Inside the ward round: Experiences and perspectives of autistic patients and mental health hospital staff.

Autistic individuals experience disproportionately high rates of mental health conditions and hospitalisation, yet research about their perspectives within inpatient decision-making structures, such as the ward round, is limited. We address this gap by exploring how autistic adults and inpatient mental health staff experience ward rounds. Using a mixed-methods qualitative design, we integrated 12 video-recorded naturally occurring ward rounds with 36 reflective interviews across two hospital settings in England. Our reflexive thematic approach created four themes: (i) the intersection of autism and mental health; (ii) the need for adapted treatment; (iii) autism in the hospital environment; and (iv) strengths versus deficit approach to care. The findings spotlight how institutional routines and medicalised language shape autistic people's involvement and experiences of inpatient care. We argue that a focus on autism-specific knowledge, strengths-focussed practice, and person-centred interactions are jointly essential to improving the wellbeing and effectiveness of hospital mental healthcare.