Are you OK? Safety strategies for Autistics

There is a big trigger warning in this one around mental illness and suicide so if those are not things you want to encounter on your foray into blogland, maybe give this one a miss

I will also note that the strategies in this post are ones I have found helpful. They will not work for everyone and I am not a psychiatrist or mental health professional, so please do not take them as clinical advice.

Picture this scenario:

An employee in a corporate workplace who is Autistic and has schizophrenia comes into work and isn’t feeling great. At lunchtime she has an exchange on social media which exacerbates her difficult time. She wants to stay at work but knows she needs to leave. She tells her supervisor she is having a hard time and the supervisor recommends she goes home  and asks if she will be OK to go home by herself. That evening the supervisor sends the employee a text message checking if she is OK. The employee calls her supervisor, knowing there will be no judgement. They discuss whether she should return to work the next day and they agree it may be a good idea to take the next day off. When the employee returns, her colleagues and managers are happy to see her and ask how she is. There is no judgement, blame or awkwardness – just concern for a colleague with a health issue.

That sounds made up doesn’t it? I can assure you it isn’t. This happened to me a couple of weeks ago. If there was a manual about how to support people with mental illness in the workplace I am sure there would be a big picture of my team. Sadly in many workplaces this is not the norm. In fact in most places mental illness is still viewed with deep unease. People are often afraid to say anything for fear of judgement. Yesterday was R U OK day in Australia – and possibly elsewhere. The point being to ask people if they are OK and help address difficulties with mental illness and support people to stay safe form suicide. There are no doubt a good many blogs and articles about this. But what about the experiences which Autistic people have around these things?

Autistic people are at a considerably higher risk of suicide than neurotypical people (although of course ‘neurotypical’ is a group encompassing other groups with a high risk of suicide so this isn’t a very accurate grouping but suffice to say Autistic people have huge issues in this area). Autistic people also experience mental illness conditions which can be missed entirely or we may be misdiagnosed with an inappropriate mental illness ‘label’ which makes matters worse.

Services for Autistic people with mental illness are sadly deficient in a lot of areas. Many mental health clinicians have a limited or very poor understanding of Autism, especially in adults. Accusing ‘help’ can be very unhelpful. While it is a good general principle to seek help for health issues, many Autistics are reluctant to do so after a history of mental health support which in fact is not at all supportive.

Many Autistic people have alexithymia, also known as emotion blindness. This does not mean we lack emotions but the we struggle to articulate or connect with our emotions, In terms on mental illness, alexithymia is a big risk factor for a variety of reasons. The first is that we may be unaware we are experiencing anxiety, depression or other mental illness symptoms. The point at which we are aware of these is when they are severe and entrenched. Alexithymia also makes it hard to gain helpful treatment for mental health issues. Clinicians often ask ‘how do you feel?’ This can be extremely counterproductive to those with alexithymia who either answer ‘good’ as that is what they were taught to say or just be completely baffled – both of which are responses unlikely to result in assistance.

Autistic people have often had frequent experiences of hostility, bullying, discrimination and exclusion by people they come across in life. We may have few or no friends and / or be estranged from family members. It is hard to remain connected and positive if you feel completely alone. We may feel misunderstood and disconnected from the human race.

This has got quite dark and frightening. I certainly don’t want to suggest we can do nothing about this because actually we can. There are some ‘Are you OK?’ strategies which Autistic people can put in place to help us address these risk factors and challenges. These include:

  • Despite feeling disconnected and isolated, many of us are in fact do not have to be alone. There are many forums for Autistic people to connect with others, through things like online or in-person social groups. I  know some people are isolated but there are ways to connect. For me the online world is my main social outlet. I love typed communication and not having to look at people when I talk to them.
  • Usually the riskiest time for suicide coincides with a mental health crisis. Mental health crises are a little like meltdowns. As with meltdowns there is a time limit. Usually – and I have this on authority from a number of sources – the risk period for a mental health crisis is between twenty minutes to an hour at the most. When I am in crisis I am definitely at a much higher risk of making regrettable decisions, however these days I tell myself, during a crisis, that it will pass and things will change one way or another. This is a skills it has taken me some time to learn but is a very useful one. Keeping a general awareness of the timeframe is often helpful even if you can’t consciously articulate that during a crisis.
  • Very simple one which is actually often ver difficult to do: If you are feeling suicidal, tell someone.
  • A lot of people are terrified of going to the psychiatric ward. I understand this – I have been there many times in several difference States and Territories and have no intention to return. However if you need to be there it is better than the alternative of taking your life. A lot of the issue is shame and stigma but in fact you are seeking help which is a very positive step and in my life has meant the difference between me being here and not.
  • If you are frightened for your safety in the ‘heat of the moment’ a helpful strategy is spending time with a friend (and if you do this, if you can, explain the reasons for wanting to see them – not only will this hopefully make them more likely to come over but also means you can be honest and talk through issues if you need to). Some people do not have this kind of support so related strategies include contacting a helpline service such as Lifeline – which also has an online typed chat option, intentionally distracting yourself with an activity (this actually works quite well for many people despite sounding simple) and being around people or pets. It is much harder to take your life is you are around people or creatures that you love. In fact being around strangers has been shown to be a protective factor as well so if you have no available friends or pets going somewhere there are people can be helpful.
  • And I will leave you with another little me story. In the late 1990s my mental health was appalling. There are a good many times that I should not have been around. At the time I hated myself and my life. I even asked a psych nurse once if they still did lobotomies because I felt that would be better than the hell I experienced. I was homeless, long term unemployed and utterly miserable. My notion of the future was pretty much the coming Thursday. I could not see any value or point to my life. Regular readers of this blog will know that I actually somehow ended up with a lot of reasons to live. Not only that but I now have this amazing and somewhat enviable life, I am happy and engaged and I have a most amazing cat and house full or art. I could not think of anyone;s life I would rather have than mine. It’s just  wonderful. And I came so close on many occasions to throwing it away. Whatever happen your life will change on one way or another, I am very grateful I didn’t;t throw away my tomorrow due to the misery in my today, You really do not know what is in the future unless you stick around to see it.

I really hope you weren’t triggered by this blog, If you do need to talk to a counsellor, Lifeline has either online chat at https://www.lifeline.org.au/get-help/online-services/crisis-chat

or a phone service on 131 114 which is 24 hours, 7 days

This service is in Australia only. There are sinker services in many otier countries.

My mental illness is just one of my attributes. I don;t know why I would ever feel ashamed of it

 

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