Pilot Test of the Forming Love around Autistic People to Prevent Suicide Program

Notable proportions of autistic people experience suicidal thinking and actions (i.e., suicidality). Many of the identified influences on suicidality for autistic people necessitate broad changes in societal attitudes, services, and supports. Yet most suicide prevention efforts focus on clinical interventions targeting change for autistic individuals themselves. We used a community-based participatory research approach to develop a novel program for autism-focused (or autism-relevant) community organizations. The program is called Forming Love around Autistic people to Prevent Suicide (FLAPS). FLAPS is a four-part virtual education and capacity-building intervention focused on supporting organizations to incorporate broad autism suicide prevention efforts into their ongoing work. We pilot tested this new program in a single-arm trial. A team of autistic and non-autistic cofacilitators delivered the full FLAPS program three times to grouped organizations. Fifty-one participants, from a total of 11 organizations, enrolled in the program. Our primary outcome measure was the tailored Steps Toward Prevention—Autism Community Suicide Prevention questionnaire, administered at preprogram, postprogram, and at the 3-month follow-up. We observed significant increases, with moderate-to-high effect sizes, in knowledge and capacity and actions. The majority of participants who provided feedback (74%) agreed that FLAPS encouraged them to think in new ways, that it was worth their time, and that their organization can use the information. At the 3-month follow-up, over 75% of respondents reported that they sometimes or frequently used concepts from the program. Future work is needed to further evaluate program outcomes, including determining any measurable impact on autistic individuals served within participating organizations. Community Brief Why was this program developed? We know that suicide risk is high in the autistic community. But there is not a lot of research on how to change that. Some studies focus on trying to help autistic people who are already feeling suicidal to manage their feelings. Those studies are important, but they only look at one part of the problem. Some of the things leading autistic people to feel suicidal are outside of their control. We wanted to see if we could try to help more autistic people and maybe even reduce risk before they feel suicidal. So, we focused our program on autism organizations. We hoped that if organizations learn more and add suicide prevention into their work, we could make a difference in helping prevent suicide for autistic people. What does the program do? Our team is a partnership of academic researchers and autistic community members. Together, we developed a program called Forming Love around Autistic people to Prevent Suicide (FLAPS). FLAPS is a four-session online program for community organizations. We worked with organization teams to help them learn about suicide prevention for the autistic community. We focused on things such as how society can treat autistic people better and help their well-being. We also talked about what kinds of services and supports can help autistic people. We cover ways to help when an autistic person is already feeling suicidal. We help them bring all this information together to decide what their organization can do. How did the researchers evaluate the new program? We ran the FLAPS program three times in this pilot study. Each time, we had a few different organizations participate. In total, 51 people signed up for the program. Before and after the program, we asked participants about their knowledge, capacity (ability), and actions related to suicide prevention for the autistic community. We also asked participants for their feedback. What were the pilot study findings? From before to after the program, we saw significant increases in knowledge, capacity, and actions for suicide prevention. Most participants who gave feedback said that FLAPS helped them think in new ways and that the information will be useful. They also told us specific things that they liked and gave us suggestions for the future. What were the weaknesses of this project? This was only a pilot study. We cannot say for sure that FLAPS caused any changes. We do not know if the organizations will actually help with suicide prevention for autistic people. What are the next steps? The FLAPS program needs to be tested more to see if it really makes a difference to the people community organizations are trying to help. We can do that better with a large randomized controlled trial. How will this work help autistic adults now or in the future? We hope that the FLAPS program can help organizations reduce suicidality and improve well-being for autistic people in their communities. More research is needed to see if the FLAPS program can do that.