Autism and suicide at work: why belonging and workplace culture matter

A note before reading: This article discusses suicide and suicidal thoughts. Please read it when it feels right for you. Support information is included below.

Research consistently shows that autistic people experience much higher levels of suicidal thoughts and behaviours than the wider population.

For workplaces, this is difficult but important to understand.

Employers cannot prevent every mental health crisis, and managers should not be expected to act as clinicians. But workplaces are part of the environments people spend their lives in.

That means it is worth asking not only what happens when someone reaches crisis, but what helps people feel accepted, heard and able to be different long before that point.

What does the research tell us about autism and suicide?

The statistics around autism and suicide are stark.

A 2023 review bringing together 36 studies and more than 48,000 autistic and possibly autistic people without intellectual disability found pooled prevalence estimates of 34.2% for suicidal thoughts, 21.9% for suicide plans and 24.3% for suicide attempts or suicidal behaviours.

A more recent review of 80 studies found that autistic people may have up to eight times the risk of dying by suicide compared with non-autistic people, although estimates vary considerably between studies.

These figures need to be handled carefully. Autistic people are not one homogeneous group, and suicide is complex. There is no single explanation for why somebody becomes suicidal.

But the evidence does tell us something we should not ignore:

Autistic people are experiencing a disproportionate level of distress.

So the next question has to be why.

Autism doesn’t exist separately from someone’s environment

It would be too simplistic to look at these statistics and conclude that autism itself explains the increased risk.

People experience autism within environments, relationships and cultures.

Research into suicidality among autistic people has identified a range of contributing factors, including mental health difficulties and interpersonal, social and psychological factors.

And when we listen to autistic experiences more broadly, we also need to consider what it can mean to repeatedly find your way through environments that weren’t designed with you in mind.

Being misunderstood.

Feeling that you don’t belong.

Having your needs dismissed.

Experiencing bullying or victimisation.

Feeling lonely.

Being judged for how you communicate.

Regularly becoming overwhelmed by your environment.

Feeling pressure to change or hide aspects of yourself to fit in.

None of these experiences provides a simple explanation for suicide.

But they remind us of something important.

People don’t exist separately from their environments.

And workplaces are one of those environments.

What can this look like at work?

Someone can appear to be doing well at work while expending a significant amount of energy behind the scenes.

They might be:

• Rehearsing conversations before meetings
• Monitoring their tone, facial expressions or body language
• Trying not to show when an environment is overwhelming
• Avoiding asking for changes because they don’t want to seem difficult
• Working hard to interpret unwritten social expectations
• Hiding distress from colleagues and managers
• Changing how they naturally communicate to appear more ‘professional’

This can be part of masking at work: consciously or unconsciously adapting behaviour to fit expected workplace or social norms.

From the outside, somebody may appear confident, engaged and comfortable.

That doesn’t necessarily tell us how much effort it takes to maintain that appearance.

This is one reason workplaces need to be cautious about assuming that someone is fine simply because their performance looks fine.

What workplaces can and can’t influence

There is an important distinction here.

Managers are not therapists.

HR teams cannot identify or remove every factor contributing to someone’s mental health.

And organisations should not suggest that creating an inclusive workplace is, by itself, a suicide prevention strategy.

People’s lives and mental health are far more complex than that.

But organisations can influence the environment people experience while they are at work.

They can influence whether somebody is routinely judged for communicating differently.

They can influence whether asking for an adjustment becomes an exhausting process.

They can influence whether managers respond with curiosity or assumption when somebody behaves in an unexpected way.

They can influence whether people have some flexibility around how they communicate, concentrate and contribute.

And they can influence whether difference is something people feel they have to hide.

That matters.

Making it safer to be different at work

A neuroinclusive workplace doesn’t wait until somebody is struggling before thinking about barriers.

It looks at how work is designed and experienced in the first place.

That doesn’t require managers to become mental health experts.

It can mean paying attention to ordinary workplace moments.

When somebody says they’re overwhelmed

Avoid immediately deciding whether their reaction seems proportionate to you.

Noise, interruptions, unexpected changes, social demands, workload and uncertainty can affect people differently.

Start by understanding what is happening and what might reduce the barrier.

When somebody asks to do something differently

A request for written instructions, a quieter place to work or a different way of contributing isn’t necessarily somebody trying to avoid work.

It may simply make the work more accessible.

Ask what the person needs and what outcome you are both trying to achieve.

When somebody communicates differently

Confidence, eye contact, quick verbal responses and ease with small talk are not measures of capability.

Be careful about turning preferences for a particular communication style into expectations of professionalism or performance.

When somebody tells you they are struggling

Take it seriously.

Someone’s external presentation doesn’t tell you everything about their internal experience.

You don’t need to immediately solve the problem.

Listen. Ask what they need. Follow your organisation’s appropriate wellbeing or safeguarding processes where necessary, and know how to help someone access specialist support.

What about masking?

Masking deserves particular attention in this conversation because it can make someone’s difficulties harder for other people to see.

If someone has spent years learning how to appear comfortable, sociable or unaffected, colleagues may have little idea what is happening beneath the surface.

The answer isn’t to try to identify who is masking.

Instead, organisations can ask a more useful question:

What is it about our culture that people might feel they need to hide?

Perhaps people don’t feel comfortable asking for clarification.

Perhaps certain communication styles are treated as more professional than others.

Perhaps opting out of social activities is interpreted as a lack of commitment.

Perhaps people feel they need a diagnosis before they can ask for something different.

Perhaps someone who previously disclosed a difficulty wasn’t taken seriously.

These are things an organisation can examine.

The goal isn’t to encourage everyone to disclose more personal information.

It is to make disclosure less necessary for people to be treated with flexibility and respect.

Building manager confidence without making managers clinicians

One risk when organisations talk about suicide prevention is placing enormous responsibility on individual managers.

That isn’t the goal.

Managers do, however, need enough confidence to respond when someone tells them they are struggling.

That includes knowing:

• How to listen without judgement
• How to take concerns seriously
• Where the limits of their role are
• What internal support is available
• How to signpost someone towards appropriate professional help
• What to do if there is an immediate concern about someone’s safety

Appropriate suicide awareness or mental health training can help people feel more prepared for these conversations.

The aim isn’t to turn managers into mental health professionals.

It’s to reduce the likelihood that fear of saying the wrong thing leads to saying nothing at all.

World Suicide Prevention Day and starting the conversation

World Suicide Prevention Day takes place every year on 10th September.

It provides an opportunity to raise awareness of suicide prevention, challenge stigma and encourage more open conversations about suicide.

For organisations, it can also be a useful prompt to consider the environments people experience before a crisis occurs.

That might mean reviewing your mental health support and crisis procedures.

But it can also mean asking broader questions.

Do people feel able to say when they aren’t coping?

Do managers know where to go when they are concerned about somebody?

Are differences in behaviour met with curiosity or judgement?

Can people ask for different ways of working?

Do people feel they have to hide parts of themselves to belong?

These questions don’t replace appropriate mental health care or suicide prevention services.

But they do help organisations consider the part they can influence.

Frequently Asked Questions

Are autistic people at greater risk of suicide?

Research has found substantially higher levels of suicidal thoughts and behaviours among autistic people than in non-autistic populations. However, estimates vary between studies and suicide risk is complex. Autism alone should not be treated as a simple explanation for an individual’s suicide risk.

Why is suicide risk higher among autistic people?

There is no single cause. Research points to multiple factors including mental health conditions and social, psychological and interpersonal experiences. Experiences such as victimisation, loneliness, exclusion and difficulty accessing appropriate support can also matter.

It is important to consider the whole person’s circumstances rather than assuming autism itself explains suicidality.

What should a manager do if an autistic employee says they are suicidal?

Take what they are saying seriously.

Listen without judgement and follow your organisation’s procedures for supporting someone who may be at risk. Managers should not try to diagnose or provide treatment themselves.

If someone is in immediate danger, emergency support should be sought.

Can a neuroinclusive workplace prevent suicide?

Suicide has complex and multiple causes, so it would be inappropriate to suggest that workplace inclusion alone can prevent it.

What organisations can do is reduce unnecessary workplace barriers and create environments where people are more able to communicate their needs, ask for help and work without constant pressure to hide difference.

Final thought

Suicide prevention cannot only begin at crisis point.

Workplaces cannot control every part of someone’s life. But they can consider the culture and environment they create.

The judgement we withhold matters.

The assumptions we challenge matter.

The way we respond when somebody says they are struggling matters.

And creating workplaces where people don’t have to constantly defend or disguise how they think, communicate and work is something organisations can influence.

What next?

If your organisation wants to create a workplace where different ways of thinking and working are better understood, we support leadership teams, HR functions and all colleagues to recognise barriers, build confidence and create more neuroinclusive ways of working.

Explore how we work with organisations →

If this article has brought up difficult feelings for you, or you’re worried about someone else: In the UK and Ireland, you can contact Samaritans free on 116 123. If you or someone else is in immediate danger, call 999 or go to A&E.

Sources and further reading

Newell, V., Phillips, L., Jones, C., Townsend, E., Richards, C. and Cassidy, S. (2023), A systematic review and meta-analysis of suicidality in autistic and possibly autistic people without co-occurring intellectual disability, Molecular Autism, 14(1), article 12. https://doi.org/10.1186/s13229-023-00544-7

Brown, C. M., Newell, V., Sahin, E. and Hedley, D. (2024), Updated systematic review of suicide in autism: 2018–2024, Current Developmental Disorders Reports, 11(4), pp. 225–256. https://doi.org/10.1007/s40474-024-00308-9