First trial of new suicide prevention intervention designed for autistic people

A new suicide prevention intervention designed specifically for autistic people has been trialled at as part of a programme of research.

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 found that almost two thirds found them useful. The study was funded by the National Institute of Health Research (NIHR) and the results were published in the Lancet’s journal eClinicialMedicine.

Previous studies have shown 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 Sarah Cassidy, University of Nottingham, was one of the academics leading the research who said the trial built on work to “establish a better pathway for mental health support for autistic people that is tailored to theirs and their family’s specific needs.”

“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 personalised 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 showed to reduce self-harm, suicidal thoughts and suicidal behaviours 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 which is more accessible for autistic people. Additional sections have been added to AASP for autistic people to let support workers know how to best communicate and support them 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 it 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.

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 consider the research results as a possible intervention to be delivered throughout the NHS in the future.

“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 reduce self-harm, suicidal thoughts and behaviours in autistic adults,” Dr Cassidy said.