Understanding Self-Harm and Suicidality in Autistic Adults Across the Lifespan

New population-level data show higher rates of self-harm and suicidality among autistic adults, most pronounced in midlife and older age. This trend matters for adult mental health services because it signals growing demand for detection and monitoring as patients age and has direct implications for resource planning.

The research drew on national registry–level data and analyzed age bands across young, midlife, and older adults. It reported more than a 2-fold increase in recorded self-harm events and roughly a 3-fold increase in suicide attempts in midlife and older groups; primary endpoints included recorded self-harm events, suicide attempts, and suicidal ideation—providing broad cohort coverage.

Key risk factors were prior traumatic experiences, concurrent psychiatric comorbidity, social isolation, sensory and communication barriers to help-seeking, and physical health comorbidity. The analysis attributes a substantial portion of observed suicidality risk to historical trauma, positioning trauma as a proximal contributor and underscoring the need for trauma-aware assessment in routine care.

For practice, adopt screening protocols that extend adult age windows, systematically document trauma histories, and record nonverbal or self-injurious behaviours to improve detection. Use collateral information and adaptable communication strategies when verbal reporting is limited. Given the elevated baseline risk in midlife and older autistic adults, lower the threshold for expedited psychosocial evaluation and urgent safety planning when there are recent self-harm events, escalating intent, or new severe functional decline—linking earlier detection to earlier intervention.