Over-Represented and Under-Served: Autistic Children and Young People Seeking Help for Suicidal Crisis in a UK Emergency Department

Purpose Hospital Emergency Departments are increasingly playing a role in the care of young people experiencing suicidal crisis. Autistic young people, who already experience elevated rates of suicidal thoughts and death by suicide, may face particular difficulties in such environments. Methods This retrospective medical records review explored patterns of Emergency Department attendance for suicidal crisis among young people (aged 8–16 years) attending a UK paediatric hospital between 2019 and 2021. Anonymised clinical records from 338 young people were analysed using descriptive and exploratory statistics. Results 35.8% of attendees were autistic and 62.0% of those were female. Autistic young people were attending at significantly younger ages than non-autistic young people, and were significantly more likely to be known to mental health services and to have attended the Emergency Department previously for suicide ideation. Conclusion Findings indicate that autistic young people, and in particular autistic females, were over-represented in crisis presentations, despite previous attempts to seek help. Further research is needed to understand what could help prevent autistic young people from reaching crisis, and what support may be beneficial in the Emergency Department to de-escalate crises, improve wellbeing, and prevent re-attendance.