First trial of new suicide prevention intervention designed for autistic people

A new suicide prevention intervention developed specifically for autistic adults has been trialed as part of a program of research to identify ways to reduce suicide and self-harm among autistic people.

The trial has been carried out by experts at the University of Nottingham's School of Psychology and Newcastle University, who tested autism adapted safety plans with a group of autistic people and learned that almost two-thirds found them useful. The study results were published in the journal eClinicalMedicine.

Dr. Sarah Cassidy from the University of Nottingham and Professor Jacqui Rodgers from Newcastle University led the research. They have shown in previous studies that autistic people are at a higher risk of self-harm and suicide compared to non-autistic people, but there is a lack of research into what could help reduce this risk.

Dr. Cassidy said, "We have consulted with autistic people and those who support them worldwide to identify the most important areas of suicide prevention research to focus on, and one of the top priorities was to develop new personalized suicide prevention interventions with and for autistic people. One of the suggested interventions to focus on were safety plans, as many autistic people reported using these, but recommended that adaptations were needed to make these clearer and easier to use."

Safety plans are a personal step-by-step plan a person can make to help keep themselves safe. Safety plans typically include a person's reason for living, activities and people that can help distract from thoughts of self-harm, friends, family and professionals the person can contact for support, emergency contacts during a crisis, and a plan for making the environment safe. Safety plans have been shown to reduce self-harm, suicidal thoughts and suicidal behaviors in a range of groups, but never before in autistic people.

In this new research, the team tested a safety plan, specifically aimed at autistic people, with 49 participants. The autism-adapted safety plans (AASP) have clearer wording that is more accessible for autistic people. Additional sections have been added to AASP to let support workers know how to best communicate and support autistic people in a crisis. A resource pack was also developed with guidance to help autistic people and those who support them to complete an AASP together successfully.

The autism-adapted safety plans (AASP) were tested with autistic adults, who completed them with a service provider to further refine the AASP and study processes. They were asked to complete questionnaires before, one, and six months after consenting to the study.

Most (68%) of the autistic adults were satisfied with the AASP and said their experience of using the AASP was positive and suggested minor changes to some questionnaires to make them clearer.

Dr. Cassidy notes, "This research builds on our work to establish a better pathway for mental health support for autistic people that is tailored to theirs and their family's specific needs. Working with autistic people to trial a new adapted safety plan has allowed us to gain insight into what they need, so this can now be fed into a larger trial to investigate whether AASP reduces self-harm, suicidal thoughts and behaviors in autistic adults."

The autism communities priorities were published in a policy brief by the International Society for Autism Research, and incorporated into the Department for Health and Social Cares Suicide Prevention Strategy 2023–2028, and the DHSC suicide prevention strategy will be considering the research results as a possible intervention to be delivered throughout the NHS in the future.