One person dies by suicide every 40 seconds. Some of those most at risk include people experiencing mental health difficulties (such as depression) and vulnerable groups who experience discrimination (such as LGBTQ+ people).
Yet one at-risk group that is still largely overlooked when it comes to this crisis is autistic people. Research shows that autistic people are six times more likely to attempt death by suicide – and up to seven times more likely to die by suicide – compared to those who are not autistic.
This risk of death by suicide is even greater among autistic people without intellectual disabilities. The greatest risk is among autistic women, who are 13 times more likely to die by suicide than women who are not autistic.
It’s not entirely clear why autistic people are at increased risk of having suicidal thoughts and behaviours, though it’s likely a number of factors are at play.
For example, negative childhood experiences – such as bullying – have been associated with suicidal thoughts and behaviour in autistic youth. In autistic adults, loneliness, social and communication difficulties, feeling like a burden to others and a lack of support have also been linked.
Camouflaging autistic behaviours – such as adjusting your behaviour to fit into certain social situations (such as forcing eye contact) – has also been linked to increased risk of suicide. Having a mental health condition, such as depression, is also linked with an increased likelihood of experiencing suicidal thoughts and behaviours.
While some of these risk factors may be increased by certain autistic tendencies (such as a tendency to hyper focus on particular thoughts or behaviours), it’s likely there are many broader social, political and cultural factors at play – such as autistic people feeling excluded from society, or not feeling they belong.
Barriers to support
Having access to mental health services is one important way of preventing suicide. But many autistic people struggle to get support if they’re experiencing suicidal thoughts.
Again, there are a number of reasons why they may struggle to get the help they need. The first being a lack of access to mental health services. This may be due to long waiting lists, caused in part by a significant and historic lack of funding to mental health services in the UK.
Another factor is that healthcare staff often lack training on how to support autistic people who may be experiencing suicidal thoughts. There is also no consensus within the medical community on how best to help autistic people in this way.
These problems for healthcare professionals is partly because the severity, type and intensity of suicidal thoughts may present differently in autistic people. Communication difficulties in some autistic people may also make it hard for them to express how they are feeling. And unless they’re asked outright by a healthcare professional if they’re experiencing suicidal thoughts, this behaviour may be missed by current clinical tools, such as screening questionnaires.
Our research has even been able to show just how big this lack of knowledge really is. Our study, which was conducted in Canada, found that half of autistic people with suicidal thoughts or behaviours who attended a psychiatric hospital emergency room were missed during initial health screenings. This is staggering, especially considering how important this initial screening is to ensure timely mental health support for those at serious risks.
It’s clear that more needs to be done to help autistic people get the support they need and deserve. Part of this simply comes down to increasing awareness, so that people working in healthcare may better recognise possible warning signs of suicide and better help autistic people who are struggling with mental health more broadly. Greater awareness of the mental health problems autistic people may face is also important for friends and family of autistic people, so they may be able to look for and recognise certain risk factors, and offer support if possible.
If you suspect someone close to you may be struggling with suicidal thoughts, it’s important to reach out to them, asking them how they’re feeling and giving them the time and space to articulate what they’re feeling, seeing or thinking. Remaining nonjudgmental, without criticising or blaming them also is key. Merely asking if they are having thoughts of ending their life is a key suicide prevention tool.
If you feel you are in crisis, speak to someone as soon you can to let them know you are thinking of ending your life. It may be helpful to call an ambulance or an emergency crisis team or attend a local emergency room if you feel you are in crisis.
If you’re struggling with suicidal thoughts, the following services can provide you with support:
In the UK and Ireland – call Samaritans UK at 116 123.
In the US – call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or IMAlive at 1-800-784-2433.
In Australia – call Lifeline Australia at 13 11 14.
In other countries – visit IASP or Suicide.org to find a helpline in your country.
Patrick Jachyra has been supported by the Canadian Institutes of Health Research Fellowship Program and the Centre for Addiction and Mental Health Discovery Fund Talent Competition Post-Doctoral Fellowship.
Jacqui Rodgers receives funding from Autistica, ESRC, NIHR.
Sarah Cassidy receives funding from the National Institute of Health Research, Autistica, the Economic and Social Research Council, the International Society for Autism Research, Slifka Ritvo Foundation, and the Chief Scientist Office Scotland.