Overview
Rates of suicide have increased significantly over the past two decades, particularly among youth. Compared to the general population, autistic people are significantly more likely to think about suicide, attempt suicide, and die by suicide. Autistic individuals have identified suicide prevention as a top research priority; however, little is known about how to best help autistic youth at risk for suicide. The purpose of this study is to compare the effectiveness, feasibility, and acceptability of two suicide prevention strategies tailored for autistic individuals: the Safety Planning Intervention tailored for Autistic individuals (SPI-A) and SPI-A plus structured follow-up contacts (SPI-A+).
Description
This study includes three aims:
Aim 1: Among autistic youth (age 12-24) at risk for suicide, compare the effectiveness of SPI-A vs. SPI-A+. The primary outcomes of interest are suicidal ideation (SI) and suicidal behavior (SB). Secondary patient-centered outcomes are mental health treatment initiation and engagement, quality of life, well-being, skills to manage SI, access to lethal means, safety plan use, and acute care services for suicidality.
Aim 2: Compare implementation outcomes of acceptability and feasibility for the two interventions from the perspectives of patients, clinicians, and health system administrators.
Aim 3: Explore patient characteristics that may moderate the relationship between intervention and SI and SB.
Eligibility
Patient Participants
Inclusion Criteria:
- 12-24 years old
- Able and willing to provide informed consent (age ≥18) or assent and parental consent (age <18)
- Able to speak English
- Have received a safety plan tailored for autistic youth during a clinical visit
Exclusion Criteria:
- Altered mental status that precludes ability to provide informed assent or consent (acute psychosis, intoxication, or mania)
Clinician Participants
Inclusion Criteria:
- Employment as a provider serving autistic patients at one of the study sites
- Employment in a role that involves suicide risk intervention with youth patients at a participating clinic
- Able to read and speak English
- Able and willing to provide informed consent
- 18-99 years old
Exclusion Criteria:
- There are no exclusion criteria for the clinician participants
Health System Leader Participants
Inclusion Criteria:
- Health system or clinic leader at one of the study sites
- Employed in a role that provides administrative oversight to clinicians conducting safety plans with patients
- Able to read and speak English
- Able and willing to provide informed consent
- 18-99 years old
Exclusion Criteria:
- There are no exclusion criteria for the health system leader participants