# Experiences and Outcomes of Suicidal Individuals with and without Autism in Emergency Departments Nationwide

> **NIH NIH R21** · UNIVERSITY OF PENNSYLVANIA · 2022 · $201,358

## Abstract

PROJECT SUMMARY/ABSTRACT
Over half a million people in the U.S. present annually to Emergency Departments (EDs) for suicidal ideation
(SI) and/or suicidal behavior (SB). After leaving the ED, their short-term risk of repeated self-harm and death
by suicide are exceptionally high. Individuals with autism spectrum disorder (ASD) are disproportionally
represented among those seen in the ED for suicide-related emergencies. Individuals with ASD are up to nine
times more likely to experience SI and up to five times more likely to attempt suicide than the general population.
Despite their increased risk for suicide and high rates of suicide-related ED visits, little is known about the
experiences or outcomes of suicidal individuals with ASD seeking emergency care. The proposed mixed
methods study will contribute to long-term efforts to reduce deaths by suicide by informing the adaptation and
implementation of evidence-based practices for suicide prevention for individuals with ASD. The study
objectives are: (a) to use a retrospective, longitudinal design to compare the experiences and outcomes of
individuals with and without ASD who sought care for SI or SB in EDs nationwide; and (b) to interview key
stakeholders about ways to improve ED-based suicide prevention practices and increase post-ED mental
health treatment engagement for individuals with ASD. Claims records from over 100 million publicly- and
privately-insured individuals will be used to ascertain and follow a diverse national cohort of patients with a
suicide-related ED visit. Hospital- and county-level information will be drawn from the American Hospital
Association Annual Survey Database, SAMHSA National Survey of Mental Health Treatment Facilities, and
Area Resource File. Outcome variables include ED discharge disposition, outpatient mental health service
utilization, SI or SB recurrence, and death by suicide (from the National Death Index). Semi-structured
interviews with individuals with ASD and suicide-related ED visits, their family members, and ED physicians
will elaborate upon the quantitative findings and inform potential targets for future ED-based intervention and
implementation strategies. Results will help policy makers and healthcare workers across the U.S. to better
understand critical points of prevention and intervention for suicidal individuals with ASD. This project is well-
aligned with the Interagency Autism Coordinating Committee's objective to reduce disabling co-occurring
mental health conditions and premature mortality in people with ASD, and NIMH's Strategic Objective 4 focused
on strengthening the public health impact of NIMH-funded research.

## Key facts

- **NIH application ID:** 10487447
- **Project number:** 5R21MH125262-02
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Shari Jager-Hyman
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $201,358
- **Award type:** 5
- **Project period:** 2021-09-10 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10487447

## Citation

> US National Institutes of Health, RePORTER application 10487447, Experiences and Outcomes of Suicidal Individuals with and without Autism in Emergency Departments Nationwide (5R21MH125262-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10487447. Licensed CC0.

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