Educational Program for Suicide Prevention in Autism

Overseen By Anne V Kirby, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Utah

Disqualifiers: No internet access, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 7

30 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

The trial aims to test a new educational program, "Forming Love around Autistic People to Prevent Suicide," designed to enhance support for suicide prevention among autistic individuals. Researchers seek to determine if the program improves knowledge, skills, and actions related to this cause. Participants will engage in four online sessions, complete surveys, and may opt to join an interview to share their thoughts. This trial suits active members of organizations working with autistic people who have internet access for virtual sessions. As an unphased trial, it offers participants the opportunity to contribute to research that could influence future support strategies for autistic individuals.

Do I have to stop taking my current medications for this trial?

The protocol does not specify whether you need to stop taking your current medications.

What prior data suggests that this educational intervention is safe for participants?

Research shows that autistic individuals are more likely to experience suicidal thoughts and behaviors than non-autistic individuals. This highlights the importance of suicide prevention efforts, such as the educational program under testing.

The program, "Forming Love around Autistic People to Prevent Suicide" (FLAPS), emphasizes teaching and support rather than medical treatment. As an educational program, it avoids the side effects or safety concerns associated with new drugs. Instead, it aims to enhance knowledge and skills to help prevent suicide among autistic individuals.

Without clinical data on side effects or adverse events, educational programs like this are generally considered safe. They offer valuable information and strategies without causing harm. Participants might experience emotional responses during discussions, but these feelings are not harmful and can be an important part of learning and growth. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike traditional treatments for suicide prevention in autism, which often focus on medication management and cognitive behavioral therapy, the FLAPS intervention offers a unique approach by emphasizing the formation of supportive and loving relationships around autistic individuals. Researchers are excited about this because it targets the social environment, which can significantly impact mental health. This method promotes inclusivity and understanding, potentially reducing feelings of isolation and improving emotional well-being, which are critical factors in preventing suicide among autistic people.

What evidence suggests that this educational program is effective for suicide prevention in autism?

Studies have shown that autistic people are more likely to experience suicidal thoughts and behaviors than non-autistic individuals. Research indicates that building human connections can help lower these high rates of suicidality. Community surveys emphasize the importance of making lives feel more meaningful to prevent suicide among autistic people. Initial findings suggest that programs developed with input from autistic individuals can effectively reduce suicidality. In this trial, participants will receive the FLAPS intervention, an educational program designed to form supportive relationships and enhance suicide prevention efforts. ^{1 6 7 8 9}

Who Is on the Research Team?

Anne V Kirby, PhD

Principal Investigator

University of Utah

Are You a Good Fit for This Trial?

This trial is for individuals involved in organizations focused on autism, who are interested in learning about suicide prevention for autistic people. Participants should be willing to engage in a virtual educational program and complete surveys.

Inclusion Criteria

Active member of an organization whose work impacts autistic people

Fluent English language to participate in virtual educational intervention

Exclusion Criteria

No access to an internet-connected device

Unable to participate in a virtual educational intervention

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Educational Intervention

Participants engage in a four-part virtual educational intervention focused on suicide prevention for autistic people

2 months

4 virtual sessions

Follow-up

Participants are monitored for changes in knowledge, skills, and actions to support suicide prevention for autistic people

3 months

Online surveys at post-intervention and 3-months after intervention

What Are the Treatments Tested in This Trial?

Interventions

• Forming Love around Autistic People to Prevent Suicide

Trial Overview The study tests an educational intervention called 'Forming Love around Autistic People to Prevent Suicide'. It examines if the program boosts knowledge, skills, and actions related to suicide prevention among autistic individuals.

How Is the Trial Designed?

Group I: FLAPS intervention Experimental Treatment 1 Intervention

Participants receiving FLAPS intervention

Who Is Running the Clinical Trial?

University of Utah

Lead Sponsor

Trials

1,169

Recruited

1,623,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Published Research Related to This Trial

A two-hour suicide care educational intervention significantly improved family caregivers' ability to care for suicidal individuals and fostered more positive attitudes towards them, based on a study of 74 participants.

While the intervention did not reduce caregivers' stress levels, it highlighted the importance of providing education to family members, which is often overlooked in suicide prevention programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Short-term effects of a suicide education intervention for family caregivers of people who are suicidal. Sun, FK., Chiang, CY., Lin, YH., et al.[2013]

Community-based interventions that effectively reduce suicide deaths include strategies to limit access to lethal means, implementing supportive organizational policies in workplaces, and conducting community screenings for depression, based on a review of 56 publications covering 47 unique studies.

The European Alliance Against Depression was identified as the most promising multistrategy intervention, while the effectiveness of other approaches like public awareness campaigns and crisis lines remains unclear and inconsistent.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Population- and Community-Based Interventions to Prevent Suicide. Linskens, EJ., Venables, NC., Gustavson, AM., et al.[2023]

Autistic patients have a significantly higher risk of all-cause mortality, with a risk ratio of 2.32, indicating they are more than twice as likely to die compared to the general population, based on a review of 15 studies involving 216,045 individuals.

The study found that female autistic patients face an even greater risk of mortality (RR=4.66) compared to males (RR=2.00), highlighting the need for targeted support and interventions, especially for women and adolescents at risk of suicide.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Early death and causes of death of patients with autism spectrum disorders: A systematic review]. Zhao, YN., Fan, HY., Wang, XY., et al.[2023]

Suicide is a major public health crisis, with over 44,000 deaths in the US alone in 2015, highlighting the urgent need for effective suicide prevention strategies that integrate research into practice.

The article introduces the Assess, Intervene and Monitor for Suicide Prevention (AIM-SP) model, which provides a structured approach to implementing evidence-based practices in clinical settings, focusing on ongoing risk assessment and support for individuals at high risk.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Zero Suicide Model: Applying Evidence-Based Suicide Prevention Practices to Clinical Care. Brodsky, BS., Spruch-Feiner, A., Stanley, B.[2023]

The Autism Adapted Safety Plan (AASP) is the first safety plan specifically designed for autistic adults at risk of self-harm and suicidal behavior, aiming to provide structured support during crises.

This pilot study will assess the feasibility and acceptability of the AASP among 90 participants, focusing on their experiences and the effectiveness of recruitment methods, which could inform larger future studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adapted suicide safety plans to address self-harm, suicidal ideation, and suicide behaviours in autistic adults: protocol for a pilot randomised controlled trial. Rodgers, J., Goodwin, J., Nielsen, E., et al.[2023]

Suicide prevention programs must be tailored to specific sociocultural contexts, as strategies effective in one area may not work in another, highlighting the importance of localized approaches.

Integrated approaches that combine public health measures with individual care and ongoing social support are more likely to achieve significant outcomes in reducing suicide rates than isolated interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Suicide prevention: at what level does it work? Bertolote, JM.[2023]

The gatekeeper training (GKT) program significantly improved university teachers' competence and confidence in managing suicidal students compared to a general mental health lecture, highlighting its effectiveness in suicide prevention training.

Participants in the GKT program reported higher satisfaction and demonstrated a greater intention to act as gatekeepers, emphasizing the importance of active involvement in training for effective outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of suicide prevention gatekeeper training for university teachers in Japan. Hashimoto, N., Takeda, H., Fujii, Y., et al.[2022]

The review identified a significant concern regarding suicidality among autistic individuals, highlighting the need for more focused research on how autism influences suicidal thoughts and behaviors.

There is a lack of autism-specific suicide awareness and prevention programs, indicating a gap in resources for autistic individuals, their families, and healthcare professionals to effectively address this critical issue.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Scoping Review of Autism and the Way It Changes the Presentation of Suicidal Thoughts and Behavior Compared to the General Population. Cleary, M., West, S., McLean, L., et al.[2023]

In a study of 107 verbal youth with autism spectrum disorder (ASD) during psychiatric admission, 22% reported frequent thoughts about death or suicide, highlighting a significant prevalence of suicidal ideation in this population.

The presence of comorbid mood or anxiety disorders was associated with increased risk of suicidal thoughts, indicating the importance of targeted screening and prevention strategies for youth with ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Talking About Death or Suicide: Prevalence and Clinical Correlates in Youth with Autism Spectrum Disorder in the Psychiatric Inpatient Setting. Horowitz, LM., Thurm, A., Farmer, C., et al.[2021]

Suicide is a significant but understudied issue among individuals with Autism Spectrum Disorders (ASD), particularly in high-functioning autism, where comorbidities like depression and psychotic symptoms complicate the understanding of suicidality.

Risk factors for suicide in individuals with ASD include inherent challenges in emotional expression, as well as external factors like bullying and abuse, highlighting the need for tailored therapeutic approaches and further research on effective prevention strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Suicide in autism spectrum disorders. Richa, S., Fahed, M., Khoury, E., et al.[2014]

The Signs of Suicide (SOS) prevention program significantly reduced self-reported suicide attempts among high school students, as shown in a study involving 2,100 students across 5 schools.

Students in the intervention group also exhibited greater knowledge and more positive attitudes towards depression and suicide, indicating that the program not only helps reduce attempts but also improves understanding of these issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An outcome evaluation of the SOS Suicide Prevention Program. Aseltine, RH., DeMartino, R.[2022]

A qualitative study involving experienced suicide researchers revealed significant challenges in defining and reporting adverse events (AEs) and serious adverse events (SAEs) in suicide prevention trials, which complicates safety evaluations.

Participants emphasized the urgent need for clear and consistent definitions and reporting standards for AEs and SAEs to improve the comparability of studies and enhance safety monitoring in at-risk populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Variability in the definition and reporting of adverse events in suicide prevention trials: an examination of the issues and a proposed solution. Oquendo, MA., Feldman, S., Silverman, E., et al.[2022]

In a review of 35 suicide cases reported as adverse events, only 6 had adequately documented suicide risk assessments, highlighting significant gaps in clinical care.

The assessments primarily focused on suicidal ideation rather than critical risk factors like previous attempts or substance abuse, indicating a need for quality improvement initiatives in training and documentation practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Analysis of Suicides Reported as Adverse Events in Psychiatry Resulted in Nine Quality Improvement Initiatives. Mackenhauer, J., Winsløv, JH., Holmskov, J., et al.[2022]

A randomized trial involving 32 schools and 249 staff members showed that QPR (Question, Persuade, Refer) training significantly improved staff knowledge and confidence in identifying and referring suicidal individuals, with effect sizes indicating meaningful improvements.

Despite increased knowledge and confidence, the training did not lead to a corresponding increase in actual suicide identification behaviors, suggesting that additional interventions are needed to encourage students to seek help from adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Randomized trial of a gatekeeper program for suicide prevention: 1-year impact on secondary school staff. Wyman, PA., Brown, CH., Inman, J., et al.[2022]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/41015936/

A scoping review Findings suggest researchers are adapting and testing interventions to reduce suicidality in partnership with autistic people, but there is ...

2. researchgate.net researchgate.net/publication/394528557_The_best_way_we_can_stop_suicides_is_by_making_lives_worth_living_perspectives_on_suicide_prevention_from_the_autism_community

perspectives on suicide prevention from the autism ... In a two-phase survey, we identified community priorities for suicide prevention in almost 4000 autistic people and 627 supporters of autistic ...

3. scholarsarchive.byu.edu scholarsarchive.byu.edu/cgi/viewcontent.cgi?article=1596&context=intuition

The Power of Human Connection: Autism and the Suicide ... A contributing factor to the high rates of suicidality within the ASD population may be due to around half of autistic and potentially autistic ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11579173/

Suicidal Thoughts and Behaviors in People on the Autism ... A growing body of research suggests that rates of suicidal thoughts and behaviors (STB) are higher among autistic individuals than non-autistic individuals.

5. sciencedirect.com sciencedirect.com/science/article/pii/S0272735824001089

Resilience in the face of neurodivergence: A scoping ... We conducted a scoping review embedded in a neurodiversity-affirmative approach to provide an understanding of resilience in neurodivergent populations.

6. journals.sagepub.com journals.sagepub.com/doi/10.1089/aut.2023.0124?icid=int.sj-full-text.similar-articles.4

Adapting Safety Plans for Autistic Adults with Involvement ... Autistic adults are at greater risk of self-harm and suicide than the general population. One promising intervention in the general population is safety ...

7. sprc.org sprc.org/resources/autism-adapted-safety-plans/

Autism Adapted Safety Plans 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 ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11042491/

Autistic People are Thinking About, and Dying by, Suicide ... Therefore, available data suggests that autistic adults are 25 times more likely to make a suicide attempt than non-autistic adults.

9. researchgate.net researchgate.net/publication/394161733_Community_priorities_for_preventing_suicide_in_autistic_people_an_approach_to_guide_policy_and_practice

Community priorities for preventing suicide in autistic people In a two-phase survey, we identified community priorities for suicide prevention in almost 4000 autistic people and 627 supporters of autistic ...