Mental Health Tool Kit
Many people experience mental health disorders, including those with Autism Spectrum Disorder (ASD). It is important to get help for yourself or a loved one who is struggling, regardless of any feelings of guilt or shame about seeking treatment. This tool kit provides an overview of mental health services as well as professional roles and forms of therapies. The questions and answers in this tool kit were prepared with assistance from Thomas Scheidemantel, MD, University Hospitals; Haley Dunn MA, LPC, Milestones Autism Resources; and Helena Farkas, LISW-S, Milestones Autism Resources.
Milestones provides consultation services to all family members, professionals, and self-advocates. Services include connecting participants to resources and providing general information and assistance. We also offer a free Autism Helpdesk. If you have any questions or concerns, please contact us at (216) 464-7600 or firstname.lastname@example.org.
What are common co-occurring mental health disorders with individuals on the spectrum?
There is often overlap between ASD and mental health disorders. Professional evaluation is required to determine the correct diagnosis and treatment approach. Listed below are some of the common reasons people with ASD might see a mental health provider:
Anxiety is characterized by excessive worry or need for reassurance. It may also present as problems with sleep, irritability or physical concerns such as headaches or upset stomach.
- Attention Deficit Hyperactivity Disorder (ADHD)
ADHD is characterized by hyperactive behavior and/or problems with attention and concentration.
- Obsessive Compulsive Disorder (OCD)
OCD is characterized by getting “stuck” on repetitive thoughts or actions.
- Depression and Other Mood Disorders
Mood disorders are characterized by sadness, irritability or mood swings.
When should I seek help from a mental health professional?
A person should seek help when behaviors and emotions are impacting ability to function across settings, such as, at school, home or work.
What are the first steps?
Finding a provider is the first step toward getting help for mental health concerns. You can reach out to friends and family, religious personnel, insurance companies, an Employee Assistance Program (EAP) or local mental health board to get recommendations.
I’ve found a provider, will they take my insurance?
When looking for a provider who accepts your insurance, start by calling your medical insurance company. Once you have a list of covered providers you can call or look on their website to see if they have training and knowledge working with individuals with ASD. If you prefer to see a provider who does not accept your insurance ask for their hourly rate and if they offer a sliding fee scale.
What are the differences among mental health providers?
There are many types of providers that are involved in mental health care. Many provide counseling, but ONLY psychiatrists, medical doctors and nurse practitioners may prescribe medications. Any of the professionals listed below can provide an assessment, diagnosis and ongoing therapy.
- Psychiatrist (MD, DO)
A psychiatrist is a medical doctor that specializes in the treatment of mental health conditions. While some psychiatrists provide psychotherapy, most only prescribe medications and work closely with other mental health providers.
- Psychiatric Nurse Practitioner (PMHNP)
A psychiatric nurse practitioner is able to provide diagnosis and treatment of mental health disorders and prescribe medication.
Therapists must have completed, at minimum, a master’s degree in a credentialed program geared toward mental health services and be licensed in their chosen field. Be sure to ask about a potential provider’s credentials, experience and their scope of practice before starting on-going therapy. Here are some titles and credentials you may see. Note that all of these specialists are equally qualified to diagnose and treat mental health concerns:
- Psychologist (MA, PhD, or PsyD)
- Counselor (LPC, LPCC, or LPCC-S)
- Social Worker (LSW, MSW, LISW, or LISW-S)
- Marriage and Family Therapist (MFT, IMFT, or IMFT-S)
For more information and to check if a therapist or medical provider is in good standing with the state:
Counselors, Social Workers, Marriage and Family Therapist Board
What about school professionals?
School psychologists can determine academic needs through psychological assessments, but not necessarily the mental health needs, of a student. It is important to seek a mental health diagnosis from one of the professionals listed above. If a student receives a mental health diagnosis and it is impacting their ability to learn, the family should contact their school psychologist. Read more information about psychologists here.
School counselors must be licensed in a public school setting, but are not required to be licensed in a private school setting. They are able to provide guidance, advocacy, help with classroom management, among many other tasks. They cannot provide ongoing therapy to address mental health disorders.
Read this list of appropriate tasks for a school counselor.
Ask your school if they have a contract with local mental health agencies and if they are able to provide ongoing therapy with licensed counselors and social workers during the school day. Speak with your providers to see if this is an appropriate option.
What is the difference between an agency and a private practice?
Agencies typically have therapists, psychologists and psychiatrists in one location. They may offer case management services to help coordinate care between providers. Private practices are typically a single therapist or a group of therapists and will refer to a psychiatrist if medication management is needed.
Will mental health providers communicate with my other treatment providers?
In order to keep your school, doctors, other therapy providers and/or family involved in the treatment process you will need to sign a consent form to allow your providers to have contact with each other. The consent form specifies which information is allowed to be shared.
What can I expect from my first appointment? How can I prepare my child with ASD?
Your first appointment with a therapist or psychiatrist will likely be 60-90 minutes in order to cover all the initial information. Ask the office to send you any paperwork or forms ahead of time so you can complete it before arriving to their office. This will help give you and your child a sense of what questions will be asked in the initial session. It can also cut down on the time in the waiting room. This first appointment will mostly focus on collecting as much information as possible about the current problems in order to develop a treatment plan. Be prepared to discuss medical, family and personal histories. Bringing sensory or comfort items to help reduce anxiety can be helpful.
What are common types of psychotherapy?
Therapists may use many different methods, but the goal is always to help a person function better in his or her relationships and social roles (family, school, work, etc.). Have your therapist explain their treatment modalities. Psychotherapy, or talk therapy, includes a wide range of treatment for mental health issues that does not involve the use of medications. Some commonly used therapies to help individuals on the autism spectrum include:
- Behavioral Therapy can treat mental health problems by replacing problematic behaviors with ones that are more positive and helpful to the individual.
- Cognitive Behavioral Therapy (CBT) is a short-term, hands-on, practical approach to problem-solving. The goal is to change patterns of thinking or behavior in order to help change the way they feel.
- Dialectical Behavioral Therapy (DBT) is a cognitive-behavioral approach that emphasizes working on social-emotional skills. It is often practiced in weekly counseling session and group therapy sessions. Therapists may use many different activities in addition to talk therapy to help reach a person’s therapeutic goals, such as, art, games, and journaling.
What is the length and frequency of visits?
Most therapy sessions are about an hour long and typically take place at an office. You may initially meet with a therapist weekly or every other week. As you make progress, the frequency of visits may decrease.
Most psychiatry appointments for medication management are 30 minutes. Maintenance visits may be every four to six weeks. Psychiatry visits are initially more frequent while medication is being regulated.
What do I do between office visits if there is an issue?
It is important to discuss with your therapist or psychiatrist how you will handle problems that may come up between visits. Many providers offer guidelines when you start with their practice. In many cases, there will be an after-hours call line for access to a therapist or to get questions answered about medication concerns.
What do I do in a crisis?
If a person is threatening to hurt himself, others or property or is actively engaged in hurting himself, others or property, call 911. Inform the operator that the individual is diagnosed with ASD. An ambulance and a police officer will usually be dispatched. If you feel you are able to transport the individual safely, take the individual to the nearest emergency room.
It can be helpful to have a list of current medications to provide doctors. For mental health issues a person may be admitted for 24-72 hours; however, not all emergency visits result in a hospital stay. The doctors and nurses can help keep the patient safe while a treatment plan is put in place.
What do I do if I do not like my therapist or psychiatrist?
If you feel you are not connecting with your provider, that you are not making progress or that they are not communicating with other providers, express your concerns. If there does not seem to be a resolution after talking, finding another provider may be your best option. Starting over with a new provider can be difficult, but worthwhile if the connection with your current provider is lacking. Ask for a copy of your notes and treatment plan if you’re new provider is in a different office to help ease the transition.
What about alternative therapies or medications?
Milestones promotes evidence-based therapies as the most successful treatment for individuals with ASD. If you choose to explore alternative therapies or medications it is important to do your research and keep all of your doctors and therapists informed of any and all treatments that are being used. Ask questions from others who have tried the treatments. Proceed with caution: just because it worked for them does not mean it will work for you.
We’ve created Guiding Questionnaires for many specialists, including Psychiatrists, Social Workers, Counselors, Therapists, and Psychologists. You can download these to take with you to interview a potential provider.
An Introduction to Behavioral Health Treatments by Autism Speaks
National Alliance on Mental Illness
Know the Warning Signs – NAMI
Alcohol, Drug Addition & Mental Health Services for Cuyahoga County (ADAMHSCC)
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