Trigger Warning: This article discusses suicide and mental health.

While this is Autism Awareness Month, I think it’s important that this is actually said, because it barely gets said at all! This doesn’t trend during Suicide Awareness campaigns, it doesn’t lead Mental Health conversations, and it doesn’t get pushed to the front of policy or media – yet by definition it is a public health crisis. A public health crisis is when a condition leads to significantly higher rates of harm or death within a specific population, requiring an urgent, coordinated response. Autistic people without intellectual disability are reported in major studies to be up to nine times more likely to die by suicide than the general population. That is not a small increase. That is not a “concern.” That is a concentrated, measurable loss of life in a defined group – and it is still not being treated with the urgency that definition demands.

This isn’t just something I talk about. I could have been part of that statistic. I know what it feels like to be in that space, and I am still actively fighting not to become part of it. That reality alone should tell you how close this sits for so many people – and how serious this actually is.

So the question is simple: why is this still not being raised to the top of the pile? We already know enough. Research consistently shows that autistic people without intellectual disability – the group most likely to be overlooked because they can “pass” – experience the highest rates of internalised distress, chronic anxiety, burnout and suicidal ideation. Autistic adults without intellectual disability show some of the highest rates of suicidal ideation recorded across any clinical group, and research into camouflaging directly links long-term masking to increased depression and suicide risk. We know that masking starts early. Autistic children learn quickly in school environments to suppress traits to avoid punishment, exclusion, or being labelled “difficult,” and that suppression does not remove the distress – it internalises it. Add to that sensory overload, constant social translation, and being repeatedly misread – called aggressive when being direct, non-compliant when overwhelmed – and what you get is not a random crisis, but cumulative psychological damage built over years.

This is where the conversation needs to be honest. This is not just a mental health issue sitting within the individual – this is structural. When environments are not built for autistic people, when behaviour is consistently misinterpreted, when people are forced to mask to survive, the outcome is predictable. Burnout, breakdown, and for too many, suicide. That is not coincidence. That is a system producing the same result repeatedly.

And the cost of that inaction is not just the final outcome. It is decades of preventable deterioration leading up to it – misdiagnosis, inappropriate treatment, being cycled through mental health services without recognition of autism, exclusion from education or employment, repeated crisis points that services react to rather than prevent. This is not just loss of life; it is prolonged harm that is already known, already evidenced, and still not being addressed at scale.

So responsibility cannot sit in vague terms like “awareness.” This sits with healthcare systems that fail to identify and support, education systems that punish difference instead of understanding it, policymakers who do not prioritise targeted intervention, and media that continues to overlook it even during the very campaigns designed to highlight suicide and mental health. If it is not being named clearly at those levels, it is not being taken seriously.

And then there is the data we don’t see. The statistics we quote are based on diagnosed individuals. We already know diagnosis is delayed, missed, or completely blocked – especially for those who mask, for people of colour, and for those who have spent years in the wrong parts of the system. So the real figure is not just high – it is almost certainly higher. How many people who have died were never identified as autistic at all? How many are missing from the data entirely?

To put this into perspective, if any other identifiable group had a mortality risk even approaching multiple times higher than the general population, there would be an immediate national response. If a specific profession were dying at that rate, workplaces would be shut down and investigated. If a specific demographic group showed that level of risk, there would be emergency funding, policy intervention, and sustained media coverage until something changed. You would not see silence. You would not see it diluted into general messaging. You would not see it parked at the edges of awareness campaigns. It would be treated as urgent, unacceptable, and in need of immediate action.

Instead, what we have here is clear evidence, repeated findings, and a response that does not match the scale of the problem. Which brings it back to the point – what is the purpose of collecting data that shows elevated suicide risk, higher distress, and poorer outcomes, if it does not lead to change? If the system can identify the pattern but not interrupt it, then it is not preventing harm – it is documenting it.

This is not unpredictable, and it is not unavoidable. The mechanisms are already understood – long-term masking, sensory and social overload, misdiagnosis, and systems that consistently misread autistic behaviour. That is not a coincidence; that is structure. And when a system produces the same outcome repeatedly – burnout, crisis, suicide – that is not an individual failing, it is a system doing exactly what it is currently designed to do. So the question is no longer “why is this happening?” – the evidence answers that. The real question is why, with all of this already known, it is still being allowed to continue.