Autism & Suicide
In this post Loren interviews Lian about her work supporting people in crisis.
Lian: is doing her master's degree training to be an integrative counsellor at the university of the west of England. Her integrative practice includes person-centered, psychodynamic and gestalt modalities.
She works for an organization called Heart to Heart. Who offer counselling with both qualified and trainee counsellors.
She also volunteers for Womenkind and Shout and used to volunteer for the Samaritans.
Loren: You've spent hundreds of hours over the past few years, volunteering to support people in crisis: what motivates you?
Lian: I never think about it. It's just the right thing to do.
The mental health burdens in this country are massive. So the more volunteers that you can get the more people we can help. Sadly there just isn't isn't enough in the NHS.
Loren: What about Autism?
When it comes to autistic people we know some are more likely to be suicidal. There's even a section of the government's Suicide prevention strategy for 2025 to 2028 on autistic people and suicide (1).
What we're teaching all NHS and all social care staff on The Oliver McGowan Mandatory Training on Autism and Learning Disability, is that the suicide rates are nine times higher for autistic people than the general population (2).
Loren: When do you interact with people that might be suicidal?
Lian: Yes, directly through my counselling or through the volunteer work I do.
Loren: What kind of support do you, do you give them?
Lian: Listening support: talking, understanding, listening, empathy.
Loren: Do you find it helps them?
Lian: I hope so.
Loren: Do you know if many of those you support are neurodivergent?
Lian: I couldn't tell you the exact numbers... It's not like many are going to go "Oh I'm neurodivergent and I'm suicidal."
Most call the helpline and explain their situation. They might mention things to do with being neurodivergent.
Loren: Why do people tell you they are suicidal?
Lian: I think there's so much stigma around it in society or people don't want to worry their friends and family. Or because there aren't a lot of people to talk to about feeling suicidal. So you call the helpline or you speak to a counsellor because we are the people who are more likely to understand - I'm not judging you for how you're feeling.
Loren: Why do you think people are suicidal: what are the main issues they're talking about?
Lian: There's no one reason, but usually things like:
lack of support
isolation
lack of money... capitalism
not fitting in in society
feeling shoe-horned into a box and feeling like you're never going to be able to cope.
Loren: We have evidence that the majority of autistic people are not in any kind of work or employment at all (3). That must have a big impact on self-esteem, purpose, and just having enough money to do basic things.
Loren: Do people tell you anything that helps them keep going?
Lian: Support, understanding empathy, feeling like somebody cares about them.
Loren: Quite a bit of my work is one-to-one phone support as well. But sometimes you can't help. There isn't any particular solution.
It's just holding space. Somebody feeling like someone is listening and they're not alone in some way. We're trying to make them feel not alone, even if it's just for an hour. When I first started doing this, it was tough that I couldn't do anything practical to help. Now I know how much it helps just to listen.
Loren: What do you find hard about it?
Lian: I think just the fact that it's often it's systemic problems within society that need fixing. It's not down to the individual, the problem is so big. There are very, very real issues. People are suicidal for very, very real reasons.
Sometimes I wish everybody thought in everybody else's best interests: if everyone was accepting and understanding and had empathy. Through all the levels of society, it just would cease to exist because people would feel happy and accepted and loved and cared about and comfortable and safe.
Loren: What kind of things do you routinely suggest to them?
Lian: I don't tend to give direct advice because I'm not in their situation and I don't necessarily know. If I'm suggesting anything it's self-compassion, self-love, self-care. Lots of people mask as they don't feel it's okay to be themselves. So they need to hear it's okay to be themselves, to have their own individual identity.
Loren: How, how do you practice self-care?
Lian: How do I accept myself? For me, I think it comes from how I grew up. I grew up with a mum being like, "Yeah, you're a bit weird: that's cool.". I am a bit weird. Let's all be weird. Normalise it. It wasn't considered bad to be who I was.
Your internal narratives are built throughout your life by what you're told by others. And if you're always told by others, "You're a freak." "You're weird" "Why are you doing that?" "Why are you feeling like that?".
Then that becomes your internal narrative. And you don't realize.
Loren: When it comes to neurodivergent people we often get sent negative messages from society.,
For example: someone who's dyslexic might feel that they're dumb or not capable from a young age. Or for someone who's autistic that they're weird. All these messages make people want to hide who they are. And it's so damaging.
One of the things we talk about is how suicide can look different in autistic people. One of those is how an autistic person might not express being suicidal until a trigger happens. Then they will attempt even though to everyone around them the week or day before they were fine.
Lian: Maybe that's because it's been building up, but they've not expressed it before as they've masking their whole lives. And then suddenly, and it seems like suddenly, they've attempted. It's not suddenly, they just haven't been able to express what's really going on.
Loren: It's also that they've got all those systemic problems in the background. To someone else, it may seem like a small thing has happened to trigger an attempt but they've got a weight of everything else on top of them.
Also when people ask them, how are you feeling? Autistic people interpret that as such a vague question. They might say "Fine." but then after they've attempted they may say "Actually I was fine on that day, but actually my life sucks overall".
Loren: How do you think we as professionals, can support suicidal people better?
Lian: I suppose, really listen. Try to understand. Make sure you're there when you say you will be there. We are humans ourselves so we can't be perfect all the time, but just try to create an accepting understanding environment. And make sure there is that willingness to talk about it.
When you're talking to someone you don't have to fix or solve... you just need to be here with them right now.
Loren: I support a lot of people that are in difficult situations or crisis. I just know a big part of my practice is joining them on their side. And someone says this fucking sucks. I might repeat back "Yeah it does". I hear what you're saying, I acknowledge what you're going through is hard.
Loren: Do you learn about neurodiversity in your counselling master's?
Lian: We do: though not as much as I think we should.
Loren: I think that will change in the future. Right now it's still relatively new to the public.
Loren: Do you have an ending message for any readers who might be feeling suicidal right now?
Lian: Talk to someone. Samaritans are 24/7. If you identify as female in Bristol, womankind is really good.
Loren: If you're considering talking therapies Cognitive Behavioural Therapy on the NHS is normally only 6 or 12 weeks. It can be longer but it usually teaches you a bunch of tools that you can use yourselves and having extra tools in your toolbox can be very useful.
If you're autistic some of the techniques can make you look at some of your natural behaviours or the things you do to self-support yourself as potentially signs that something's wrong or that something's bad. And that's not always accurate.
So what we recommend, and this is in the national training for all NHS and social care staff, is the Mind and National Autistic Society is Good Practice Guide (4). It's a booklet for the therapist that helps them adapt the therapy for an autistic person.
I'm not going to promise that that is going to make the therapy right for you. But it can help and many people say CTB helps them.
Resources / References:
(1) https://www.gov.uk/government/publications/suicide-prevention-strategy-for-england-2023-to-2028
(2) https://www.autistica.org.uk/downloads/files/Personal-tragedies-public-crisis-ONLINE.pdf
(3) ONS 2023
(4) https://www.autism.org.uk/shop/products/books-and-resources/good-practice-guide
