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

Despite suicide being a leading cause of death for autistic people worldwide, there is remarkably little research addressing suicide prevention strategies in this group. Moreover, autistic voices are often absent from published research, leaving their ideas, needs and desires concerning suicide prevention unheard. Overall, 3962 autistic people and 627 people who supported or were bereaved by the suicide of an autistic person participated in the study. Using online surveys, we garnered their ideas for policies and interventions to prevent suicide in autistic people (Phase 1). We thematically analysed 3373 suggestions and distilled these into 63 concrete ideas, which we asked an independent sample to prioritise in a four-step process (Phase 2). We analysed descriptive responses to each idea and identified differential priorities between and within autistic and non-autistic groups. Across both phases, we identified suicide prevention priorities including the upskilling of healthcare practitioners, the need for tailored and preventative support, and to improve waiting times for autism diagnosis and post-diagnostic care. Other priorities indicated the need for societal change to reduce social marginalisation, address inequities, and reduce barriers to help-seeking.With ideas spanning mental health interventions to preventative measures in the education, employment and social care sectors, participants’ views appeared to corroborate and reflect focal shifts in national and international suicide prevention policies. Moving beyond individuals at crisis point, these increasingly emphasise the need for coordinated, multisector efforts to address the long-term societal determinants of suicide (e.g. unemployment, marginalisation), foster social connectedness and wellbeing. While policies to address autism and suicide are in their infancy, we argue that similarly wide-lens, strategic responses are imperative to reduce excess mortality in autistic people.