For as long as I can remember, I’ve struggled with my mental health. I first accessed CAMHS at 11, then moved into adult mental health services a few years later. Along the way, I’ve met dozens of professionals – therapists, psychiatrists, crisis teams, care coordinators – with mixed experiences. Some interactions still fill me with anxiety even now. Others helped me feel seen for the first time.
I’m autistic and have ADHD, and I didn’t get both diagnoses until my late teens. Understanding myself has been a long journey. Understanding how to access support has been even longer.
I’m sharing my experiences because small changes really can make a huge difference. Here’s what has helped – and what would have helped sooner.
⭐ First impressions matter more than people realise
Before an appointment, the unknowns can take over:
What does the building look like? How noisy is the waiting room? Who will meet me? Where do I sit?
For autistic people, these aren’t small details – they’re the difference between arriving regulated or already overwhelmed.
What helps:
- Someone telling me what the space looks like before I come
- Being allowed to wait in the car or outside instead of a waiting room
- Meeting somewhere low‑demand for the first few sessions – like a nearby park or a quiet neutral building
If the environment is too much, I spend the whole session trying not to fall apart. I’m already anxious about the appointment; adding sensory overload means I show up with half the capacity I need.
⭐ How sessions are structured makes or breaks engagement
Across CAMHS and adult services, I’ve experienced nearly every type of session: CBT blocks, talking therapy, psychiatry reviews, crisis support, family therapy. Some worked. Some didn’t.
Here’s what makes the biggest difference:
✔ Tell me what the session will look like
Just a simple:
“Today we’ll do X, then talk about Y, and end with next steps.”
This grounds me and reduces the mental load.
✔ Balance life updates with the actual work
I often arrived with something big going on that week. Talking about it matters – but not for the entire session, every session. I’ve left therapy feeling like I wasted the time, knowing there were deeper things I needed to talk about.
A gentle prompt like:
“Shall we go back to what we planned to explore today?”
keeps things moving.
✔ Support my attention, not judge it
With ADHD, I can drift without noticing.
What helps is:
“Are we moving in this direction on purpose, or did we get pulled off‑track?”
asked kindly.
✔ Help me remember what we talked about
Working memory is hard for me. I used to leave sessions unable to remember anything – including what I’d agreed to do.
My current care coordinator sends a few bullet points after each session, including who’s doing what. It’s honestly transformative.
⭐ Longer sessions would have changed so much
It takes me 15–20 minutes to settle enough to be open, even in weekly sessions. With psychiatrists I might only see every few months, it takes even longer.
By the time I’m ready to talk about the real stuff, half the session is gone.
It becomes rushed, shallow, and not emotionally safe.
One of my siblings’ therapists offered 80‑minute sessions – and it completely changed the quality of the work. I strongly believe more autistic young people would benefit from longer appointments, especially during transitions or high‑stress periods.
⭐ Therapy isn’t one‑size‑fits‑all – especially for autistic people
I’ve tried CBT multiple times. For some people it works brilliantly. But for many autistic people, it can fall short.
Often my anxiety wasn’t about “distorted thinking” – it came from real sensory discomfort or real overwhelm. No amount of reframing changes that.
What has helped me more:
- Trauma‑informed therapy
- DBT skills
- Schema therapy
- ACT
- RO‑DBT
- IFS and parts work
- Autism‑adapted mindfulness
And using different mediums in sessions – art, writing, movement, fidgets – takes pressure off and helps me express things when words feel too heavy.
⭐ Crisis support needs consistency – but doesn’t often have it
I’ve had a lot of crisis involvement. In CAMHS, it was usually chaotic. Staff didn’t always understand autistic distress, and I was often read as “fine” or “difficult” rather than overwhelmed.
Adult services made one simple change that helped hugely:
They assigned me a small group of four staff who rotated but all knew me. It wasn’t perfect, but seeing familiar faces made crisis work less frightening and reduced the need to re‑explain everything while distressed.
Another thing that helps is a simple “Top 5 Things You Need to Know About Me” sheet.
Neurodiversity passports exist, but they’re long and rarely used. Five quick points? Much more likely to be read.
⭐ Communication needs to be flexible
Different autistic and ADHD people communicate differently – and the same person might communicate differently depending on the day.
Text services are essential for people who go non‑verbal during distress.
Phone calls are essential for people who can’t express themselves in writing.
Video is helpful for some and impossible for others.
In‑person can be grounding or overwhelming depending on the environment.
No one method works for everyone.
The best thing professionals can do is ask:
“What type of communication feels most accessible for you today?”
⭐ Diagnosis pathways need updating
I was diagnosed autistic at 15, but the ADHD diagnosis came years later. Only when I had both did everything start to make sense. The two together feel like a third, separate condition – that’s how intertwined they are.
What would have helped:
- Regular waiting‑list updates
- Support groups while waiting
- Joint autism + ADHD assessments
- Information about common comorbidities (digestive issues, pain, allergies)
- Psychoeducation for both me and my family
Parents often have similar traits themselves – but this is rarely considered in how professionals communicate with them.
⭐ If I could tell mental health professionals one thing…
Please help neurodivergent young people imagine a life they can actually live.
Not a neurotypical version.
Not a minimised version.
Not a “manage the symptoms” version.
Hold hope for us.
Believe in the possibility of recovery that fits our shape.
And understand that with the right adjustments, autistic and ADHD people can build lives that are safe, meaningful and worth living.
We have made two flyers to be shared with mental health professionals:
Thanks for sharing your experiences Sarah!
Your honesty and insight echo what many young people with SEND are telling us.
Our group is speaking up about what needs to change so accessing mental health support is safer, easier and more understanding — and we’re already sharing these insights with professionals across Buckinghamshire to drive real improvements.
Click here to read the practical steps young people say would make mental health services more accessible.
For more information
If you’d like to find out more about Shout Out for SEND, email ShoutOutforSEND@Buckinghamshire.gov.uk.