It is estimated that every year more than 1,000,000 people commit suicide worldwide, which means 1 suicide in the world every 40 seconds and for every successful suicide there are 20 other people who attempt suicide. We are therefore faced with a problem that requires the adoption of more preventive measures, attention and urgent intervention.
Suicidal behavior in people with autism is a topic that needs special attention because, although large-scale studies have not yet been conducted, there are studies to consider in which it is suggested that certain factors such as lack of social integration, unemployment and other psychiatric disorders associates could link autism and suicidal behavior.
In this article, we will explain in more detail the most relevant factors associated with suicidal behavior in people with autism, highlighting the importance of continuing to investigate this topic in order to prevent more cases and provide better support for people whose they suffer.
Suicidal behavior in people with autism
Autism spectrum disorders (ASD) have a neurobiological origin that affects the functioning and configuration of the nervous systemwhich leads to a series of difficulties essentially in two areas: communication and social interaction, on the one hand, and flexibility of thought and purchase, on the other.
Therefore, a multidisciplinary and holistic approach is needed, geared towards facilitating a series of specialized and individualized supports that are evidence-based, thus being the most appropriate to help improve the quality of life of each person who has received an ASD diagnosis. . It should be noted that in all the help that needs to be given, particular attention should be given to managing and preventing suicidal behavior in people with autism.
There is a remarkable percentage of people with autism who have thought about suicide and, nevertheless, in many occasions it is quite complex to detect the signs associated with the suffering they are experiencing. This is why some researchers have begun to study the risks and possible solutions to suicide.
What do we know about suicide in autism?
A team led by expert Sarah Cassidy, from the University of Nottingham, has been the first to investigate, through a large-scale clinical study, suicidal thoughts and behaviors in autistic people in adulthood when they had been diagnosed late with Asperger’s Syndrome. . These scientists have observed that suicidal behavior is a very worrying reality in people with autism, which is why more research is needed to help prevent and intervene in this type of case.
These researchers also pointed out that two out of three people diagnosed with ASD could have contemplated suicide at some point in their lives the fact that they had spent a large part of their childhood and youth without having received the necessary support or even without even understanding their condition.
Another important measure to prevent suicidal behavior in people with autism is based on early detection and early diagnosis of ASDas well as sufficient attention to balance and mental health from childhood, prevention and intervention against school bullying and facilitating greater help if warning signs are detected.
Risk factors associated with suicidal ideation and behavior in people with autism
Some of the factors associated with suicidal ideation and behavior in people with autism include some insufficient and unmet needs for support and assistanceunwanted loneliness, self-harm, ruminative thoughts, emotional dysregulation, isolation, psychiatric illnesses, low self-esteem and also the degree to which they might cover up their condition.
Other risk factors for suicidal behavior in people with autism are: social ostracism, bullying and victimization at school and/or work, difficulty finding a job, having lived negative or even traumatic experiences in childhood, marginalization or alienating experiences with certain professionals with whom they have dealt and with the systems theoretically designed to provide support to people with autism, among other factors.
Research on risk factors associated with suicidal behavior and ASD
Experts in the field have attempted to relate this prior knowledge of suicidal behavior in people with autism to existing models of suicide in the general population, in order to seek deeper understanding and thus serve as predictive utility. Among all these models, special emphasis was placed on the “interpersonal theory of suicide” (ITS).
In the interpersonal theory of suicide, attempts have been made to distinguish suicidal thoughts from suicide attempts, considering them as different phenomena. During the analysis and research on suicidal ideation, from the TIS, it has been highlighted the great relevance of what has been called “frustrated belonging”, which is considered a state of disconnection society with the belief of being a burden for those close to them, of being a possible risk factor for suicide.
On the other hand, according to this theory of suicide, in order for suicidal ideation to increase until it becomes a suicide attempt, a person should have been exposed for an extended period of time to a series of extremely painful physical and/or emotional events, among which would include self-harm which could lead to habituation to pain and also reduce fear of pain and even death. Additionally, mental rehearsal, in which the person imagines how to kill themselves, could also contribute to a greater risk of suicidal behavior.
It should be noted that in a 2022 study by Monseley and colleagues on some risk factors associated with suicidal behavior in people with autism, they were able to observe a lower rate of suicide attempts and death by suicide in people with autism. autistic people who had some type of relationship (married or in a relationship) that those people with autism who were single. This shows that satisfying relationships with other people who can serve as support and who are also a source of social connection are a protective factor against suicide.
Additionally, it has been associated with having a healthy and stable relationship with another person and having higher self-esteem, being less likely to suffer from certain negative states characterized by feeling like a burden and/or frustrated belonging; can therefore be a protective factor against suicidal behavior in people with autism and also in the general population. However, it should be noted that the observed direct effect of not being in a relationship on suicidal ideation was not significant.
In an article published in 2021 by Kolves et al, it is suggested that there is a higher rate of suicide attempts in people who were diagnosed at an older age than in cases where diagnosis occurred at an early age.
However, this hypothesis has not received support from all studies conducted in this regard, although it is consistent with surveys in which a higher incidence of psychiatric illnesses such as depression or anxiety has been found, among others, as well as social and behavioral difficulties and a greater history of self-harm in people with late diagnosis.
Similarly, other research in this regard has suggested that victimization and bullying are quite common among people diagnosed with late-onset autism, such that often they perceive themselves as inadequate or poorly integrated socially. Another possible relationship between a diagnosis later, poorer mental health and increased risk of suicidal behavior in people with autism may lie in the possibility that these people are more adept at covering up their difficulties. Camouflage of these difficulties has come to be associated with suicidal tendencies or suicidal experience.
Suicide Prevention Guidelines for People with ASD
Now that we have already seen some factors associated with suicidal behavior in people with autism (although more research is still needed), it is also important to know some guidelines for suicide prevention.
Some suicide researchers have made a distinction between measures that serve to reduce the risk of suicide and those that help to increase protection against it. It is also important to take into account the protective factors against suicide related to the social, local, family and, of course, individual situation.
To give a few examples, having access to health care and a good mental health support network is a good protective factor against suicide; while the implementation of measures to prevent school bullying are also protective factors against suicide. Another protective factor against suicide would be to have a strong social network that serves as support in the most difficult times of a person’s life.
We will then comment some of the prevention measures that have proven to be most effective in preventing suicide in the general population and which could also be used against suicidal behavior in people with autism.
1. Restrict access to means or instruments that can be used for suicide
First of all, it is important that there is a restriction on any type of medium that could be used to perform the suicide inside the house or any other place in which there is usually a person who is making attempts or has shown signs of alarm. After all, most people who have developed an ASD will only explore their home environment independently.
Among these means or instruments that must be restricted are weapons, pesticides or any other type of poison, firearms or certain drugs that can be used to induce suicide by overdose.
2. Education and training plans through institutions and media
Projects to raise awareness of suicide and its risks through education and training plans through associations, institutions or centers specializing in suicide, as well as through campaigns and notices through the various media with the aim of informing as many people as possible about an issue that is as important as it is worrying, which requires more professional help and which, under no circumstances, should be treated as a taboo subject.
It is important that people talk about and raise awareness about suicide to be able to provide more help to people who attempt suicide. When raising awareness about suicide, it is important to emphasize a few points: try to get help as soon as possible from a professional or an association or a center specializing in suicide and keep in mind that the warning signs should never be ignored.
Although seeking professional help is fundamental in cases of suicidal thoughts and attempts, it is important that this person has someone close by that they trust (for example, a family member, partner or friend trusted) who can provide it I support you at all times to help you move forward and reduce the risk of future attempts.
In this case, a professional could teach them a series of skills that could be used to support the person at risk (for example, do not minimize or try to change the subject when we are told about your suicidal idea, the one who told us about his suicidal thoughts must have someone who freely expresses his emotions and listens to him attentively to show him that we are there when he needs us, etc.).
3. Encourage the development of skills that can be used to prevent suicide
Its very important support the development of social skillsand socio-emotional in children, adolescents and even adults, since it is never too late, in order to prevent a greater number of suicide attempts. For this, we should start with training plans in schools and also through associations, organizations and centers specializing in suicide, as well as within associations dedicated to supporting people with TSA.
4. Early detection of red flags
Another basic measure is, as part of therapy, early detection, assessment and appropriate treatment of people who exhibit suicidal behaviorsas well as a follow-up over time to avoid possible relapses.
All these measures must be accompanied by social, psychological and, of course, family support, as well as multidisciplinary collaboration of professionals, awareness-raising and awareness-raising plans, more funding, large-scale research and more resources that can help with treatment, follow-up and management. evaluation of this type of situation.
For a good prevention plan to be carried out, the collaboration and coordination of several sectors of society are necessary, among which may be included the health system, education, government assistance, the application of law and media support and dissemination.