‘Meet us halfway’—better communication between mental health inpatient staff and Autistic service-users

In this blog, our anonymous Guest Contributor shares suggestions, derived from their own lived experience of mental health inpatient services, for how staff can develop better relationships and improve their communication with Autistic services users.

Regardless of Neurotype, different people may struggle with different aspects of communication and relationships. When it comes to communication everyone has ups and downs, strengths and weaknesses, and this should be normalised in society.

In particular, people Neurodivergent individuals, or people who struggle with their mental health might feel like they’re ‘bad at communicating’ —often because they have been told so by others. But that may not necessarily be true. In reality, we might just be communicating differently. Like speaking another language: it’s just another way.

My advice to Neurotypical people would be: meet us halfway and think outside the box. Try things with us. Encourage us and help us find ways of connecting and communicating that really work.

There’s lots of pressure put on us to communicate in a certain, narrow way. It’s strange that Neurodivergent people are expected do all the work, to learn another language and speak ‘Neurotypical’. If we communicate in a different way, then Neurotypical people may view it as wrong, but they may also be upset if we choose not to communicate at all. It feels like you can’t win. It can feel hopeless trying to communicate with people that feel so alien sometimes.

If everyone, Neurodivergent and Neurotypical, was honest about their struggles with communication and relationships, then we’d realise that sometimes we all struggle. It’s really important to understand that communication is a multifaceted thing. People shouldn’t be scorned for communicating in ways that work for them. It’s a privilege. It’s not something that comes naturally to everyone.

My advice to Neurotypical people would be: meet us halfway and think outside the box. Try things with us. Encourage us and help us find ways of connecting and communicating that really work.

In the context of mental health inpatient services, bridging this communication gap becomes even more important. Autistic service users may communicate in many different, ‘non-typical’ ways, so it’s important that staff are prepared to listen in different ways too. Here are some tips for how staff can bridge the communication gap to build better relationships with Autistic service users.

01
Understand different ‘ways of being’

Sometimes I think staff misinterpret Autistic ways of being. For example, they might think someone is being rude or distant because they aren’t making eye contact or because they don’t sound or look interested. There seems to be a lot of emphasis on looking for engagement. For Neurodivergent people that’s often not true. Eye contact can be too intense and overwhelming and it’s often easier to listen without having to look at someone. We might not be looking so we can listen better. If you’re not sure, check in with someone and ask if they’re listening. The person may be trying to process what you are saying in the way that works best for them.

02
Create a communication plan with contingencies

Having a good communication plan in place can really help. It’s important that new staff know about this before they support someone. If someone is overstimulated, then speech might not be viable. Not everyone understands how we can be expressive with words one minute then not able to speak another. It’s helpful to have a plan for communication and to support writing, pointing, communication boards and AAC.

03
Start small

Sometimes moving past small talk can be scary and tiring, especially with new people. Talking about the weather can be a safe topic and can be an ‘olive branch’ and take less energy than important or ‘deep’ topics.

04
Allow for differences in tone

Sometimes our spoken communication will sound ‘flat’ and this can be misunderstood and misinterpreted. Sometimes our communication might seem mean or ‘cold’ or upset you. Autistic communication is sometimes more direct that Neurotypical communication. 

05
Be aware of indirect/euphemistic language

Think about what is being said. For example, explain euphemisms, or don’t use them! It feels like I’m in a joke that I don’t understand, I’m trying to figure out what they mean and what I’ve missed.

It’s important if you say something literal that you stick to it. We often won’t realise that you didn’t mean what you say, and it can make it difficult to trust people if they keep saying one thing and doing another. For example, if you say “I’ll be back in a few seconds”, but you mean ‘I’ll be back shortly’ it’s confusing and we might feel lied to. If trust is broken, even in these small ways, then other things will be harder. It’s better to say what you mean.

06
Building trust can take a long time

All relationships are based on communication. Relationships are all about trust and sharing thoughts and experiences with another person. All relationships are different. They are all unique. My relationships with staff are different from my relationships with family.  To establish a relationship, demonstrate that the person can trust you. It can take years for some people to build trust. They might need time. They might struggle with how you communicate.

As hard as it is, time is one of the main factors. It doesn’t always ‘click’ immediately. It’s not like what we see in films sometimes. It’s good that it doesn’t happen immediately, because part of building trust is learning and finding out about a person. It’s safer for everyone to build relationships slowly.

07
Boundaries and barriers can help

Barriers with communication can help with building slow and trusting relationships that help make sure people don’t get overwhelmed or feel out of their depth.  If someone doesn’t respect that building relationships might take time, then they are showing me that they aren’t safe to trust.

You can’t always get someone to like you. Don’t push or make demands. Resistance might be a non-verbal way of communicating a boundary or showing that they’re not ready. Listen to this.

08
Kindness and patience underpin everything

Kindness goes a long way. Be patient, adapt your approach, accommodate us, and be willing to listen in different ways.