Autism & Developmental

Suicide and non-fatal self-injury-related emergency department visits among individuals with autism spectrum disorder.

Giannouchos et al. (2023) · Autism : the international journal of research and practice 2023
★ The Verdict

Autistic people land in the ED for self-harm far more often—so build suicide screening and fast mental-health referral into your intake.

✓ Read this if BCBAs working with autistic clients in clinics, schools, or homes.
✗ Skip if Practitioners who only serve typically developing athletes or corporate staff.

01Research in Context

01

What this study did

Totsika et al. (2023) looked at every emergency-department visit in the state that listed self-harm or suicide.

They compared autistic people to everyone else. The data came from statewide hospital records.

02

What they found

Autistic people showed up far more often for self-injury or suicide-related crises.

They also carried more mental-health diagnoses at the same time.

03

How this fits with other research

Goris et al. (2021) and Amaral et al. (2019) already saw autistic youth flooding EDs for any reason. V et al. zoom in on self-harm as one big driver.

Iannuzzi et al. (2022) showed autistic teens are admitted almost four times more often for preventable problems. The new study says self-injury is part of that picture.

Vassos et al. (2023) found a medical home cuts general ED trips by 21%. V et al. do not test medical homes, but both papers point to the same fix: catch mental-health needs early so the ED is not the first stop.

04

Why it matters

If you intake an autistic client, add two quick steps. First, run a brief suicide-risk screener at every renewal. Second, have a same-day mental-health referral list ready. These two moves can keep self-harm from becoming an ED visit.

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→ Action — try this Monday

Add the ASQ or similar suicide screener to your intake packet and update your referral sheet with three local crisis clinics.

02At a glance

Intervention
not applicable
Design
other
Sample size
14400000
Population
autism spectrum disorder
Finding
negative

03Original abstract

This study used data for 14.4 million individuals with 43.5 million emergency department visits from all hospitals in the state of New York to explore the association between suicide and non-fatal self-injury-related (self-injury) emergency department visits and autism spectrum disorder. Overall, we found that individuals with autism spectrum disorder had more emergency department visits and admissions through the emergency department, more years of emergency department utilization, and higher prevalence of mental health-related comorbidities. Individuals with autism spectrum disorder were also significantly more likely to have at least one self-injury-related emergency department visit compared to those without autism spectrum disorder. These results emphasize the need to raise awareness across both family caregivers and healthcare providers on the increased suicide and self-injury risks that individuals with autism spectrum disorder face and to improve care delivery practices. In addition, effort to promote and increase timely access to mental health care is an urgent priority for individuals with autism spectrum disorder.

Autism : the international journal of research and practice, 2023 · doi:10.1177/13623613221150089