Barriers and facilitators to primary health care for physical and or mental health issues experienced by adolescents and adults with intellectual disabilities (only), autism (only), or both: an integrative review

Abstract

Introduction: People with intellectual disabilities, autism (or both) experience health inequalities. They also experience obstacles when accessing and utilising health-care for their physical and mental health needs and issues.

Methods: An integrative review utilising systematic review methodology was conducted to identify the barriers and facilitators that adolescents and adults with intellectual disabilities, autism (or both) experience in accessing and utilising primary healthcare.

Results: 70 international studies were identified. Preliminary analysis of the review’s findings suggests several barriers and facilitators exist. For example, daunting primary care environments, communication challenges, unconscious bias, diagnostic overshadowing by staff, a lack of accessible information about services for this population, difficulties navigating services, and resource constraints for service providers. Facilitators identified include, for example, collaborative relationships between health and other care providers, virtual teams of practitioners (with skills and experience of working with people who have autism, intellectual disabilities or both), supportive staff, communication aids, preparing patients in advance of primary healthcare visits, and the inclusion of those with autism and intellectual disabilities in joint training and service developments.

Implications: Findings have implications for primary healthcare research, policy and practice. Suggestions for primary healthcare research, policy and practice focus are included for consideration.