Evaluating training for university staff to support the mental health of autistic students

A project led by the University of Bristol to understand how training can help improve knowledge and provide strategies for higher education staff to become more confident in supporting the mental health of autistic students.

Autistic students are a growing group in UK universities, who often have unique challenges around their mental health and higher education experience. Previous work has shown that they struggle to access support for these difficulties, partly due to lack of autism understanding among higher education staff. A collaboration between the University of Bristol, University of the West of England (UWE), University of York, Spectrum First, and the National Autistic Society sought to develop and trial training for university staff in understanding and supporting autistic students.

This project, Supporting the Mental Health of Autistic Students (SMHAS),​ was funded as part of the Mental Health Funding Programme: Using innovation and intersectional approaches to target mental health support for students.

Around 0.75 per cent of the UK higher education population is autistic, a number that is likely to grow as more young people with a diagnosis reach university age (Gurbuz et al., 2019; NHS England, 2022). Autistic people have more mental health challenges, from childhood through to old age, and the same is true of the university age population. Anxiety, depression, obsessive compulsive disorder, eating disorders, and co-occurring ADHD are all common among autistic university students (Jackson et al., 2018; Scott et al., 2023). These can have a significant impact on autistic students’ day-to-day lives, affecting their engagement with academic and social aspects of university. Students can struggle to access support for these issues, often facing a lack of knowledge from staff who support them (Scott & Sedgewick, 2021). These difficulties have been directly linked to higher levels of degree non-completion among autistic students and are potentially linked to under-achievement for those who do complete their qualifications (Cage et al., 2020; Cage & Howes, 2020). This can have long-term implications for employment prospects, as well as negatively impacting wellbeing.

This project worked with autistic students to design, trial, and evaluate a training course for university staff to improve their knowledge, and decrease stigma towards autistic students.

Working with a group of autistic students from three universities, as well as partner organisations specialising in supporting autistic people and students, we developed a short training course for university staff around autism, mental health, and higher education. Three forms of the course were trialled – a five-week online version (42 staff); a three-hour online version (32 staff); and a three-hour in-person session (52 staff). The training covered stereotypes about autism; autism and mental health; autism in higher education; and strategies for working with autistic students.

These priorities were set initially by the autistic students, based on multiple conversations about what they felt it was most important for university staff to know, the issues they had encountered at university around their neurodivergence, and how to tailor general autism-related information to the higher education context. This resulted in a programme which covered:

1. What is autism?
2. Stigma and stereotypes
3. Autism and mental health
4. Autism and the university environment
5. Practical strategies to help autistic students

One of the key factors in the success of the training was the participatory approach taken from the outset. Autistic students were involved in the funding bid, training design, training delivery, and dissemination of results, including as conference presenters and authors on publications. The training took the form of a mix of pre-recorded lectures from a neurodiverse team, short films and interviews with the autistic students, activities, and live group discussions. This variety, with student voice embedded throughout, meant that the training focused on the genuine experiences and views of autistic people, something which trainees said that they appreciated and made the learning significantly more relevant.

Along with the partnership with autistic students, the partnerships between the universities and external organisations were important to the success of the project. Individuals from each university, as well as the National Autistic Society and Spectrum First York, contributed ideas on what the training should cover. They also helped to develop the form the training took, sharing their experience with successful and unsuccessful approaches to online training and to encouraging consistent engagement from trainees. Effective joint working was supported through multiple live meetings to discuss ideas, and then deciding to use shared documents rather than multiple versions – this meant that everyone involved could comment or make changes in response to each other, rather than things getting lost between versions. While a small point, this significantly improved working across multiple systems, organisation norms, and different working patterns, and meant that the final product was far more reflective of the sum of the expertise in the group.

Another key factor was the flexibility of a research team, which had the capacity to adapt the initial training design (the five-week course) into a shorter online and in-person course in response to requests from potential trainees. This meant that the training was able to reach more people within the initial project timeline, and to reach a wider variety of university staff members, potentially generating more, and wider reaching, impact.

What have been the barriers or challenges?

Generally, the project encountered few barriers to success. One issue was the limited number of initial sign-ups to take part in the five-week version of the training, potentially because this was run in the summer holidays when many staff were not available. To overcome this, the team offered shorter versions of the training in term-time, and also managed to get faculty-level support for staff to attend as a professional development exercise. Future similar trainings should gain this form of institutional buy-in prior to the training going live, to improve uptake and engagement.

The level of engagement of the autistic students themselves, while a key strength of the project, was not always straightforward. There were differing communication styles and adjustment needs within the group, which required careful discussion and planning to balance and manage. The Principle Investigator also made clear from the outset what students would be asked to contribute and the timeline for this, to help alleviate potential anxieties or uncertainty autistic students may have held about the project. This ensured that the group remained engaged throughout the life of the project, which is a significant success.

What was the result?

The quantitative evaluation of the programmes showed that, although there was no statistical change in autism knowledge and stigma, this was likely because many staff were already knowledgeable and interested, so scored highly on pre-training measures. Post-training interviews, however, revealed meaningful improvements in trainee knowledge and changes in attitudes towards autistic people. Trainees specifically mentioned how valuable they found the inclusion of autistic students within the training, emphasising that this demonstrated variation between autistic people in terms of how they present and what aspects of university might be more or less difficult for them, and that this made the course much more engaging. They also gained more nuanced knowledge about autism and autistic people, losing some of the stereotypes they previously held, especially around different presentations of autism. Therefore, the project team considered the training to be successful, because it had an impact on improving the support that staff could offer to students.

The training outcomes were positive for staff from both academic and professional services. It may be that it was more positive for those who had less knowledge prior to training, but there were no indications that anyone who took part did not benefit in some way. There are also early indications that the training has improved staff-student interactions, based on interviews with autistic students.

The key amendment to the programme which enabled these successful outcomes was the development of multiple forms of the training. This meant that those who could not attend the early five-week version still had the opportunity to take part, broadening the impact on practice within the university. We did not find any significant differences between the three types of training regarding the impact on staff knowledge scores, although those who took part in the five-week version felt that they had a more in-depth understanding of the material. This means that adopting the short-course version of the training could represent a low-cost opportunity for universities to have a positive impact on staff knowledge and stigma.

Could the approach be replicated and scaled up?

There are active plans to replicate and scale up the training via the development of an online independent learning module. This is currently hosted on the University of Bristol staff training platform, with plans to make it externally available. Doing so will maximise the potential for scaling up the training by opening it up to institutions across the higher education sector. Several third sector organisations have also expressed an interest in using the training in their work with autistic young people and their families, giving potential to expand beyond higher education.

Is there evidence of sustainability beyond the lifetime of the project?

There are plans for the project to be sustainable long-term through the online independent learning module and the project website. This website hosts links to publicly available materials and publications from the project, and will link to the training itself when possible, ensuring widespread and long-term impact.