Self-harm is more prevalent for autistic people than the general population and may include behaviours like hitting themselves, scratching, or picking their skin. This is referred to as repetitive and restrictive behaviour which may be a way the person reacts to stress or anxiety, or may be used to distract or calm themselves. This is often not associated with suicide ideation. Autistic people may also engage in other types of self-injury such as cutting, which may indicate psychological stress and could be a warning sign for suicidal thoughts or behaviour. It can be very difficult to distinguish between self-injury that is associated with repetitive and restrictive behaviour, and self-injury indicating psychological distress. Look out for instances when these behaviours become out of the ordinary for that person and their self-harm begins to escalate and become more frequent or they use new methods. Also consider the function of the behaviour. Is the self-injury in the context of a repetitive behaviour they have engaged in the past when bored or stressed or does it seem related to a recent stressor? If you are unsure, it is always good to ask anyway if they are having thoughts about suicide. If their behaviour is causing them harm (whether in the context of suicide ideation or not), see if you can link them with a psychologist or occupational therapist who can teach them other less harmful behaviours, to cope with anxiety, stress, boredom etc. such as having a sensory tool they can fidget with.

'Beneath every behaviour there is a feeling. And beneath each feeling is a need. And when we meet that need rather than focus on the behaviour, we begin to deal with the cause, not the symptom.'~ Ashleigh Warner.

Most autistic people feel deeply and intensely and have a rich interior life. The deep intensity of their emotions can be a consequence of their cognitive differences. They can have compassion and awareness of others, just like anyone else. They can experience intense emotion as a kind of sensory overload, which takes time to process. Without the benefit of learned emotional regulation, therapy or support, this can lead to suicide ideation. Telling them to think about the impact their suicide might have on others may not be the most helpful thing to say because sometimes they feel so worthless and burdensome that part of the motive towards suicide is to stop having a negative impact on people around them (regardless if it’s true or not). Instead, focus on alleviating stressors around them, such as anti-bullying support at school or in the workplace (see more examples in the next steps). If you are a parent, teacher or supporter of autistic people, talking about how hard it is to support them in front of them can make things worse. Get support for yourself where you can through support groups or your own counselling.

Autistic people often strongly crave connection and want friends to spend time with. They may find it difficult to make and keep friends because of their different understanding of social cues and expectations, particularly within groups, which can lead to feelings of isolation and alienation. This can lead to suicide ideation. You can help by learning about how their autistic behaviour presents, appealing to the tendency to systematise by providing contextual information, being inclusive and by focusing on common ground rather than difference. Many autistic people can prefer autistic friendships who have similar interests to them. You can help by connecting them with the autistic community. They may also prefer parallel activities rather than direct social activities. Fear of miscommunication or being misunderstood is a barrier to friendships. Autistic people can also have constant strong analytical internal dialogue. This can lead to slower responses when communicating with others. Giving them time to process and respond without rushing them or interrupting can help.

INFO: The LGBTIQA+ community’s suicide risk is much higher than peers who do not identify in this group. Their risk does not come from how they identify but from discrimination, bullying, harassment and a sense of not belonging. Being a strong ally can act as a protective factor. Ideas to be a good ally: don’t assume someone’s sexual identity or relationship/marital status, ask people what their pronouns are, use their correct pronouns and correct yourself and others if they use the wrong pronouns, do not make homophobic, transphobic or other similar jokes or comments, stand up for others when you hear these types of jokes, use inclusive language, learn what 'micro-aggressions' are and work on eliminating these, learn about issues this community faces, be a visible support and learn more about how to be a good ally. 

INFO: Vital care is often not covered by Medicare and there are many barriers to appropriate care. Rural accessible support is lacking. Mainstream support is not experienced as accessible. The majority of LGBTIQA+ people have poor experiences visiting doctors and mental health professionals due to discrimination, lack of inclusivity, sensitivity, education, awareness, training and support for their needs.  

INFO: LGBTIQA+ people experience poorer mental health and have higher rates of suicide than their peers (up to 18xmore likely to experience suicidal thoughts). These increased rates are directly related to experiences of stigma, prejudice, discrimination and abuse on the basis of being LGBTIQA+. 

INFO: Experiencing multiple minority identities can magnify social challenges and isolation. This is called intersectionality: holding 2 or more minority identities. Someone who is autistic and LGBTIQA+ experiences unique and increased challenges. This intersection can mean they are rejected from LGBTIQA+ groups because of their autistic traits, and rejected from autistic communities because of their LGBTIQA+ orientation. People who are both autistic and LGBTIQA+ need to be seen and supported as a whole person, including their interests and strengths.