Suicide crisis and self-harm attendance at A&E in autistic CYP

Background

Research suggests that autistic people are at a higher risk of suicide than non-autistic people. Figures show that up to 66% of autistic adults had thought about suicide during their lifetime (compared to 20% of non-autistic adults), and up to 35% had planned or attempted suicide.

It has been reported that children diagnosed with autism were nine times more likely to receive care in an Emergency Department due to a psychiatric crisis than children without a diagnosis were. Children and young people with autism more frequently present to A&E with self-injurious behaviours, which in turn increases the risk of hospitalization when compared with non-autistic peers.

A&E departments are often the first point of contact for people in suicidal crisis, making them a critical point for intervention and improvement. However, multiple factors can contribute to increased levels of distress for patients with autism during a visit to an A&E or Emergency Department. These might include communication deficits; hypersensitivity to auditory, visual, or other sensory stimuli; long wait times; rapid or multiple relocations to different areas within the hospital, as well as an unfamiliar environment.

This study aims to provide a comprehensive evaluation of:

  • the prevalence of attendance of autistic CYP to A&E departments in suicidal crisis and / or Self-Harm
  • explore the experiences of autistic CYP
  • the experiences of A&E staff

Methodology

Study 1. Systematic Review

A Systematic Review on the topic will be carried out. The review will seek to describe and evaluate the current literature estimating the prevalence of presentation of autistic people in suicidal crisis / self-harm attendance at A&E.

Study 2. Quantitative Data Collection

Data will be collected from six A&E sites across England. Participant’s medical notes will be identified using the electronic databases at each A&E site. The researcher will have on-site access to these notes. Potential participants will be screened, and if eligible, data will be recorded on a quantitative proforma. Once extracted data will be immediately anonymised. No identifiable data will be held by the researcher.

Study 3. CYP and Carer Qualitative Interviews

Qualitative interviews will be conducted with autistic CYP who have accessed A&E services for suicidal crisis or self-harm. These interviews will take place over the telephone, face-to-face or via Teams depending on the preference of the participant.

Study 4. A&E Staff Qualitative Interviews

Qualitative interviews will be conducted with A&E staff. These interviews will take place over the telephone, face-to-face or via Teams depending on the preference of the participant.

Who is carrying out the study?

This PhD is funded by ARC North West and will be carried out at Liverpool John Moores University in conjunction with local NHS Trusts.

Opting-out from the use of your data

This study is in compliance with the NHS National Data Opt-Out requirements.

If you have used any A&E sites in suicidal crisis across Mersey Care and Cheshire & Wirral Partnership NHS Trust and do not wish for your information to be used please contact the researchers by email, phone or post: