Unrecognized Even in Death: The Statistical Invisibility of Autistic People in Brazilian Suicide Mortality Records

Suicide is a leading cause of premature death in Brazil. Some groups are at higher risk of committing suicide, including individuals with Autism Spectrum Disorder (ASD). This study aimed to assess whether autistic people are being identified in Brazilian official mortality records and whether this condition is being acknowledged as a contributing factor to suicide.

We assessed a standardized version of the Brazilian Mortality Information System (SIM), filtering deaths by suicide from 1996 to 2024 in which the underlying cause of death was intentional self-harm, sequelae of intentional self-harm, or undetermined intent possibly due to self-harm. Variables potentially indicating contributing conditions related to ASD or intellectual disability (ID) were examined.

Of 579,121 deaths by suicide, only 81 certificates recorded ASD or ID, and only 16 recognized autistic people. Fifteen were men, with a mean age 33.5 ± 17.2 years. The first certificate listing ID was in 2000; the first mentioning autism was not until 2008.

Our findings suggest under-reporting of ASD as a factor relevant to suicide and a substantial disparity compared to other countries' statistics. Improving certifying professional training and integrating datasets may enhance suicide prevention efforts for people with neurodevelopmental conditions.