Autism or ADHD alongside mental-health difficulties

Ask how they prefer to communicate. They might find a short written message easier than a phone call, want one question at a time, or need more time to answer. Say clearly what you are asking rather than relying on hints.

Ask whether noise, lighting or a crowded space is making things harder. Offer a quieter place or a pause. Do not assume that every autistic person wants the same changes.^[2]

Autistic burnout is a term developed by autistic people to describe severe exhaustion associated with sustained demands, sensory overload and the effort of hiding autistic traits, often called masking. Everyday tasks and communication may become harder. These experiences deserve support, but the term alone does not establish what is causing a change.

Ask which demands can be reduced and what helps them recover. With their agreement, offer practical help with a meal, an appointment or a task they choose. Make room for rest and interests they enjoy, without setting a deadline for recovery. If difficulties persist or worsen, encourage a GP appointment to consider physical and mental-health needs too.

National Autistic Society: autistic fatigue and burnout. This guidance draws on autistic people's experiences; it is not a diagnostic test.

A meltdown can involve overwhelming distress and a temporary loss of control. A shutdown may be quieter: the person might withdraw or find speaking and responding difficult. Neither should be treated as deliberate behaviour.

When they feel able, ask what helps and agree a plan: preferred communication, somewhere quieter, whether they want you nearby and who to contact.

During overwhelm, reduce noise, bright light and unnecessary demands where possible. Use few words and allow time to respond. Offer space without insisting they move. Do not force conversation, touch or eye contact, or try to restrain them to make them calm down. Follow any agreed plan and give them time afterwards before discussing what happened.

Your safety matters too. Step back if you are at risk and seek help. You do not have to manage repeated crises alone: ask their team about a support plan and use support for you. If the change is new or you are unsure what is happening, seek medical advice rather than deciding it is a shutdown.

National Autistic Society: meltdowns · Leicestershire Partnership NHS Trust: meltdowns and shutdowns.

An adult usually needs to agree to assessment and treatment. You can encourage them and offer practical help, but usually cannot make them accept it. If they refuse, you can still tell their GP or team what you have noticed and ask for advice. Read what you can do if they refuse help and how consent works. If help cannot wait, seek urgent advice without waiting for their agreement.

Ask the service in advance what the appointment will involve and what changes are possible. Examples include written questions, a quieter waiting space, an agreed place to wait outside, a longer appointment or bringing a chosen supporter.

Help the person make a short note of what helps and what makes communication harder. Ask for this to be recorded so they do not have to explain it at every visit. If they want you there, ask what part they want you to play rather than answering everything for them.

Prepare for a meeting · Record information-sharing preferences.

ADHD can make organisation and keeping track of tasks difficult. Ask whether one reminder, a written plan or doing a task alongside them would help. Agree how to remind them so that it does not become repeated checking or an argument.

Keep any agreed plan small enough to use. For example: one appointment in a shared calendar, with their permission, and a reminder about the journey. Ask the clinician about treatment or medicine concerns; do not adjust ADHD medication yourself.^[3]

Ask which difficulty the service is assessing and how they will adapt the assessment. Be specific about new symptoms and the impact on everyday life. Ask who is responsible for help while another assessment is pending.

In England, NHS England guidance says access to mental-health care should not be restricted because someone is autistic or awaiting an autism assessment. Across the UK, our guide to delays and refusals gives the different routes for asking for a review or raising concerns.^[4]

If there is a sudden serious change or help cannot wait, use sudden change or urgent help.