Project Summary

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

PCORI has identified suicide prevention among youth as an important research topic. Suicide rates in the United States have been increasing over the past two decades, and the COVID-19 pandemic may have led to further increases. Patients, caregivers, clinicians, and others want to learn: What are effective ways of preventing suicide among youth ages 15 to 24? To help answer this question, PCORI launched an initiative in 2020 on Suicide Prevention: Brief Interventions for Youth. The initiative funded this research project and others.

What is the research about?

Suicide is a leading cause of death among youth. Autistic people are much more likely to attempt suicide and to die by suicide than non-autistic people. Questions remain about how to best help autistic youth who are at risk for suicide.

In this study, the research team is comparing two ways to help autistic youth manage thoughts of suicide and reduce suicidal behaviors. In the first way, a clinician works with the patient to create a safety plan using an approach that is tailored for autistic youth. Then the clinician provides follow-up care. The second way includes a tailored safety plan without follow-up care. A safety plan helps patients understand warning signs for suicide and find resources to prevent suicide.

Who can this research help?

Results may help doctors and healthcare administrators when considering ways to prevent suicide among autistic youth.

What is the research team doing?

The research team is enrolling 150 clinicians from four healthcare systems across the United States. The team is assigning clinicians by chance to provide safety plans with or without follow-up care for their patients with autism who are at risk for suicide. Follow-up care occurs via telehealth visits. During these contacts, clinicians assess patients’ suicide risk, review the safety plan, and help patients start mental health treatment. All patients receive at least two follow-up visits.

Patients include 1,500 autistic youth ages 15–24 who are receiving care from clinicians in the study. The research team is assessing youth at the first clinic visit and 1, 6, and 12 months later. Patients answer questions about:

  • Suicidal thoughts and behaviors
  • Mental health treatment
  • Quality of life
  • Well-being
  • Skills to manage thoughts of suicide
  • Access to things that they can use to self-harm
  • Safety plan use
  • Use of acute care services for suicidal thoughts and behavior

The research team is also asking 60 youth, 40 clinicians, and 15 healthcare administrators about their views on the safety planning process.

Autistic people, including people who have had suicidal thoughts and behaviors, their families, and clinicians are helping to plan and conduct this study.

Research methods at a glance

Design Element Description
Design Randomized controlled trial
Population 1,500 autistic youth ages 15–24 who are at risk for suicide; 150 clinicians who serve autistic youth in diagnostic, primary care, or medical specialty clinics; 15 organizational leaders across the 4 study sites in Pennsylvania, Ohio, Maryland, and North Carolina
  • Safety planning intervention for autistic individuals
  • Safety planning intervention for autistic individuals plus structured follow-up care

Primary: suicidal ideation, suicidal behaviors

Secondary: mental health treatment initiation and engagement, quality of life, social well-being, skills to manage suicidal thoughts, access to lethal means, safety plan use, and acute care services for suicidality

Timeframe Timeframe Length of follow-up for collecting data on primary outcomes. View Glossary 1-year follow-up for primary outcomes

Project Information

Brenna Maddox, PhD
Shari Jager-Hyman, PhD
The University of North Carolina at Chapel Hill
A Comparison of Two Brief Suicide Prevention Interventions Tailored for Youth on the Autism Spectrum

Key Dates

July 2021
January 2028

Study Registration Information


Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: April 12, 2024