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Autistic adults often experience symptoms of severe mental illness (SMI), yet research on such comorbidities remains limited. This study explored risk and protective factors for SMI among clinically and self-diagnosed autistic adults (n = 11), comparing those diagnosed in childhood with those diagnosed later in life. This study also examined their navigation of neurotypical society and perceptions of existing mental health care. Using mixed methods, the study collected quantitative survey data using the PHQ-9 and GAD-7 and qualitative interview data.