Self-harm and Mental Health Characteristics of Prisoners with elevated rates of autistic traits.
Prisoners with elevated autistic traits carry a six-fold higher suicide-attempt rate, so autism screening is vital in forensic intake.
01Research in Context
What this study did
The team gave a short autism quiz to adult men in one UK prison.
They split the men into two groups: high autistic traits and low traits.
Then they asked each man about self-harm thoughts, suicide tries, and other mental-health problems.
What they found
The high-trait group was 5.6 times more likely to have tried suicide.
Almost two out of three in that group had a past attempt, versus about one in ten of the others.
They also reported more self-harm ideas in the last month and more illnesses like depression.
How this fits with other research
Chen et al. (2017) saw the same self-injury risk, but in preschoolers with autism.
Together the papers show the risk starts early and stays high across the lifespan.
McPhillips et al. (2021) found another hidden risk—poor motor skills—in young offenders.
All three studies flag neurodevelopmental issues that prisons rarely screen for.
Why it matters
If you work with adults in forensic or psychiatric settings, add a quick autism screener to intake.
A high score is a red flag for suicide watch and for mental-health referral.
You can’t treat what you don’t measure, and this five-minute step may save lives.
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02At a glance
03Original abstract
BACKGROUND: Prevalence studies among prisoners have found rates of 1-4% for autism spectrum disorder (ASD) or autistic traits. However, little is known about those prisoners with high levels of autistic traits. AIM: This aim of this study was to compare the mental health characteristics of prisoners with autistic traits with neurotypical prisoners not screening positive for neurodevelopmental disorders. METHOD: The study recruited 240 male prisoners from a London prison and screened for autism spectrum disorder using the Autism Quotient (AQ) 20 and 10, and Autism Diagnostic Observation Schedule (ADOS). The Mini International Neuropsychiatric Interview was used to assess for depression, anxiety, self-harm behavior and suicide. RESULTS: Screening using the AQ identified 46 prisoners with significant autistic traits, with 12 meeting the diagnostic threshold for ASD using the ADOS. Those screening positive with autistic traits were significantly more likely to have thought about self-harm and suicide in the past month than neurotypical prisoners and have a comorbid mental disorder. They were also significantly more likely to report having attempted suicide during their lifetime compared to neurotypical peers at a rate of 64.9 % compared to 11.6 % for the neurotypical prisoners. CONCLUSION: Prisoners with elevated levels of autistic traits were more likely to report self-harm, suicidal thoughts and were more vulnerable to a range of mental disorders than neurotypical prisoners. There is a need for more evidence on the experience of autistic prisoners to inform how pathways should work to improve health outcomes through increased awareness and access to screening and subsequent diagnosis which currently prisons are currently not set up for.
Research in developmental disabilities, 2021 · doi:10.1016/j.ridd.2021.103987