Mental health challenges are common in people with a diagnosis of Autism Spectrum Disorder (ASD) but are largely overlooked within current autism employment programs and interventions. While workplace initiatives to help support autism characteristics in the workplace are relatively successful, we contend that the complexities of mental health in autism present as potential risk factors for the sustainability of autism employment programs. In this chapter we first detail common co-occurring psychiatric conditions in autism. We then investigate the complex interaction between mental health and well-being, autism characteristics and the workplace through the lens of Job Demand-Resource theory and to argue the importance of developing specific mental health supports in autism employment programs and initiatives. Established mental health initiatives for the general population and their limitations in supporting the mental health and well-being of autistic employees are then explored. Finally, we present two new autism specific mental health initiatives that may help fill the resource gap in this area.