OARacle Newsletter

Suicide is a leading cause of early death for autistic individuals. Researchers do not know whether an autistic adult is more likely to consider suicide than a non-autistic adult or if suicidal thoughts and behaviors are connected to a person’s social activity. Autistic adults seeking help for mental health problems, including suicidal thoughts, report feeling left out from society and their community, but have reported using online social networking sites to connect with others with positive results.

In their 2022 OAR-funded study, “Suicidal Thoughts and Behaviors in Autistic Adults: The Role of Community and Social Connections,” Brenna Maddox, Ph.D., and Dara Chan, Sc.D., investigated how social connection and community participation relate to suicidal thoughts and behaviors in autistic adults. Dr. Maddox is an assistant professor in the Department of Psychiatry at the University of North Carolina – Chapel Hill and an implementation scientist at the TEACCH Autism Program. Her work focuses on improving community services for autistic people across the lifespan with a particular interest in suicide prevention. Dr. Chan is an associate professor in the Division of Clinical Rehabilitation and Mental Health Counseling at UNC – Chapel Hill. She has pioneered the use of GIS/GPS to understand community integration and participation in autistic adults.

Their study examined how social isolation contributes to suicidal thoughts and behaviors in autistic adults. They also explored the role of both in-person and online connections, given potential differences in socializing post-pandemic and in autistic adults. Their goal was to identify tangible risk factors that could be modified in future interventions for suicidal ideation.

Methodology

Seventeen autistic adults with a history of mental health treatment completed the study. They lived in various communities across North Carolina. Most participants were female (70.5%) with an average age of 33. Most of them lived with a partner/spouse or roommate (41%), but others lived with family (29%) or alone (29%). Almost three-quarters (71%) were employed, either part-time (42%) or full-time (58%). About half the adults reported a diagnosis of anxiety or depression, but less than half (41%) were currently seeing a mental health counselor.

The first step in the study was for participants to complete three surveys and a clinical interview. In the first survey, they reported information about age, co-occurring health and mental health conditions, living situation, employment status, and service use. Drs. Maddox and Chan used that data to understand if any of those factors made a difference in how much individuals were participating in the community and connecting with others, and if those factors reduced suicidal thoughts or behaviors.

The second survey asked about whether and what kind of home and community activities they participated in. The third survey included two subscales to measure internalizing symptoms, meaning/purpose in life, and general life satisfaction. The clinical interview assessed past and current suicidal thoughts and behaviors.

Participants then carried a GPS tracker that captured how much time they spent away from home, how far they traveled to locations, and the number of unique locations they visited over the week they had the tracker. They also filled out a daily social diary and travel diary for each of those seven days. Because autistic adults may socialize and connect with others in different ways than non-autistic adults, the social diary asked about their online (email, text, phone, social networking) and in-person interactions with family and non-family members each day of the study, and their use of social networking sites. In the travel diary, participants recorded more information about what they did in the community, including where they went, why they were going, who they went with, and how they got there.

The researchers conducted follow-up interviews, which helped them to better understand where participants were going and what they were doing out in the community, and ensure that the trackers had properly tracked their movements. They also asked questions about other places in the community they may not have gone to during that particular week but that were places they visited frequently or as part of their typical routine.

The researchers used the data to look for patterns based on the combination of GPS, interview, travel diary, social diary, and survey data to see connections between participants’ social and community experiences and suicidal thoughts and behavior.

Outcomes

Contrary to what researchers anticipated, there were no significant differences in GPS community participation measures or the number of in-person or online social connections between those who reported recent suicidal thoughts/behaviors and those who did not, and there were no differences in overall life satisfaction or meaning/purpose between these two groups. The researchers noted in their final report that participants spent an average of 18 hours a week on social media sites, suggesting that excessive amounts of time spent on social media may predict recent suicidal thoughts/behaviors.

However, those who had received mental health services in the past two years had significantly larger activity spaces, spent more time away from home, visited more vocation-related locations, and had higher scores for meaning/purpose in life.

Practical Findings

Considering the prevalence of social media use in the autistic community, it is crucial that future investigations disentangle risk and protective effects of intentional and non-intentional social media use to identify ways in which widely used platforms may make a positive difference in the mental health of autistic individuals.

While participants with recent suicidal thoughts/behaviors had similar amounts of involvement in their communities as those who did not have recent suicidal thoughts/behaviors, use of mental health services was related to better community participation outcomes and greater feelings of meaning/purpose in life. It is possible that engagement with mental health services helped those participants better manage symptoms, build coping skills, and reduce suicidal thoughts and behaviors to support broader community participation.

The researchers noted that despite findings that reflect low overall service use in adulthood, their study provides additional support for the importance of mental health services for autistic adults related to greater community participation and meaning/purpose in life.  

Sherri Alms is the freelance editor of The OARacle, a role she took on in 2007. She has been a freelance writer and editor for more than 20 years.