Researchers are urging for improved diagnosis, prevention, and treatment of psychiatric illness in autistic individuals due to their heightened risk of self-harm and suicide compared to non-autistic individuals. Dr. Meng-Chuan Lai, a staff psychiatrist and senior scientist at the Centre for Addiction and Mental Health (CAMH), emphasized the important role of psychiatric diagnosis in explaining these increased risks. A study conducted by CAMH and the Institute for Clinical Evaluative Sciences (ICES) revealed that autistic females had an 83% increased risk of self-harm, while autistic males had a 47% higher risk compared to their non-autistic counterparts. Although deaths by suicide were rare, the risk was still higher among autistic individuals, with psychiatric disorders being a contributing factor.
The study, published in the journal JAMA Network Open, supports previous research suggesting that autistic individuals are more vulnerable to various psychiatric disorders such as anxiety, depression, ADHD, substance use, and certain psychotic disorders. However, psychiatric disorders often go undiagnosed in autistic individuals, as clinicians may mistakenly attribute self-harm symptoms to autism, a phenomenon known as “diagnostic overshadowing.” Dr. Yona Lunsky, an adjunct scientist at ICES and director of the Azrieli Adult Neurodevelopmental Centre at CAMH, emphasized the need for proactive mental health care to identify and address psychiatric disorders early on in autistic individuals.
The researchers examined data from Ontario health administration databases, following both children and adults diagnosed with autism from April 1, 1988, to March 31, 2018. They compared autistic individuals with non-autistic individuals from the general population and analyzed Ontario emergency department visits resulting from self-harm. The study included data from over 379,000 people over a 15-year period and revealed an increased rate of suicide among autistic females and males compared to their non-autistic counterparts over a 25-year period.
The study findings highlight the high incidence of self-injury in autistic individuals. Philippa Hood, an autistic self-advocate and psychology graduate student at Simon Fraser University, stressed the critical lack of accessible services dedicated to autistic individuals suffering from psychiatric illnesses. Hood called for more qualitative research into self-injury among autistic individuals to inform effective interventions in the future. Megan Pilatzke, an autistic woman in Sudbury, Ontario, shared her own experiences with depression and anxiety, stressing the importance of consulting with autistic individuals and providing individualized support and care.
Dr. Lai emphasized the need to modify the healthcare environment and communication style to accommodate autistic individuals. Overstimulation and unclear language can hinder their well-being and understanding of information. However, the study has limitations and further research is required to understand the reasons behind the increased risk of mental health issues in autistic individuals. Potential factors include stigma, social factors like employment rates, bullying, victimization, and shared biological factors between autism and psychiatric conditions.
Individuals who are struggling with thoughts of suicide can seek support from Talk Suicide Canada (1-833-456-4566) or by texting 45645 in the evenings. Residents of Quebec can call 1-866-APPELLE (1-866-277-3553) or visit suicide.ca for support through text and online chat.
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