I have an autistic roommate renting a room in a house that I'm renting. I've had issues in the past where I've told him that he needs to keep his room free of trash and while I don't personally care about it being a mess as long as he's not living in unsanitary conditions, it could eventually be a problem with the owner one day.
Several months ago, I started helping a friend who lost the room he was renting because the house was getting sold. The entire house reeked of what I now recognize as roach poop and the kitchen had so much poop it was nauseating. The roaches hitched a ride on his mini fridge despite him swearing religiously that he cleaned out his room every weekend. I suspect that he has autism but I can't tell him that because he'll take it the wrong way and see it as putting him down. He was sleeping in the living room and didn't pay rent. He also put up a huge argument when I told him that he needed to clear out within the next few days and did everything he could to try to negotiate for longer. He's living with his grandparents now and he put up a huge argument saying he didn't want to live with his parents because he wanted to be "independent" and he had "already told them he had a place to live."
I told the other roommates they'd need to clear out for a while and offered to pay for two months of storage for them so that I can get as much out of the house as possible. I've been storing and throwing away a lot and I'm using this as an opportunity to get rid of a lot of clutter. I hate throwing a lot of stuff out but I also hate having too much stuff even more. The roach poop situation hasn't been that bad but I've cleaned out most of it and they've lost most of their hiding spots.
The other roommates have moved out temporarily and stripped their rooms mostly down to the furniture. The autistic roommate has barely done anything even though I told him that I'm going to have to kick him out if he doesn't get his room cleaned. It's a disaster but I could easily box it all up within a day. I had a super messy "man cave" room as well, but the entire rest of the house except for the roommate's room is now good for pest control. I've told him that if he has trouble I can go through with him and help him box stuff up.
The owner has been really good with everything and he said he didn't want to give me a deadline and was impressed with how quickly I got everything cleaned up. He did tell me though that I'm going to have to make a decision about the roommate if he doesn't show substantial progress soon. I've told him he can just take all his stuff to storage for a couple months and he doesn't need to make a decision about getting rid of stuff until after the pest control is done so he doesn't feel like he was forced to throw stuff away.
I don't know if he has a hoarding disorder or not. He doesn't seem to have a problem with holding on to literal trash. I would really hate to kick him out but honestly I feel like it might be a personal improvement.
My friend who has been living rent free is obsessed with coming back after the pest control is done even though a huge part of me doesn't want that. I don't want to charge him rent because he'll never be able to afford a place to move in to if I do that. If I have to kick out the roommate though I will absolutely offer him the room though.
Nothing in your post suggest anything to do with autism.
This is probably it, or depression, or a mix of a bunch of different things. Or maybe even ADHD. ADHD paralysis is having decision fatigue so the person does not do anything.
I really don't have a solution for you. You seem to be a caring person that reached their limit.
I don't know your relationship with any of these people but what I would do is kick out the roommate and charge the friend. Having a place is the exchange for money. If his goal is to have his own place, he should figure that out. That shouldn't be your concern. You aren't their guardians.