Understanding Autistic Identity Disclosure in Higher Education.

As the number of adults who identify as autistic increases rapidly, understanding factors that contribute to autonomy and achievement of a good life for autistic adults is becoming increasingly important. Research in this area is constrained by a paucity of measures of quality of life that have been developed and validated specifically for autistic adults. Existing studies using nonoptimal measures conclude that autistic adults report more challenges and poorer well-being compared with peers for many measures of independent, adaptive daily living (ADL), including measures of social interactions, self-care, physical health, mobility, leisure, and community participation. Importantly, these struggles in ADL may be bi-directionally associated with mental health challenges for autistic adults. Two important elements of ADL that are vital for this study include postsecondary educational experience and the quality and consistency of employment. For example, in general population studies, better long-term mental health is associated with both higher education and steady employment. However, relationships between work, education, and mental health also interact with individual and systemic variables that mediate both directionality and strength of impact; for example, work-related concerns related to low perceived control, relational injustice, stressful roles, or bullying; and varied challenges in education settings such as personal needs insecurity or strong institutional pressures to achieve without concomitant personal support increase mental health burdens for many people. There is less research to date about mechanistic relationships among employment, education, and mental health in autistic adults. A large survey study of 370 autistic adults by Mason et al. reported that being employed is a positive predictor of mental health, and a longitudinal comparison of surveys for 144 autistic adults, taken just before the onset of the COVID-19 pandemic and about 10 weeks after the COVID-related shutdown in the United States, showed that job loss or job reduction was associated with higher levels of depression even after accounting for baseline depression. And while autistic university students in multiple countries enjoy the freedom and autonomy they enjoy, they simultaneously struggle to manage multiple academic and living responsibilities, and report generally poor support especially for non-academic aspects of their experience. Overall, autistic adults report many more mental health challenges than their peers in higher education or employment settings, including more loneliness, depression, anxiety, and significantly increased risk for suicidal thoughts and behaviors. However, the nature of these interactions is not understood.