Suicide and autism - a guide for professionals

Sadly, autistic people are at an increased risk of suicide compared to non-autistic people. Feeling socially isolated and lonely, and finding it difficult to communicate their feelings, can lead some people to have suicidal thoughts.

If you are caring for an autistic person who is suicidal and needs immediate help to keep safe, take them to the Accident and Emergency (A&E) department of any hospital. This guide sets out other ways to help, as well as advice for medical professionals on the identification of suicidal thoughts in autistic people.

What is suicide?

“Suicide is the act of intentionally taking your own life. Suicidal feelings can range from being preoccupied by abstract thoughts about ending your life, or feeling that people would be better off without you, to thinking about methods of suicide, or making clear plans to take your own life.

People might have:

suicidal thoughts with suicidal behaviours 
suicidal thoughts without suicidal behaviours.

Mind

Triggers for having suicidal thoughts

All the current research suggests that autistic people are at an increased risk of suicide compared to non-autistic people, but the prevalence rates vary dramatically. 

Both autistic and non-autistic people experience similar triggers for suicidal thoughts, including:  

depression  
feelings of hopelessness 
difficult life events 
trauma and childhood trauma
substance abuse
employment or money concerns 
grief and loss (death and end of relationships)
social isolation 
having an underlying (mental and/or physical) health condition.

Researchers and autistic people’s accounts suggest a number of potential risks specifically for autistic people. These include:  

experiencing bullying, social isolation/rejection and loneliness 
self-harm
finding it difficult to understand their own feelings and learning to manage them (also known as emotional regulation)
camouflaging (hiding or masking autistic traits or behaviours) 
sleep problems
difficulty accessing post-diagnosis and mental health support  
difficulty communicating emotions and thoughts with others 
experiencing alexithymia (difficulties identifying and describing their own and others emotions) 
co-occurring mental health conditions, such as OCD and depression.

Autistic people report that social isolation and loneliness are the most common reasons for suicidal thoughts.

Some people highlight issues relating to receiving their autism diagnosis later in life. If they had been aware that they were autistic earlier on then this may have prevented suicidal thoughts. An autism diagnosis would have given them better self-understanding and access to support which would have improved mental wellbeing.

What should you do if the person you support is feeling suicidal?

Immediate options for anyone feeling suicidal or unable to keep themself or others safe

Take them to any hospital's Accident and Emergency (A&E) department (sometimes known as the emergency department).
Call 999 and ask for an ambulance, if you can't get to A&E.
Ask someone else to call 999 for you or take you both to A&E.

If the person needs support right now but doesn’t want to go to A&E, here are some other options you can try:

Encourage them to call Samaritans for free on 116 123 or email jo@samaritans.org – they're always open and are there to listen.
Encourage children and young people under 19 to contact Childline on 0800 1111 – the number will not show up on the phone bill
Contact their GP for an emergency appointment for them or the out of hours team.
Contact NHS 111 (England, Scotland and Northern Ireland) or NHS Direct 0845 46 47 (Wales).
Contact your local crisis resolution and home treatment (CRHT) team, if the person you support is under their care.

Other ways to support autistic people having suicidal thoughts

If the person you support is starting to have suicidal thoughts, help and encourage them to access:

support through their GP and a referral to community mental health teams
helplines and listening services
peer support, such as
Big White Wall, which offers support from trained professionals
Side by Side, Mind's online community.

You can also visit our mental health support page for more information about seeking help.

Identification/assessment of suicidal thoughts/attempts in autistic people – advice for medical professionals

Research indicates that suicide screening and measuring tools are not reliable for autistic people as questions can be misunderstood or misinterpreted. They suggest current tools need adapting to meet the needs of autistic people, or that new autism specific tools need to be developed.

As mentioned above, many autistic people also struggle in identifying and expressing their thoughts and emotions, which in turn can make it difficult for professionals to accurately assess autistic people.

Synapse, Papyrus and Dr Sarah Cassidy offer advice for professionals on how to communicate with an autistic person who may be suicidal:  

Establish rapport, for example, “I'm listening and I want to support you”.   
When asking a question, allow enough time for the person to process the information and be able to answer.   
Keep your language clear and use what/when/where/who questions.   
Make sure that the language you use is simple and doesn’t have more than one meaning.
Use visual aids if the person needs them, to help them identify and express their emotions.
Develop options and a plan of action.