Reducing self-harm and suicide in autistic adults

In a blog for Suicide Prevention Awareness Month, Emma Nielsen and Jane Goodwin discuss the use of safety plans to reduce self-harm and suicide for autistic adults, as evaluated in their study registered at the ISRCTN registry.

Suicide risk is much higher in adults who have a diagnosis of autism than it is for people without this diagnosis. Despite this risk, there aren’t any suicide interventions developed specifically for autistic people. In our study, we are adapting a suicide prevention tool with autistic people and those who support them.

More than 6 in 10 autistic people have considered suicide, more than 3 in 10 autistic people have attempted suicide, and almost 8 in 10 autistic adults have a mental health condition

Why are autistic people more likely to experience self-harm and suicide?

There are lots of things that put autistic people at risk for self-harm and suicidal thoughts and behaviors. Some of these are part of who an individual is. For example, many autistic people have “sticky thinking” which means they can focus on a particular train of thought. This can mean that suicide feels like the only escape.

However, many factors are due to the environment autistic people are required to function in. Autistic people are often forced to modify their innate autistic behaviors in order to cope in a society that is set up for non-autistic people. We call this “camouflaging”, and it can increase feelings of loneliness and not being accepted.

Also, autistic people often don’t have access to appropriate support because services are not set up for their needs. This can make them feel hopeless. Finally, autistic people are more likely to experience difficult life events, which can increase risk of attempting suicide.

Our studyAutism-Adapted Safety Plans

Research into other types of mental health difficulties, such as anxiety and depression, indicate that autistic people require changes to be made to standard treatments to make them accessible and meaningful.

We have worked with autistic people and those who support them (such as friends, family, and health professionals) to develop an autism-specific version of a commonly used intervention known as a safety plan. Safety plans are a tool to think about what might be helpful in a future crisis, and they have been shown to help in the general population.

Our Autism Adapted Safety Plan includes space to think about warning signs of an impending crisis, internal coping strategies that might help, people and professionals you know and/or who you can reach out to for support, and ways to make the environment safer.

It also has questions about how the autistic adult would like to be communicated with when distressed, and whether they would like to share the safety plan with trusted people. Now, we want to find out whether our Autism Adapted Safety Plan is useable and useful for autistic adults.

Mature male psychotherapist or counsellor interacts with a male client during a one-to-one therapy session.
© Christopher Ames / Getty Images / iStock

If you would like more information about the study or would like to be involved, please visit our website.

Why is it important?

Research suggests that when people are suicidal, they typically feel trapped in a moment of intolerable distress. We also know that these feelings often come and go again. An Autism Adapted Safety Plan might help autistic adults to navigate their difficult feelings and distract from their suicidal thoughts until they pass.

There is still a lot of silence around self-harm and suicide. People often worry that talking will “put ideas into somebody’s head”. However, it is OK to talk about self-harm and suicide! An Autism Adapted Safety Plan might also be a useful way to help autistic adults to open up important conversations with people who support them.

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