with youth in treatment.
Result(s): The experience of racism in adolescence has a significant impact on the developing adolescent identity and increases the risk of poor self-esteem, social isolation, and mental illness.
Conclusion(s): Racism is an unquestionably prevalent social issue affecting Americans of varying ethnic backgrounds. The experience of racism can be unique for differing ethnic groups. Because racism has a significant impact on the identity of developing youth and can increase the risks of mental illness, it is imperative for psychiatrists to consider race and ethnic bias in our discussions, assessments, and treatment of our patients. ETHN, ADOL, IDD
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