Reading · Lindsey Mack's Complexity Edge

Studies show that Autistic people are up to seven times more likely to die by suicide and six times more likely to attempt suicide than the general population. Suicide is the second leading cause of death for Autistic people.

To add to this complexity, highly-masked Autistics are at an increased risk of lifetime suicidality due to factors related to consciously or subconsciously hiding their true selves on a daily basis. So, even those clients who do not appear to be Autistic may be struggling with Autism and the exhaustion of masking behind the scenes, with great impact on their mental health.

With the added layer of masking, in addition to the overall lack of education most providers (medical, mental health, etc) receive on neurodivergence, it’s no wonder that many continue to feel underprepared to screen for Autism at the onset of mental health screenings and assessments in clinics and hospitals around the globe.

This must change, as lives are at stake.

I’m proposing that we collectively screen for Autism in all of our adult & young adult patients/clients at every mental health assessment using a simple 5-step flow chart for providers, that offers specific step-by-step guidance on:

Which Autism-specific screenings to offer your patients/clients
How to navigate elevated screenings with the patient/client
What to say and what resources to offer patients/clients who are curious in more information or assessment

[Scroll down to access the 5-Step Screening Protocol for Screening for Autism in Adults]

Anyone who works with clients/patients in a mental health, healthcare, or health-related setting can integrate this 5-Step Protocol into their adult mental health screenings and/or assessments.

Statistics on Suicide Risk in Autistic Individuals (www.autistica.org.uk)
- Autistic adults with no learning disability are 9 X more likely to die by suicide than the general population
- It is the second leading cause of death for Autistic people. Average life expectancy for Autistic people is just 54 years old
- Up to 66% of Autistic adults have considered suicide
- Suicide attempts tend to be more aggressive and lethal
- Autistic children are 28 X more likely to think about or try suicide
- One study showed that 15% of Autistic children had suicidal thoughts
  compared to 0.5% of typically developing children
- In the 86 days leading up to the first Lockdown and up to the 56 days
  after, 1⁄4 of young people who died by suicide were Autistic or had ADHD
- Autistic people make up approximately 1% of the population but 11% of suicides
Is Camouflaging Autistic Traits Associated with Suicidal Thoughts and Behaviours?… (Cassidy, 2020)
- Results suggest that camouflaging Autistic traits is associated with increased risk of experiencing thwarted belongingness and lifetime suicidality. It is important for suicide theories such as the IPTS to include variables relevant to the broader Autism phenotype, to increase applicability of models to both Autistic and Non-Autistic people.
Autistic People and Suicidality (www.autism.org.uk)
- Just like in the general population, experiencing mental health problems, social isolation and unemployment can increase suicide risk in Autistic people. Yet, being Autistic in itself is thought to contribute to this risk over and above these other factors.
Autism combined with high IQ increases risk of suicidal thoughts (University of Iowa)
- Twice exceptional youth—children who have a diagnosis of Autism and who also have exceptional cognitive ability—are at increased the risk of suicidal thoughts, according to a recent study by researchers at the University of Iowa.
  Specifically, the study found that Autistic children are almost six times more likely to have thoughts of suicide if they have an IQ of 120 or higher than if they have average IQ.
  This finding is both unexpected and concerning because high cognitive ability is generally considered to be protective against suicidal ideation, and because suicide rates are already significantly higher in Autistic individuals.
- This likely translates to Neurocomplex and 2E adults

As providers of all types, we have the ability to collectively reduce the distress and suicide rates in unidentified Autistic individuals by screening for Autism in all of our patients/clients at every mental health assessment. Identifying Autistic traits during an assessment has the opportunity to help the client in many ways that may include:

Access to wiring-aligned accommodations to support their work, education and mental health
Increase in self understanding and acceptance around their neurodivergence and how it impacts sensory, communication, social, and other areas of functioning in neurotypically dominated environments
Rewriting their life narrative around their mental health journey (ie why medication trials have not been helpful, understanding the overlap of Autistic burnout and depressive symptoms, etc.)
Opportunity to seek out neurodiversity-affirming therapists and providers who truly understand Autistic wiring, masking, etc.

Download the 5-Step Screening Protocol for Screening for Autism in Adults below: