Why did we develop autism adapted safety plans?

Research shows that autistic people are more at risk of self-harm and suicide than non-autistic people. However, there are no suicide prevention interventions which have been developed specifically for autistic people. Developing personalised suicide prevention interventions with and for autistic people is a top research priority identified by the autism community. Safety plans have been shown to reduce risk of self-harm, suicidal thoughts and behaviours in a range of different groups. Safety plans have also been suggested as a potentially useful personalised suicide prevention intervention by autistic adults and those who support them.

What are safety plans?

Safety plans are prepared by a person at risk of self-harm or suicide before a crisis. The plan describes a series of steps a person can follow to help keep themselves safe when they feel the urge to self-harm or end their life. Safety plans are personal and need to be written in the persons own words. A person can develop a safety plan on their own, or with the support of a trusted person if they wish. This trusted person can be a friend, family member, support worker or any other professional. 

What is an autism adapted safety plan?

We conducted a series of studies to: 

1)       Adapt safety plans with and for autistic adults and those who support them; 

2)       Explore whether our autism adapted safety plans were acceptable and useful to autistic adults and those who support them.

We found that safety plans need to be adapted to meet the unique needs of autistic adults. Many autistic adults needed the support of a trusted person to complete the safety plan. Safety plans needed clearer instructions, examples and resources to help autistic people successfully complete a safety plan. Some sections needed rewording or adding to make them clearer and more relevant to autistic people. We found that a majority of autistic adults and those who support them were able to complete an autism adapted safety plan, and found their safety plan useful.

Can I download a copy of an autism adapted safety plan?

You can download a copy of the autism adapted safety plan with an accompanying resource pack here. The resources are suggestions to help you understand and complete the safety plan for yourself, or to support another person to complete their safety plan.

Please contact lp-mhautism@exmail.nottingham.ac.uk or measures@newcastle.ac.uk with any queries.

What is the underlying research supporting autism adapted safety plans?

You can download a copies of the underlying research papers developing and testing autism adapted safety plans below:

1) Rodgers, J., Goodwin, J., Nielsen, E., Bhattarai, N., Heslop, P., Kharatikoopaei, E., ... & Cassidy, S. (2023). Adapted suicide safety plans to address self-harm, suicidal ideation, and suicide behaviours in autistic adults: protocol for a pilot randomised controlled trial. Pilot and feasibility studies, 9(1), 31.

2) Goodwin, J. et al. (2024) Adapting safety plans for autistic adults with involvement from the autism community. Autism in Adulthood.

3) Rodgers, J., Cassidy, S., Pelton, M., Goodwin, J., Wagnild, J., Bhattarai, N., ... & Vale, L. (2024). Feasibility and acceptability of autism adapted safety plans: an external pilot randomised controlled trial. eClinicalMedicine, 73.

What are the next steps for autism adapted safety plans?

Our research shows that autism adapted safety plans are safe to use, acceptable to autistic adults and those who support them, and feasible to deliver. Our team are applying for further funding to test whether autism adapted safety plans reduce self-harm, suicidal thoughts and suicidal behaviours in autistic people. 

The Department for Health and Social Care as part of the suicide prevention strategy 2023-2028 will also consider the results of our research to see if autism adapted safety plans can be delivered more widely through the NHS in the future.

Many thanks to all our supporters!

We thank all the autistic people and those who support them who supported this work to adapt and test autism adapted safety plans. We also thank our collaborators at the Universities of Nottingham, Newcastle, Glasgow, Durham and Northumbria, and our funder the National Institute for Health Research [Public Health Research Programme (NIHR129196)] for supporting this research. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.