Autism Spectrum Disorder and Suicidal Behaviors: Medications and Services Utilization
Objectives: To examine psychiatric medication and mental health service utilization, for children and young adults with ASD, in relation to suicidal thought and behaviors.
Methods: 992 parents of a verbal child or dependent young adult with ASD who were enrolled in the Interactive Autism Network (IAN), an online ASD research registry, completed the Mental Health and Suicidal Behaviors Questionnaire, a custom measure of suicidal thoughts and behaviors, current psychiatric medications, service use history, comorbid mental health conditions, and family history. Individuals with ASD had a mean age of 13.6 years (range 8-25 years; SD = 3.0), were predominantly male (81%), white (85%), and non-Hispanic (89%).
Results: 9.2% of parents reported that their child or young adult had a suicide plan or tried to end their life. An additional 11.6% reported that their child displayed active ideation (wanting to end their life without plan/attempt), and 21.1% said their child displayed passive ideation (wanting to die without active ideation or plan/attempt). 55.2% reported that the child/dependent was taking psychiatric medications (Mean = 1.98 medications, SD =1.09, range=1-7), with treatment significantly greater in those with ideation, plans, or attempts than those without. Most common were ADHD medications (34.8%), antidepressants/anti-anxiety medications (30.0%), and antipsychotics (17.6%) (Table 1). 72.0% sought treatment in response to their child’s ideation or plan, and 88.6% in response to a suicide attempt (Figure 1), most commonly from a psychologist/counselor (64% with ideation/plan, 80% with attempt) or psychiatrist (50%, 54%). Other sources of treatment were from pediatricians, emergency departments, or other professionals. Hospitalization occurred in 45% of those with attempts, 15% of those with ideation or plan. Most were satisfied with actions taken or treatment (82% with ideation or plan; 78% with attempt). Similarly, most were satisfied with their access to treatment in response to their child’s suicidality (78% with ideation or plan; 71% with attempt). However, this left approximately a quarter dissatisfied with actions taken, treatment received, or access to treatment.
Conclusions: Parents of children and young adults with ASD participating in an online research network report high rates of suicidal thought and behaviors, with high use of mental health therapies, medication, and other treatments. While a majority reported general satisfaction with the child’s or dependent’s care regarding suicidality, many reported insufficient treatment. Further understanding of the impact and availability of such treatments is required to decrease injury and death in this highly vulnerable population.