Autism Adapted Safety Plans

Research shows that autistic people are disproportionately impacted by suicide. However, there are few evidence-based suicide prevention interventions specifically designed for autistic people. A new randomized controlled trial in the United Kingdom aimed to determine the feasibility and acceptability of autism adapted safety plans and make recommendations for future research.

The researchers recruited participants via non-profit non-governmental organizations and self-referral from social media announcements. To be included in the study, individuals had to have a formal diagnosis of autism, have reported self-harm or suicidal thoughts or behaviors in the past 6 months, have enough English fluency to complete the safety plan, and be over age 18. 

Participants were randomly assigned to receive usual care with or without autism adapted safety plans. Data collection took place via telephone or video call. The researchers assessed suicidal behaviors using the Suicidal Behaviours Questionnaire – Autism Spectrum Condition and measured life disadvantage using the Vulnerabilities Experience Quotient. They measured the feasibility of the autism adapted safety plan using the System Usability Scale and Client Satisfaction Questionnaire-8. 

All participants completed a safety plan. Completion of the outcomes was high, and retention of participants was 95% in the 6-month follow-up. Although both participant groups experienced some adverse events during the follow-up period, none were related to study participation. A majority (68%) of participants who completed the autism adapted safety plan were satisfied with the plan, but only 41% rated it as usable. Overall feedback on the safety plan was positive with some suggested changes to better capture the experiences of self-harm and suicidality.

This study addressed a gap in previous research. The findings suggest that a future trial to define the efficacy of autism adapted safety plans is both feasible and acceptable to autistic people. The researchers recommend that future research should explore the effectiveness and cost-effectiveness of these safety plans in routine clinical settings.

Rodgers, J., Cassidy, S., Pelton, M., Goodwin, J., Wagnild, J., Bhattarai, N., Gordon, I., Wilson, C., Heslop, P., Ogundimu, E., O’Connor, R. C., Ramsay, S. E., Townsend, E., & Vale, L. (2024). Feasibility and acceptability of autism adapted safety plans: An external pilot randomised controlled trial. eClinicalMedicine, 73(102662). https://doi.org/10.1016/j.eclinm.2024.102662