"The best way we can stop suicides is by making lives worth living”: perspectives on suicide prevention from the autism community

Autistic people are at higher risk of dying by suicide than non-autistic people, but research focused on suicide prevention for this group is lacking. We asked autistic people and those who support them about pathways to suicide prevention, the balance of crisis measures vs. longer-term prevention, the importance of formal diagnosis, and the role of co-production.We used an online survey to collect quantitative and qualitative data. Participants were 2463 autistic people and 315 non-autistic people who supported or had been bereaved by the suicide of an autistic person. We thematically analysed their free-text responses. Although participants reported that crisis interventions (e.g., dedicated helplines) were helpful, they preferred larger-scale preventative measures (e.g., improving support in schools) which better addressed systemic inequalities. Participants were positive about providing support to people awaiting autism assessment, but some were less supportive of providing dedicated autism supports to people who self-diagnose or who are not currently diagnosed (but may be questioning autism). Most participants viewed co-production as vital for ensuring interventions reflect the expertise and empathy of autistic people.Suicide in autistic people must be viewed in the context of pervasive and systemic injustices, rather than individualistic psychopathology. Accordingly, the extent to which crisis interventions can reduce suicide rates is contingent on additional systemic, preventative and coordinated actions to tackle the social determinants of suicide and support enduring wellbeing in this group. Support should be produced in partnership with autistic people and their advocates, and needs- rather than diagnosis-based.