Community priorities for preventing suicide in autistic people: an approach to guide policy and practice.

Abstract

Background Suicide is a leading cause of death for autistic people worldwide, but there is remarkably little research addressing suicide prevention strategies in this group, and virtually none that asks autistic people what they need and want. Methods Overall, 3962 autistic people and 627 people who supported or were bereaved by the suicide of an autistic person (>95% UK-based) participated in our online surveys. We garnered their ideas for policies and interventions to prevent suicide in autistic people (Phase 1). We thematically analysed 3373 suggestions, distilling these into 63 ideas which an independent sample prioritised (Phase 2). We identified shared and differential priorities between participants. Results Across two samples of autistic and non-autistic people, differences were overshadowed by consensus on necessary pathways to suicide prevention. Paramount among these were the upskilling and resourcing of healthcare services to deliver timely, autism-specific support, and the improvement of diagnostic services, ensuring autistic people not diagnosed in childhood are assessed accurately, quickly, and with sensitive post-diagnostic care. Other priorities, across phases, emphasised a social, societal response to suicide in autistic people, one where reducing stigma and providing social support were favoured over crisis apps, and where support should be embedded across the lifecourse in relation to education, employment, and social care in the community. Conclusion While UK-centric, the findings corroborate international calls for autism-specific support for people in crisis, delivered by those with specialist knowledge. These results also highlight the relationship between suicide prevention and timely autism diagnosis, and the essential need for post-diagnostic care. Mirroring shifts in national and international suicide prevention policy, participant priorities extend the focal point of suicide prevention beyond individuals in crisis, emphasising the need for coordinated, multisector efforts to address systemic societal determinants of suicide: a strategic and expansive perspective thus far lacking in an autism context.