Autism Adapted Safety Plans
Research type
Research Study
Full title
Adapted suicide safety plans to address self harm, suicidal ideation and suicide behaviours in autistic adults: an intervention single arm feasibility trial and external pilot randomised controlled trial
IRAS ID
280742
Contact name
Jacqui Rodgers
Contact email
Sponsor organisation
Newcastle University
ISRCTN Number
ISRCTN70594445
Duration of Study in the UK
2 years, 5 months, 28 days
Research summary
Research Summary
Suicide is more common in autistic people than in people without this diagnosis. Around 66% of autistic adults have considered suicide, much higher than the UK general population where the rate is about 17%. No research has explored autism suicide prevention strategies. Autistic people require adaptations to be made to standard mental health treatments to make then accessible and meaningful. This research project aims to find out how acceptable and feasible an adapted version of a well-established suicide prevention strategy (Safety Plans) are for use with autistic adults with a history of self-harm, suicidal thoughts or suicidal behaviours. This research project will be in three stages. In stage one we will consult with autistic adults, family members and professionals working with autistic people about our safety plans and other aspects of the research to ensure that they are fit for purpose. In stage 2 we will recruit 10 autistic adults and ask them to use the plans and complete a number of questionnaires about their thoughts, feeling and behaviours. We will ask for their feedback on all of the procedures, as well as feedback from their support workers. In stage 3 we will recruit 70 autistic adults who have experienced suicidal thoughts and feelings who will be allocated by a computer to either use our adapted safety plans or receive their usual care package. We will follow up participants up at one month and six months and ask them to complete a range of measures to tell us about their thoughts feelings and behaviours, whether they used the plan and what they thought about it. At the end of the study we will have useful information about whether the adapted safety plans are acceptable and usable by autistic adults, whether the questionnaires and interviews we have chosen are appropriate.Summary of Results
: Autistic people are more likely to experience self-harm and suicidal behaviour than non-autistic people. No suicide prevention interventions have been developed specifically for autistic people. Interventions to support autistic people tend to work best when developed specifically to meet their needs. Safety plans are developed by people with help from staff to identify their own warning signs and what or who could help them when they are in crisis. Research shows that safety plans help keep people safe from self-harm and suicide. Safety plans may be potentially useful to autistic people. We need to adapt safety plans to make sure they are useful for autistic people.
We asked autistic people, their families, and service providers, what they thought about a draft autism adapted safety plan. Their feedback helped us refine the safety plan for autistic people. Next, autistic adults completed a safety plan with a service provider. This helped us to refine the safety plan and study processes. Next, 25 autistic adults completed a safety plan with support and 24 autistic adults received usual care. We asked autistic adults to complete some questionnaires before, one and six months after consenting to take part in the study. We asked participants who completed an autism adapted safety plan what they thought about it.
Most (68%) of the autistic adults were satisfied with their safety plan. Less than half of the autistic adults thought their safety plan was usable (41%). Autistic people said their experience of using their safety plan was positive. Autistic adults suggested minor changes to some questionnaires to make them clearer. Most participants remained in the study regardless of whether they received the autism adapted safety plan or not. The autism adapted safety plans were delivered to autistic participants very consistently by support workers.
We conducted the first study to develop and test a safety plan intervention with autistic adults. Our findings suggest that autistic people are satisfied with autism adapted safety plans and with taking part in the study. This means that it is possible to undertake a larger study testing if autism adapted safety plans can reduce self-harm and suicidal behaviour in autistic adults. This further work could potentially help prevent the high rates of self-harm and suicide in autistic adults.REC name
Wales REC 5
REC reference
20/WA/0101
Date of REC Opinion
19 May 2020
REC opinion
Further Information Favourable Opinion