Adapted Suicide Safety Plans to Address Self-Harm, Suicidal Ideation and Suicide Behaviours in Autistic Adults: Protocol for a Pilot Randomised Controlled Trial

Jacqui Rodgers*, Jane Goodwin, Emma Nielsen, Nawaraj Bhattarai, Phil Heslop, Ehsen Kharatikoopaei, Rory C. O'Connor, Emmanuel Ogundimu, Sheena E. Ramsay, Katie Steele, Ellen Townsend, Luke Vale, Emily Walton, Colin Wilson, Sarah Cassidy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
17 Downloads (Pure)

Abstract

Background
Suicide prevention is a national priority for the UK government. Autistic people are at greater risk of experiencing self-harm and suicidal thoughts and behaviours than the general population. Safety plans are widely used in suicide prevention but have not yet been designed with and for autistic people. We developed the first safety plan specifically targeting suicidality in autistic adults: the Autism Adapted Safety Plan (AASP). It consists of a prioritised list of hierarchical steps that can be used prior to or during a crisis to mitigate risk of self-harm and suicidal behaviour. This is a pilot study that aims to assess the feasibility and acceptability of the AASPs and the research processes, including the response rates, potential barriers and reach of AASPs, methods of recruitment, what comprises usual care, and economic evaluation methods/tools.

Methods
This is an external pilot randomised controlled trial of a suicide prevention tool aimed at mitigating the risk of self-harm and suicidal behaviour in autistic adults: AASPs. Participants will be assessed at baseline and followed up 1 month and 6 months later. Assessments include questions about self-harm, suicidality, service use, and their experience of the AASP/taking part in the study. Autistic adults who have a clinical autism diagnosis and self-reported history of self-harm, suicidal thoughts, or suicidal behaviours within the last 6 months will be invited to take part in the study. Informed consent will be obtained. Participants will be recruited via community and third sector services (including community settings, autism charities, and mental health charities). They may also “self-refer” into the study through social media recruitment and word of mouth. Ninety participants will be randomised to either develop an AASP or receive their usual care in a 1:1 ratio.

Discussion
The present study will provide an evaluation of the suitability of the processes that would be undertaken in a larger definitive study, including recruitment, randomisation, methods, questionnaires, outcome measures, treatment, and follow-up assessments.

Trial registration
ISRCTN70594445, Protocol v4: 8/2/22.
Original languageEnglish
Article number31
Number of pages9
JournalPilot and Feasibility Studies
Volume9
DOIs
Publication statusPublished - 28 Feb 2023

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