Suicide and Autistic People: A Higher Risk, and a Preventable One

Autistic people are more likely than non-autistic people to have suicidal thoughts, to attempt suicide and to die by suicide. Pooled across ten studies, the risk of death by suicide was 2.85 times as high^[1]. That gap is not a fixed consequence of being autistic. The research points to factors that services and society can change, and suicide is preventable^[2].

Behind these figures are patterns autistic people and their families describe again and again. It is the adult who got through school and work by copying other people and hiding what that cost, and who was told they seemed fine. It is the teenager whose distress did not look the way a checklist expected, and so was not taken seriously. None of this is inevitable. Support helps, and existing approaches can be adapted with and for autistic people^[3].

Across countries, autistic people are more likely to die by suicide

A 2024 systematic review and meta-analysis of ten studies covering 10.4 million people put the relative risk of death by suicide for autistic people at 2.85 (95% uncertainty interval 2.05–4.03) compared with non-autistic people, and found it significantly higher for autistic women than men^[1]. Combining that with GBD 2021 global health estimates, the authors modelled around 13,400 excess suicide deaths among autistic people worldwide in 2021, or 1.8% of all suicide deaths, while cautioning that the underlying studies were limited in number and geographical coverage^[1].

National studies agree on the direction, though not the size. In Sweden, 27,122 people diagnosed autistic between 1987 and 2009 had 7.55 times the odds of death by suicide of matched controls^[6]. In Denmark, a register study of 6.56 million people aged ten or older, followed from 1995 to 2016, found 3.75 times the rate of suicide among autistic people after adjustment^[7]. In Utah, the cumulative incidence of suicide among autistic people in 2013–2017 was 0.17%, against 0.11% among non-autistic people; in the preceding 15 years the difference was not significant^[8]. In Taiwan, a nationwide study of 64,685 autistic people found higher mortality for most causes examined and called for suicide prevention to be prioritised for autistic women and autistic people without intellectual disability^[9].

Not every study finds a clear gap once other factors are accounted for. In a Finnish birth cohort of 4,695 autistic young people followed to 2015, the unadjusted hazard of death by suicide was 2.1 times that of matched peers, but the authors concluded the association was explained by co-occurring psychiatric conditions^[10]. In Ontario, Canada, the crude hazard of suicide death was 1.98 times as high for autistic women and 1.34 times for autistic men (not significant), and the increases were associated with psychiatric diagnoses^[11]. Suicide is one part of a wider mortality gap, covered in our article on autism and life expectancy.

Suicidal thoughts and attempts are far more common among autistic people

Suicidal thoughts are much more common than suicide deaths, and they are a signal that support is needed, not a prediction. A 2023 meta-analysis pooled 36 studies of 48,186 autistic and possibly autistic people without co-occurring intellectual disability: 34.2% reported suicidal thoughts, 21.9% suicide plans and 24.3% suicide attempts or behaviours, with high variation between studies^[4]. For autistic young people aged 25 or under, a 2022 meta-analysis found pooled prevalence of 25.2% for suicidal thoughts and 8.3% for attempts. Figures were higher when young people reported for themselves than when parents reported for them^[12] — distress is not always visible to those closest.

Among 374 adults newly diagnosed with Asperger's syndrome (the study's diagnostic category) at a specialist clinic in Cambridge, England, between 2004 and 2013, 66% of respondents said they had ever had suicidal thoughts and 35% had planned or attempted suicide. Their odds of lifetime suicidal thoughts were 9.6 times those in a general UK population sample^[13]. Population records show a similar gap for attempts: 3.19 times the rate in Denmark after adjustment^[7], and an age- and sex-adjusted relative risk of 3.14 for attempted suicide among people aged 6 to 45 in Manitoba, Canada, in 2018–2022^[14].

In most studies, the gap is widest for autistic women and autistic people without intellectual disability

In the Swedish data, the odds of death by suicide were 9.40 times those of controls for autistic people without a recorded intellectual disability, and 2.41 times for those with one. Autistic women had 13.05 times the odds of women in the control group; for autistic men the figure was 6.28^[6].

Other studies mostly agree on sex. The pooled 2024 estimate was significantly higher for autistic women^[1]. In Utah, the recent gap was driven by autistic women, whose risk was 3.42 times that of non-autistic women^[8]. In Denmark, autistic women had 4.41 times the rate of suicide attempts of autistic men, against 1.41 times among non-autistic people, although there was no sex difference in suicide deaths among autistic people^[7]. The pattern is not universal: an earlier Taiwanese population study highlighted raised suicide risk among autistic men, and raised accident risk among autistic women^[15]. Ratios also depend on how common suicide is in the comparison group. Diagnosis and masking among autistic women are covered in our article on autistic women and girls.

For autistic people with intellectual disability, the increase in suicide risk relative to non-autistic people was smaller than for those without: in Sweden the odds ratio was 2.41 against 9.40^[6], and the Taiwanese study also found a lower suicide risk for autistic people with intellectual disability than for those without^[9]. But the largest meta-analysis of suicidal thoughts excluded them by design^[4], so far less is known about how their distress is experienced or recognised.

Much of the risk runs through things that can be changed

The most consistent finding is the role of co-occurring mental health conditions. In Denmark, 92.3% of autistic people who attempted suicide and 90.6% of those who died by suicide had at least one other diagnosed condition; autistic people with no other diagnosis did not have significantly higher rates^[7]. In Finland, a 2.7-fold hazard of hospital-treated self-harm fell to 0.8, no longer significant, after adjustment for co-occurring psychiatric conditions^[10]. In Ontario, psychiatric diagnoses were significantly associated with the increased risks, especially for suicide death^[11]. A 2026 Swedish study of nearly 3 million people born between 1974 and 2004 found that autistic people with psychiatric conditions had an all-cause death rate of 3.2 per 1,000 person-years, against 0.96 for autistic people without them and 0.27 for non-autistic people — and “an especially high risk of death by suicide compared with all comparison groups”^[16].

This is easy to misread. It does not show that autism is irrelevant: mental health conditions are far more common among autistic people^[14], and the experiences described below may be part of the reason. It does show that much of the excess risk travels through conditions that can be recognised and treated, which makes accessible, autism-informed mental health care a central suicide prevention tool — the conclusion these studies draw themselves^[11][16]. See also our article on depression in autistic people.

Masking, unmet needs and loneliness

Autism-specific factors appear too. In an online survey developed with a steering group of autistic adults, 72% of 164 autistic adults scored above the cut-off for suicide risk, against 33% of 169 general population adults. Among the autistic adults, camouflaging (masking autistic traits to fit in) and unmet support needs predicted suicidality, and the authors identified both as risk markers specific to autistic people^[17]. England's suicide prevention strategy now names “pressure to ‘camouflage’ or ‘mask’ autism” as a risk factor^[18].

Connection matters as well. In an Australian national survey of 185 autistic people aged 14 to 80, 36% reported recent suicidal thoughts, and the links between loneliness, social support and suicidal thoughts ran through depression^[19]. A 2024 review of 80 studies found loneliness, bullying, interpersonal conflict and unmet support needs generally associated with higher risk, but most studies were cross-sectional and cannot establish cause^[5]. Among autistic young people, adverse childhood experiences were strong risk factors and resilience was protective^[12].

Many autistic people who die by suicide were never diagnosed

A study of 372 coroners' inquest records from two regions of England (2014–2017) found evidence of autism, diagnosed or possibly undiagnosed, in 10.8% of people who died by suicide, against the 1.1% expected from UK prevalence (odds ratio 11.08). Only 0.5% had an autism diagnosis recorded^[20]. In follow-up interviews with 29 families, evidence of autism was found for 12 people (41.4%). The authors note that undiagnosed autism cannot be confirmed after death, and the interview sample was small^[20].

England's 2023 suicide prevention strategy is explicit: “Undiagnosed or late-diagnosed autism may be a preventable risk factor for suicide and, therefore, earlier identification and timely access to autism assessment services is vital”^[18]. In the Cambridge clinic study, adults were diagnosed at an average age of 31.5^[13]; our article on diagnosis in adulthood looks at that gap.

A diagnosis does not guarantee help, either. In a UK survey, the 754 autistic adults who had not sought NHS help the last time they felt suicidal most often said “I tried to cope and manage my feelings by myself”, “I did not think they could help me” and “The waiting list is too long - no point”^[21]. The English strategy acknowledges that autistic people report difficulty getting mental health support because of their diagnosis, a pending assessment or a lack of reasonable adjustments^[18].

What the evidence asks of us

Autistic people have already said what would help. A policy brief from the International Society for Autism Research (INSAR), built on consultation with more than 1,000 autistic people and supporters, including workshops in the UK, US and Netherlands, found removing barriers to mental health services was the most important issue^[3]. A 2026 study of 3,962 autistic people and 627 supporters or bereaved people, more than 95% in the UK, prioritised the upskilling and resourcing of healthcare services to deliver timely, autism-specific support, and better diagnostic services, and favoured reducing stigma and providing social support over crisis apps^[22]. Drawing on those priorities and the evidence above:

• Name autistic people in suicide prevention policy. In 2021, INSAR found few countries identified autistic people as a high-risk group^[3]. England did so in 2023^[18]; other national strategies can follow.
• Make mental health care reachable and adapted. INSAR calls for more and longer therapy sessions, continuity of care, suitable sensory environments, and ways to make an urgent appointment without a phone call or face-to-face meeting. Its first request of professionals: believe an autistic person who says they feel suicidal, “even if such information comes in a different or unexpected manner”^[3].
• Recognise and treat co-occurring conditions early. Given how strongly they shape risk, timely detection and treatment of mental health conditions is suicide prevention^[11][16].
• Shorten the wait for diagnosis, and support people after it. Both England's strategy and autistic people's own priorities put this at the centre^[18][22].
• Look for autism in suicide prevention. The coroner study's authors call for clinicians to screen for autistic traits in people presenting with suicidal thoughts, and for coroners to gather evidence of autism systematically^[20]. England has committed to working with the National Confidential Inquiry into Suicide and Safety in Mental Health on a clearer national picture^[18].
• Fund research on what helps. Only three of 80 recent studies tested an intervention, and only six came from non-Western settings^[5]. One promising example is an autism-adapted safety plan: in a UK pilot trial with 49 randomised participants, 68% of those offered it were satisfied, and the trial met its criteria to proceed to a full effectiveness trial^[23].

The evidence is consistent enough to act on now, and every step here is within the reach of health services, commissioners and governments.

Language: this piece uses identity-first language ("autistic people"), the preference of most autistic-led organisations, and uses clinical terms such as "autism spectrum disorder" or "Asperger's syndrome" only when naming a study or diagnostic category.

Why we're publishing this

Health Insurance UK is a commercial health-insurance resource, not a charity and not a campaign. We compiled this evidence because autistic people, families and the organisations pushing for better mental health care deserve the international research in one place, stated accurately and without sensationalism, ready to put in front of a commissioner, a policymaker or a journalist. The case belongs to the community; our part is to stand alongside it and say plainly what the data shows: the gap is real, it is measurable in many countries, and much of it sits where services can act.

How to read this data

The studies use different measures: relative risks, odds ratios, rate ratios and hazard ratios. Because suicide is rare these give broadly similar answers, but they are not interchangeable, and studies differ in period, age range and adjustment, so we quote each in its own terms. Register studies count only people with a recorded diagnosis, and many autistic adults are undiagnosed. Clinic and online survey samples are self-selected, not population estimates. Pooled prevalence varies widely between studies, and most risk-factor research is cross-sectional: it shows associations, not causes.

Accuracy matters. A 2025 analysis of articles citing the Swedish study found 70.4% were incorrect or misleading; its authors note that suicide “was the cause of death for which the odds ratio was largest, but not the cause of the largest proportion of deaths”^[24]. We make no life-expectancy claims from it. Most population evidence comes from Nordic countries, the UK, North America, Taiwan and Australia. Following Samaritans' media guidelines, this article gives no detail of methods or locations and includes sources of support^[25].

Use this data

Free to cite with attribution to Health Insurance UK. Charities, campaigners and journalists are welcome to reuse these figures and charts; if you do, please include a source of support such as the helplines above. For the underlying figures as a spreadsheet, get in touch. More articles are in our Autism & Health research library.

Important: This article summarises published research for general information. It is not medical advice and cannot be used to diagnose, treat or predict anything about an individual. If you have concerns about your own or someone else's health, please speak to a qualified health professional.

Sources

1. Santomauro DF, Hedley D, Sahin E, et al. The global burden of suicide mortality among people on the autism spectrum: a systematic review, meta-analysis, and extension of estimates from the Global Burden of Disease Study 2021. Psychiatry Research, 2024. europepmc.org/article/MED/39197224
2. World Health Organization. Suicide (fact sheet). WHO, 2026. who.int/news-room/fact-sheets/detail/suicide
3. Cassidy S, et al. Autism community priorities for suicide prevention (policy brief). International Society for Autism Research, 2021. autism-insar.org/…/2021-insar_policy_brief.pdf
4. Newell V, Phillips L, Jones C, Townsend E, Richards C, Cassidy S. A systematic review and meta-analysis of suicidality in autistic and possibly autistic people without co-occurring intellectual disability. Molecular Autism, 2023. europepmc.org/article/MED/36922899
5. Brown CM, Newell V, Sahin E, Hedley D. Updated systematic review of suicide in autism: 2018–2024. Current Developmental Disorders Reports, 2024. eprints.whiterose.ac.uk/id/eprint/223992
6. Hirvikoski T, Mittendorfer-Rutz E, Boman M, Larsson H, Lichtenstein P, Bölte S. Premature mortality in autism spectrum disorder. British Journal of Psychiatry, 2016. cambridge.org/core/journals/the-british-journal-of-psychiatry/…
7. Kõlves K, Fitzgerald C, Nordentoft M, Wood SJ, Erlangsen A. Assessment of suicidal behaviors among individuals with autism spectrum disorder in Denmark. JAMA Network Open, 2021. jamanetwork.com/journals/jamanetworkopen/fullarticle/2774853
8. Kirby AV, Bakian AV, Zhang Y, Bilder DA, Keeshin BR, Coon H. A 20-year study of suicide death in a statewide autism population. Autism Research, 2019. europepmc.org/article/MED/30663277
9. Wu CS, Tsai HJ, Chien YL, Gau SS. All-cause mortality and specific causes of death in autism: a nationwide analysis. Autism in Adulthood, 2025. europepmc.org/article/MED/40151655
10. Jokiranta-Olkoniemi E, Gyllenberg D, Sucksdorff D, et al. Risk for premature mortality and intentional self-harm in autism spectrum disorders. Journal of Autism and Developmental Disorders, 2021. europepmc.org/article/MED/33140146
11. Lai MC, Saunders NR, Huang A, et al. Self-harm events and suicide deaths among autistic individuals in Ontario, Canada. JAMA Network Open, 2023. jamanetwork.com/journals/jamanetworkopen/fullarticle/2808056
12. O'Halloran L, Coey P, Wilson C. Suicidality in autistic youth: a systematic review and meta-analysis. Clinical Psychology Review, 2022. europepmc.org/article/MED/35290800
13. Cassidy S, Bradley P, Robinson J, Allison C, McHugh M, Baron-Cohen S. Suicidal ideation and suicide plans or attempts in adults with Asperger's syndrome attending a specialist diagnostic clinic: a clinical cohort study. The Lancet Psychiatry, 2014. docs.autismresearchcentre.com/papers/2014_Cassidy_et_al_Suicidality_LancetPsychiatry.pdf
14. Singal D, Enns JE, Friesen K, et al. Mental health disorders and suicide risk among autistic children, adolescents and adults: a population-based study using linked administrative data. The Lancet Regional Health – Americas, 2026. europepmc.org/article/MED/42338461
15. Tsai SJ, Chang WH, Cheng CM, et al. All-cause mortality and suicide mortality in autistic individuals: an entire population longitudinal study in Taiwan. Autism, 2023. europepmc.org/article/MED/37161269
16. Taylor MJ, Martini MI, Kuja-Halkola R, et al. Association between co-occurring psychiatric conditions and premature mortality in autistic people: population-based cohort study. British Journal of Psychiatry, 2026. cambridge.org/core/journals/the-british-journal-of-psychiatry/…
17. Cassidy S, Bradley L, Shaw R, Baron-Cohen S. Risk markers for suicidality in autistic adults. Molecular Autism, 2018. europepmc.org/article/MED/30083306
18. Department of Health and Social Care. Suicide prevention in England: 5-year cross-sector strategy. GOV.UK, 2023. gov.uk/government/publications/suicide-prevention-strategy-for-england-2023-to-2028
19. Hedley D, Uljarević M, Foley KR, Richdale A, Trollor J. Risk and protective factors underlying depression and suicidal ideation in autism spectrum disorder. Depression and Anxiety, 2018. europepmc.org/article/MED/29659141
20. Cassidy S, Au-Yeung S, Robertson A, et al. Autism and autistic traits in those who died by suicide in England. British Journal of Psychiatry, 2022. cambridge.org/core/journals/the-british-journal-of-psychiatry/…
21. Procyshyn TL, Moseley RL, Marsden SJ, et al. ‘I did not think they could help me’: autistic adults' reasons for not seeking public healthcare when they last experienced suicidality. Autism, 2025. europepmc.org/article/MED/40952036
22. Moseley R, Procyshyn T, Chikaura T, et al. Community priorities for preventing suicide in autistic people: an approach to guide policy and practice. Autism in Adulthood, 2026 (accepted version). eprints.bournemouth.ac.uk/41681
23. Rodgers J, Cassidy S, Pelton M, et al. Feasibility and acceptability of autism adapted safety plans: an external pilot randomised controlled trial. eClinicalMedicine, 2024. europepmc.org/article/MED/38864075
24. Hand BN, Nikahd M, Wolf BJ, et al. Citation context analysis of autism mortality and suicide findings from Hirvikoski's landmark study. JAMA Network Open, 2025. jamanetwork.com/journals/jamanetworkopen/fullarticle/2830153
25. Samaritans. Media guidelines for reporting suicide. Samaritans, 2026. samaritans.org/about-samaritans/media-guidelines/media-guidelines-reporting-suicide