Original title: “For me, it is like a tide: it is always there...”: a qualitative exploration of dynamic suicidal thoughts in autistic adolescents
Mirabel Pelton, Lilian Clark, Xinxin Zhu, Ed Flexney +6 · September 2026
Autistic young people face twice the risk of dying by suicide compared to non-autistic peers, yet the reasons why are not well understood. To find out, researchers interviewed nine autistic young people about their teenage years. They found that suicidal thoughts felt constant, shifted constantly like a tide, and could suddenly become crises. These thoughts served different personal meanings and functions. Harmful school settings, feeling pushed to hide autistic traits, rejection, and dismissive health services fueled severe distress. However, building a positive autistic identity helped protect them. Finding neurodivergent communities, using supportive resources, and leaving school allowed them to gain control, cope on purpose, and follow their goals. Living well as an autistic person provided the strongest protection. Even so, setbacks and other people's lack of understanding continued to cause problems. Lasting safety requires fixing damaging school environments and changing how society treats autistic people.
Imagine living near the coast. The tide is always there, rising and falling in a daily rhythm. But sometimes a storm surge makes it flood unexpectedly, and you cannot predict when it will happen. In this paper, the constant presence of suicidal thoughts is like the tide, and the crises are like storm surges triggered by harmful environments and pressures to hide one's true self.
Autistic young people are twice as likely to die by suicide than their peers, yet the reasons are poorly understood. This study gives voice to their experiences, showing how harmful school environments, pressure to mask autistic traits, and invalidation in healthcare fuel suicidal distress. It reveals that lasting prevention requires not just clinical support but structural changes to reduce stigma and create accepting environments.
The study is based on interviews with only nine individuals, so findings may not represent all autistic adolescents. It relies on retrospective accounts from young adults recalling their teenage years, which may be subject to memory bias. As a qualitative study, it identifies themes but does not establish causal mechanisms or test interventions. The conceptual models are derived from a small sample and require further validation.
Ask anything about this paper. Answers come from its abstract, and say so when the abstract doesn't cover your question.
“For me, it is like a tide: it is always there...”: a qualitative exploration of dynamic suicidal thoughts in autistic adolescents — Mirabel Pelton, Lilian Clark, Xinxin Zhu et al. — PsyArXiv — doi:10.31234/osf.io/n6cts_v2
Abstract licence: CC BY
Explanation generated by Synthesis from the abstract — it is not the original paper. This is a preprint, so it hasn't necessarily been peer reviewed.