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TEACCH® Autism Program

Why Are We Doing This?

Autism and Suicide

Suicide is the second leading cause of death among young people ages 12-24. The rate of suicide in young people has increased by more than 46%, while rates of other leading causes of death have declined. The enormous emotional, physical, and financial impact of suicide and related behaviors affects youth, families, communities, clinicians, and healthcare systems. Autistic individuals are at particularly high risk for suicide. Compared to the general population, they are:

  1. up to nine times more likely to experience suicidal ideation
  2. up to five times more likely to attempt suicide, and
  3. over seven times more likely to die by suicide.

The autism community has identified adapting suicide prevention interventions for autistic people as a top priority.

 

Safety Planning Intervention (SPI)

The largest Safety Planning Intervention (SPI) trial demonstrated the effectiveness of SPI plus structured follow-up contacts (SPI+) relative to usual care (without safety plans) in non-autistic patients (Stanley et al., 2018). In this study, suicidal patients who received SPI+ had 45% fewer suicidal behaviors. They were also more than twice more likely to access outpatient mental health treatment within 6 months of a suicide-related emergency department (ED) visit. In routine clinical practice, but, SPI implementation varies. It is often limited to a single encounter (without follow-up) in non-specialty mental health settings (e.g., ED, primary care). Citing this large study in their clinical guidelines, the Joint Commission and the American Association of Pediatrics recommend SPI as a first-line suicide prevention intervention. Yet, neither guideline includes the follow-up component in their description.

 

Current Study

To date, we don’t know much about which of these two approaches is more effective in general, and with autistic individuals in particular. Without research-based guidance, providers face a difficult decision about which adapted approach to SPI is more effective for autistic patients:

  1. SPI-A delivered in a single encounter; or
  2. SPI-A+, modeled after a multi-component, evidence-based intervention.

The goal of this study is to compare the effectiveness of these two tailored suicide prevention approaches among autistic youth.

This study is available on ClinicalTrials.gov. Learn more about the study.