September 16th, 2016

Autism And Suicide: How Many More?


September is Suicide Prevention Month, and this is the obligatory statement on something I want to be finished discussing. Suicide is a problem for Autistic people. A year rarely goes by without at least one fairly high-profile attempt or crisis tinged with suicidality. Suicide lurks, with the other early killers like eating disorders, along the fringes of our lives picking off acquaintances, colleagues, and friends. It’s hard to pinpoint the cause of the problem because there has been relatively little research on mental health and quality of life for Autistic people alive today, but there are obvious issues that might be contributing to these deaths.

Good mental health care isn’t necessarily available to Autistics. Some Autistic people who take medication report extremely long trial-and-error periods before finding workable drugs. Not all mental health professionals are sufficiently familiar with autism to make Autistic clients feel comfortable. Practitioners may have a hard time spotting people at serious risk of suicide when an Autistic person’s intense suffering manifests in unconventional ways. There is prejudice among mental health professionals, too. When people are struggling, the last thing they want to do is position themselves to encounter demeaning treatment. Repeated bad experiences with mental health professionals make people reluctant to keep trying, which is one reason Autistic adults who know they need help don’t always seek it. The lucky few who live in communities with autism-friendly practitioners may still struggle to access care because of the poverty that disproportionately affects people with disabilities. Sometimes, care is simply unavailable to people with the most significant needs. 

Such social problems are probably also a factor that drives up our suicide rate. Even the best mental health care can’t solve problems that arise outside of the individual. Autistics face societal barriers to the two things that may be the only universal human desires: connection and autonomy. Companionship is a human need, a reason to keep going when life’s many challenges arise. Too many Autistics are never empowered to find the place where they can slip into some positive social role, nurture others, and be cared for in return. So long as they remain isolated, these people will be particularly vulnerable to sinking under the burden of the human condition.

Autonomy and hope are crucial, too. Recent media coverage of faltering, white, working class communities in America has cited despair as the undertow that is pulling whole towns toward early graves. This is a problem for the many Autistic adults whose options in life are very limited. People who need housing supports are lucky to find even one good, nearby option. Long waiting lists for services and tight eligibility requirements can prevent young adults who want to become more independent from leaving home. People who don’t drive cannot independently decide where to spend their time in much of the country. We live in a society where work is often part of personal identity, and money is the key to independence. Our unemployment rate is appalling even by disability community standards. College or trade school may improve one’s odds, but housing supports are an issue there, too. Where does that leave an Autistic twenty-something, even without underlying mental illness, who is unemployed, living unhappily at home, and stuck in the house all day for want of public transportation? Until more Autistic adults have a realistic chance at fulfilling lives, too many will see death as an option.

These are things that I have said before. I am tired of discussing this problem because it seems soluble, but not enough is done to solve it. This is a matter of life and death, but a significant contingent of autism advocates see other priorities as much more urgent. Every dollar that goes into cure research isn’t spent on helping people who are alive today stay that way. The idea of a cure is inherently part of the problem because it invites Autistics to hope for different selves instead of learning to love the only selves we’re ever likely to have. That way lies death. However, whatever we want for the future, there is no reason we can’t take on today’s perils together. It is difficult to see how anyone could consider it a good use of resources when organizations almost completely neglect people who are in need today. I wonder how many more people in my community will die before priorities change and more of the research becomes about things like independent living supports, quality of life, and suicide prevention. Until we start tacking the obvious contributing factors and augment common-sense solutions with further research, suicide will remain a part of high mortality rates and early death in the Autistic community.

It will be difficult to address the combination of health and social issues likely at the root of the problem until Autistic people alive today are valued enough that more funding is available for preserving and enriching our lives. However, Autistics have never been passive victims. We can’t and won’t tolerate an intolerable status quo until well-intentioned others deign to save us. If we use the tools we have to support each other, there is hope. We can be attentive to people who seem isolated and intentionally include them. We can check up on people who are known to be struggling and be vulnerable in ways that show them that they’re not alone. We can make our community welcoming to newcomers who desperately need the shelter of Autistic space. We can spread the word about autism-friendly mental health services wherever they exist. We can advocate for policies that support independence, like employment first and walkable communities. We can refuse to support disability organizations that put all their resources toward a controversial, perhaps impossible, long-term goal while people in need today suffer and die. Conversations about autism are moving in a positive, practical direction. External support for our efforts will grow over time, but we can’t afford to wait for it. As more and more external rescuers arrive, let’s leave them surprised, as usual, at how much of the problem we sorted out for ourselves.

If you’re in crisis, know that people care about you. Please reach out to anyone and everyone you trust to help you through this. Here are some resources:

National Suicide Hotline
Trans Lifeline

The Trevor Project

Emory University’s Suicide Prevention for Students with Disabilities

How to Help a Suicidal Autistic Person

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