This might be controversial on International Men’s Day, where we are meant to ‘focus on promoting men’s health and wellbeing, raising awareness for men’s mental health issues, celebrating positive male role models’ – but I find it hard to celebrate when we are still facing a suicide crisis.
Suicide rates aren’t dropping in any sustained way, despite the same slogans and the same tactics year after year. From a logical perspective, if the approach isn’t working, why are we repeating it?
As an autistic person, I’m looking at what the data actually says – and who is being left out. At the top of the list of men dying by suicide are autistic men without an intellectual disability. Multiple studies have found significantly elevated rates of suicidal thoughts and attempts among autistic adults compared with the general population, and this heightened risk is especially pronounced among those without an intellectual disability. If that’s what the research consistently indicates, why isn’t this front and centre in men’s mental health campaigns? If some groups are at far higher risk, shouldn’t that be highlighted explicitly? I’m yet to come across a mainstream high-profile health service that approaches this.
We already do this in other areas of healthcare. For example, prostate cancer awareness and screening campaigns frequently emphasise the higher risk among Black men. High-risk groups are named, resourced, and targeted – because it saves lives! So why, when it comes to mental health and suicide prevention, are autistic and the wider neurodivergent communities ignored?
I keep seeing “It’s okay to talk.” I have been talking (for over two decades) even through traumatic suicide attempts and without trauma therapy afterwards! What happens when “talking” doesn’t work because the service you’ve been offered misunderstands your communication style, sensory profile, or needs? Who is “it’s okay to talk” actually for, if the system on the other side isn’t prepared to listen differently, respond differently, and provide neurodiversity-affirming care?
After more than 20 years in the mental health system with a bipolar disorder diagnosis, the moment I received an autism diagnosis (and later ADHD), my support was taken away – as if autism explained everything and therefore all my mental health issues went away! How does that make sense? Autism should change how support needs are delivered, but it should not be used as a reason to remove support altogether. That speaks volumes about the system; for one, it shows that it is fragmented and doesn’t know where neurodiversity “belongs” – so people continue to fall through the cracks, and we as a society are stuck in this cycle.
If the current approach were working, we would see sustained reductions in suicide rates across groups that are most at risk, especially autistic men without intellectual disability. We don’t! That should be a huge indicator to change the strategy and approach.
Some Questions..
- Why aren’t men’s mental health campaigns explicitly naming autistic and neurodivergent men as a high-risk group, the way other health campaigns highlight specific high-risk populations?
- Why are outcomes for autistic adults treated as an afterthought when the risk signals are so strong?
- Who designed the current “it’s okay to talk” model, and was it designed with autistic communication and sensory needs in mind, or only for neurotypical conversational norms?
- Why do mental health services withdraw after an autism diagnosis instead of adapting with autism-informed, trauma-informed, and sensory-informed care?
- Where is the separated group data? Are we tracking suicide, self-harm, and service outcomes by neurotype, co-occurring conditions, gender, ethnicity, and socioeconomic status to see who is falling through the cracks?
- Why aren’t frontline staff (A&E, crisis teams, community mental health, police, probation, housing) universally trained in autism-informed crisis response – more than half-day courses?
- Why are reasonable adjustments (sensory environments, longer/shorter appointments, written follow-ups, clear structure, predictable plans) still treated as optional rather than standard?
- Who is accountable when a diagnosis results in less support, not better-tailored support? Where can people appeal that decision quickly?
If We’re Serious About Change
- Put high-risk groups in the headline, not the footnotes. Say it plainly: autistic men (especially without intellectual disability) face elevated suicide risk.
- Redesign “talk” to include different ways of communicating: written options, asynchronous support, visual plans, sensory-friendly spaces, and clinicians trained to avoid misreading autistic communication as “non-engagement.”
- Autism (or ADHD) diagnosis should trigger tailored support, not discharge – if in under mental health services.
- Fund neurodiversity-affirming peer specialists in crisis teams and follow-up services.
- Require demographic group data, publish it, and tie funding to measurable improvements among the highest-risk groups.
Right now, the approach doesn’t seem to be working – especially not for those at the top of the risk pile. If we want different results, we need a different approach, not more of the same (which isn’t working but also excludes the neurodivergent community). Until this changes, we will continue to repeat the same cycle with the same heartbreaking outcomes.
International Men’s Day, Autism, and a System That Still Isn’t Listening – 19.11.25
