RECENT LOSS OR CHANGE

• Relationship break-up

• Job loss

• Money loss

• Health deterioration/diagnosis

• Good reputation  

INTENSE EMOTION

• Shame, guilt, humiliation, disgrace (e.g. being found out for doing something culturally inappropriate)

• Hopelessness

• Worthlessness

• Autistic people can often feel like they are a burden to others and feel their impact on others outweighs their worth which can lead to suicide ideation.

• Anger

• Feeling trapped  

MENTAL HEALTH

• Diagnosis of a mental illness: depression, OCD, bipolar, schizophrenia, PTSD and borderline personality disorder are some of the disorders associated with higher suicide risk.

• Neurodevelopmental disorder: ASD (9x more likely to suicide than non-autistic people), ADHD, intellectual impairment.  

HISTORY

• Previous trauma

• Previous suicide attempt or self-harm

• Family member who died by suicide

• Impulsive/limited self-control  

SITUATIONAL

• Unemployed

• Isolated

• Autistic people often struggle with making and keeping friends more than their neuro-typical peers and can experience a sense of isolation more strongly. They can interpret their lack of friendships as a personal flaw which can lead to suicide ideation.  

• Living alone

• Bullying

• This is a particularly important risk factor for autistic people. Autistic people are much more likely to experience bullying than neurotypical peers, and bullying significantly contributes to suicidal thinking. If this is not visible or known for an autistic person, its important to ask them if they experience bullying (at school, work, university, etc.).

• If they are an adult, ask something like: ‘Does anyone at your work/uni/social groups ever do or say anything that makes you feel uncomfortable, scared, sad?’

• If they are a child, ask something like: ‘Is anyone ever mean to you at school?’

• If they reply yes, follow the next steps in the tool.

• Harassment

• Discrimination or rejection

• Chronic pain

• Medical illness

• Substance use

• Recent discharge from psychiatric inpatient care

• Domestic violence victim  

IDENTITY

• Male (although the suicide rate in females is rising)

• Note that in autism, the female to male ratio is more equivalent than the general population. This means that being female may be more of a risk factor for suicide for autistic people than non-autistic people.   

• LGBTIQAP+ orientation

• Aboriginal or Torres Strait Islander background

• Migrants, refugees, asylum seekers with limited social support and cultural and language barriers

• Autistic/person who identifies as being on the autism spectrum (feel different and like they don’t belong) 

LACK OF PROTECTIVE FACTORS

• Reasons to live

• Good coping skills

• Moral objections to suicide  

• Good social support

• Employment

• Medication

• Good physical health

• Good mental health

• High self-esteem

• Religious affiliations/spirituality

• Sense of responsibility to family

• High self-efficacy

• Good social and communication skills

• Good problem-solving skills

• Healthy relationships

• Children living in home

• Good frustration and distress tolerance

• Hopefulness

• Cognitive flexibility

• Sense of meaning

• Sense of purpose

• High life satisfaction

• Feeling safe

• Strong family connections and attachments

• Support and advocacy  

RISK FACTORS TO BE MORE AWARE OF
IF PERSON IS ON THE AUTISM SPECTRUM

• Feeling like a burden to others: financially, practically, emotionally

• Exhaustion and frustration from hiding or concealing one’s autistic traits (camouflaging/masking) 

• Feelings of not getting it ‘right’

• Female

• Distress from changes to routine

• Burnout from study, work, family or social commitments

• Bullying

• Isolation

• Limited support and advocacy

• Limited access to mental health providers with expertise in autism or working with autistic people

• Feeling that “nothing helps”

• High levels of perfectionism and difficulty achieving their own high standards

• Hopelessness about anything improving for them or their future

• Feeling pressure (demands) from others to behave or perform differently or beyond their capacity:

• E.g., engage more with others at social events

• E.g., attend more social events

• Feeling like others do not understand them or their needs

• Feeling alone/lonely and disconnected from others

• Lacking a sense of belonging

•  Alexithymia: difficulty with experiencing emotion (body sensations), identifying emotion (naming and recognising) and expressing emotion (describing and communicating feelings to others).

If someone autistic that you know seems ‘unphased’ or unaffected by something which would cause distress to anyone else, ask them how they are coping. Ask them to draw or write down how they are feeling. Just because they can’t show, describe or name it, doesn’t mean they don’t feel it or are affected by it. Don’t assume they are okay.

 If someone autistic that you know seems ‘unphased’ or unaffected by something which would cause distress to anyone else, ask them how they are coping. Ask them to draw or write down how they are feeling. Just because they can’t show, describe or name it, doesn’t mean they don’t feel it or are affected by it. Don’t assume they are okay.

 If they seem more withdrawn or shut down than usual, they may be feeling something but have no idea what it is or how to express it.