Background: Autism Spectrum Disorder (ASD) and related intellectual and developmental disorders (I/DD) can severely impair a person’s communication abilities and social skills. ASD affects virtually all aspects of everyday functioning to some degree. Difficulties are seen in communication, social interaction, adaptive functioning, and self-care skills. Many people with ASD engage in behaviors that jeopardize their safety and health, i.e. self injury, pica (ingesting inedible items), elopement (running away), flopping (throwing themselves on the ground), aggression, sleep disorders, and severely restricted eating. Most people with autism have psychiatric symptoms that are separate from autism itself. About 70 percent "may have" another mental disorder and 40 percent "may have two or more" such disorders, according to the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, or DSM-5.

The Problem:  In Washington State, there is a large gap between the supply of Licensed mental health professionals and these services. None of the current medical/mental health education and training programs offer coursework in autism. There are very few mental health counselors, psychologists, psychiatrists or neurologists in the State that have the training or desire to work with teens and adults with ASD+I/DD around severe disruptive behavior, feeding disorders, Functional Life Skills, and of the handful that do are associated with pediatric programs ONLY. We cannot rely on pediatric education and training to design, implement, and oversee mental health services for a population of adolescents and adults in crisis that are often hard to discharge from Emergency Departments and involuntary placements.

Without active treatment, some clients develop or intensify aggressive, destructive, or self-injurious behaviors. Supported Living providers have terminated clients with significant behavioral challenges and abandoned them at hospitals. These vulnerable individuals, often a danger to themselves and others, then bounce between their family home (if they have one), temporary respite placements, hospital boarding, jail, or homelessness at great expense to our state, medical and mental health systems. The DD Ombudsman's “Stuck in the Hospital” report details this crisis, which is a direct result of the lack of timely active treatment that is presently only available in the state’s 4 residential habilitation institutions.