Document Type

Capstone Experience

Graduation Date

8-2025

Degree Name

Master of Public Health

Department

Health Promotion

First Committee Member

Regina Idoate, PhD

Second Committee Member

Aislinn Rookwood, PhD, MPH

Third Committee Member

Michaela Ahrens, MS

Abstract

Autism spectrum disorder or difference (ASD) is a lifelong neurodevelopmental disability, usually identified during childhood. However, many adults miss the opportunity for diagnosis during childhood due to previous misunderstandings about autism presentation, camouflaging behaviors, and misdiagnoses. While current diagnostic tools for assessing autism in children are more robust, similar measures are lacking for adults who were not diagnosed in childhood. This gap poses risks for poor mental health outcomes among adults who missed a timely ASD diagnosis, which can be especially challenging for autistic college students. Although some higher education institutions offer support programs for autistic students, most do not, and, to our knowledge, no institutions routinely screen for ASD. Following the Community Readiness Model, we assessed the University of Nebraska Medical Center’s (UNMC) current readiness to address the mental health needs of autistic students. The Community Readiness Model (CRM) helps determine which stage of readiness a community is in, enabling strategic planning of future interventions that match the community readiness stage. Six participants affiliated with UNMC were recruited through purposeful and snowball sampling and participated in a brief interview. Participants were asked about the five dimensions of community readiness: leadership, resources, efforts, knowledge of efforts, and community. The findings reveal that UNMC was at Stage 3, Vague Awareness, regarding autism and mental health. The Community Climate dimension was the highest ranked, at Stage 5, Preparation; meanwhile, the resources dimension had the lowest overall level at Stage 2, or Denial/Resistance. This study revealed several obstacles to community readiness, including challenges and disparities in accessing autism evaluations and, therefore, accommodation services. Remote students may have fewer mental health resources than students studying on campus. Recent federal changes have contributed to uncertainty surrounding funding for autism and mental health in higher education spaces. These findings help guide numerous recommendations for raising community readiness levels at UNMC. A small sample size and brief interviews limit this study. Future studies should include more diverse representation, especially the perspectives of more neurodivergent individuals.

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Available for download on Friday, August 07, 2026

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