NHS Five steps to mental wellbeing

5 steps to mental wellbeing - NHS

The NHS Five Steps to Mental Wellbeing is a simple, evidence-based framework designed to help everyone improve their mental health and wellbeing. By incorporating these five actions into daily life, individuals can build resilience, manage stress, and experience greater overall life satisfaction. The five steps are: Connect, Be Active, Take Notice, Keep Learning, and Give.

However, the article focuses on the neurotypical view of the five steps. For instance, the article recommends that in the step of connecting with other people, individuals are not advised to  “rely on technology or social media alone to build relationships. It's easy to get into the habit of only ever texting, messaging or emailing people” This ignores the challenges that many people with Autism and ADHD face with social anxiety, sensory overload in groups or difficulty with social cues and sustained attention.

This article aims to adapt the NHS 5 steps to mental well-being for autistic individuals and individuals with ADHD, focusing on four main areas:

• Predictability

• Individual Interests

• Sensory Considerations

• Executive Function Support.

1. Connect

The challenge for people with Autism and ADHD can be social anxiety, sensory overload in groups, or difficulty with social cues and sustained attention.

• Focus on Quality over Quantity: Prioritise connecting with a few trusted people( family, close friends) rather than large social groups.

• Structured Interaction: Use shared interests as a foundation for connection (e.g., join a highly specific club or a gaming community).

• Non-Verbal Connection: Engage in parallel play or shared activities that don’t require constant eye contact or conversation, like building, crafting, or walking.

• Plan and Prepare: For social events, plan ahead: set a time limit, know the environment, and have an “escape plan” or quiet area identified if needed.

2. Be Active (Exercise)

Executive dysfunction (common in ADHD) can make starting and maintaining routines difficult, while sensory sensitivities (common in Autism) can make traditional exercise challenging.

• Make it Interest-Driven: Find activities that genuinely interest the individual (e.g martial arts, parkour, dancing to favourite music, deep-diving into a complex video game that requires physical movement)

• Sensory-Friendly Environments: Opt for activities in quiet, predictable, or private spaces(home gym, early morning swims, walking a familiar route). Avoid overly loud or bright gyms if possible.

• Movement for Focus (ADHD): Incorporate movement into tasks, such as pacing while on a phone call or using a standing/treadmill desk or fidget toys during static tasks.

• Hyper-Focused Activity: Use hyper-focus (Autism/ADHD) to engage deeply in a sport or activity, but be mindful of burnout and schedule in rest.

3. Take Notice (Mindfulness/Awareness)

Mindfulness can be difficult when the mind is racing (ADHD) or preoccupied with intense focus (Autism).

• Focus on Sensory Input: Instead of abstract awareness, focus on concrete sensory details that are calming or interesting. (e.g., the texture of a soft blanket, the taste of a favourite food, the pattern of light on a wall)

• Special Interest as Mindfulness: Engage deeply in a special interest as a form of focused, calming presence.

• Externalise Noticing: Use structured tools like a mood tracker, a journal, or an app to log feelings and observations rather than relying solely on internal processing.

• Predictable Transitions: Use routines and sensory cues to help with transitions between tasks, which can be a key source of anxiety and distress.

• Have an escape plan or quiet area identified if needed.

• Set a time limit for tasks.

• Know the environment beforehand.

4. Keep Learning (New Skills)

The motivation for learning is high in both groups, but challenge can arise from distraction (ADHD) or preference for deep knowledge over broad topics (Autism)

• Leverage Special Interests: Direct learning toward special interests for maximum motivation and engagement. Deep-dive into one topic is often more rewarding than surface learning of many.

• Bite-sized Information(ADHD): Break down learning goals into very small, manageable chunks to overcome the difficulty of starting and maintaining focus. Use visual aids and varied formats (videos, audio, hands-on)

• Structured and Predictable Learning: Choose learning environments that are structured and clear, such as online courses, 1:1 tutoring, or self-directed learning in a controlled setting.

• Gamification: Turn the learning process into a game with measurable progress and rewards to tap into the ADHD need for stimulation and novelty.

5. Give (Altruism/Contribution)

Giving can be a powerful way to connect and feel purpose, but it must be manageable and align with personal strengths.

• Defined, Contained Tasks: Volunteer for specific, time-limited tasks that have a clear start and end point and utilise organisation or detailed, orientated skills(e.g organising a library, data entry, quality control)

• Skill-Based Giving: Use existing special interests or skills to contribute, such as coding for a non-profit organisation, teaching a specific skill, or creating art for a cause.

• Remote or Asynchronous Giving: Consider opportunities that don’t require face-to-face interaction or a rigid schedule, such as admin work from home or making donations.

Micro-Giving: Focus on small, daily acts of giving that are less taxing, such as offering a clear, specific compliment, helping a family member with a known task, or sharing hyper-focused knowledge with someone interested.