(PS4-31) Confidence Is Key: Evaluating the Impact of ECHO Autism on Mental Health and Medical Provider Self-efficacy Treating Autistic Individuals with Co-occurring Mental Health Conditions

Background: About 80% of autistic adults without Intellectual Disability will experience at least one psychiatric condition in their lifetime (Mosner et al., 2020), which is higher than the general population (Lai et al., 2019). Community providers, in both mental and physical healthcare, report a lack of confidence and support in treating autistic individuals with co-occurring mental health conditions (Doherty et al., 2022; Maddox et al., 2020). A potential solution to this problem is the Extension for Community Healthcare Outcomes (ECHO), which is a teleconsultation program that leverages technology to disseminate knowledge from field-area experts to participant learners to increase access to care. Prior research has demonstrated the effectiveness of project ECHO for sharing Autism-related topics in both physical health and mental health. (Mazurek et al. 2019; Dreiling et al., 2022).

Objective: We examine differences in provider self-efficacy gains on a subset of questions designed to capture provider confidence in supporting autistic individuals with co-occurring mental health conditions across the two participant groups (Mental Health (MH) ECHO Autism and Medical (MD) ECHO Autism) to assess whether there was a significant change in provider self-reported confidence in supporting this population.

Methods: Both participant groups completed a demographic questionnaire, pre-participation, and post-participation surveys via Qualtrics.  These pre and post participation surveys assessed self-efficacy using a 6-point Likert scale ranging from “No Confidence” to “Highly Confident/Expert.” Participants in the MH ECHO Autism (n = 111) consisted of individuals who work in mental healthcare or a related field with master’s or doctoral-level degrees (e.g., social workers, psychologists). Participants in the MD ECHO Autism (n=41) consisted of individuals who work in physical healthcare or a related field (e.g., pediatricians, nurse practitioners). Participants in both the MH ECHO Autism and MD ECHO Autism practiced in a variety of settings in rural, suburban, and urban regions across the state of North Carolina.

Results: A total of 111 MH ECHO Autism participants (99 female, 11 male, 1 transgender) completed both the pre and post participation surveys. Analyses indicate significant pre (m = 40.19)-post (m = 53.34) changes in self-efficacy assessing and treating mental health conditions in autistic people; t(110) = -17.12, p = < .001. A total of 41 MD ECHO Autism participants (39 female, 1 male) completed both the pre and post participation surveys. Analyses indicate significant pre (m = 42.90) -post (m = 54.15) changes in self-efficacy assessing, treating, and connecting autistic individuals with mental health services; t(40) = -6.920, p = < .001.

Discussion:  Participants in both MH and MD ECHO Autism programs demonstrated significant gains in self-efficacy related to assessing, supporting, and treating autistic individuals with co-occurring mental health conditions. By empowering clinicians and medical providers to feel more confident in treating autistic individuals, ECHO Autism is a powerful tool to increase service accessibility for autistic individuals across medical and mental health community-based settings.