"I recognise me": exploring the mental health experiences of self-identified autistic adults in the UK, an interpretative phenomenological analysis

Gay, Jessica Laura

London Met Repository

Lists

Tools

Gay, Jessica Laura (2026) "I recognise me": exploring the mental health experiences of self-identified autistic adults in the UK, an interpretative phenomenological analysis. Doctoral thesis, London Metropolitan University.

Abstract
Documents
Details
Record

[+][-]

Abstract

Background: Self-identifying as autistic is a phenomenon that has garnered increased attention in recent years. In the current context of diagnostic inequalities, lengthy assessment waiting times and the increased awareness and advocacy promoted by the neurodiversity movement, many adults are turning to self-identification as an alternative to formal diagnosis. Research has clearly established that those formally diagnosed with autism face increased mental health needs and have poorer mental health treatment outcomes than the non-autistic population. This has led to a significant focus on how to improve the mental health of autistic people through research, service provision and clinical practice.
Rationale: By contrast to those with a diagnosis, the experiences and mental health needs of those who self-identify as autistic remain under-researched. This study aimed to bridge this gap in knowledge by exploring the mental health experiences of adults who have come to self-identify as autistic in the UK, with a focus on accessing mental healthcare and therapeutic interventions. The findings also aim to inform Counselling Psychology (CoP) practice, to improve the accessibility, inclusivity and efficacy of therapeutic support for this under-recognised population.
Methodology: The research was conducted in two stages, beginning with a systematic review and qualitative meta-synthesis, which examined the existing evidence base on autism self-identification. Following PRISMA guidelines, four qualitative studies met the inclusion criteria and were thematically synthesised using Noblit and Hare’s meta-ethnographic approach. Subsequently, an empirical qualitative study using Interpretative Phenomenological Analysis (IPA) explored the lived experiences of 8 self-identified autistic adults who participated in online semi-structured interviews. Interviews were transcribed and analysed according to the guidance of Smith et al. (2022).
Findings: IPA analysis identified six group experiential themes (GETs). “The Alien Inside Me”: Feeling Different and Being Othered captures lifelong feelings of perceived difference and experiences of social rejection. Like a Game of Buckaroo: Masking, Stress and Burnout documents the unhelpful strategies used to cope with a seemingly hostile world, and the emotional and physical consequences of cumulative stress. Interpersonal Mirrors and Lightbulb Moments in Autistic Self-Identification portrays how autism self identification arose relationally, through participants seeing themselves reflected in other autistic people, enabling new self-knowledge and easing identity confusion. Kafkaesque Systems: Structural Barriers and Medical Harm documents structural inequalities and barriers faced in accessing adapted and affirmative mental health support in the absence of a formal diagnosis. Validation and Invalidation in Therapeutic Encounters details experiences of therapy, offering contrasting insights into encounters that were either attuned and validating or misattuned and invalidating. Shaking Off the Imposter: From Shame to Self-Validated Identity conveys the transformative impact of autistic self-identification on participants, helping them move beyond shame, increase self-compassion, and affirm themselves in the absence of a formal diagnosis.
Implications: The findings of the study have implications for CoP practice with self identified autistic adults. In relation to therapeutic practice with individuals, this study highlights the neuroaffirmative, formulation-based approaches that validate self-identification regardless of diagnostic status. The relational qualities of openness, flexibility, curiosity and radical acceptance were identified as central facilitators of positive therapeutic outcomes. At a systemic level the findings point to a need for mental health services to extend autism informed adaptations to those without formal diagnosis who identify as autistic and for training programs to incorporate heterogeneity, diagnostic inequalities and masking to address professional knowledge gaps. Due to its commitment to social justice and philosophical alignment with neuroaffirmative practice CoP is well placed to lead on developing more accessible and inclusive mental health services for a vulnerable, under recognised neurodivergent population.

Documents