what is the span.toolkit?
The Suicide Prevention for Autism Neuroaffirming (span.toolkit) is an evidence-based, co-produced resource portal designed to support mental health professionals working with autistic adults.
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1 in 3 autistic people experience thoughts of suicide
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Autistic people are significantly more likely to die by suicide than the general population.
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Autistic people face significant barriers to effective, autism-informed mental healthcare.
The span.toolkit provides validated, autism-adapted clinical tools for identifying and managing suicidal thoughts and behaviour, lived experience-led education and training materials, and policy resources to support leaders and executive decision-makers in driving service-level change across clinical and community settings.
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These resources were co-developed with lived experience and healthcare experts to reflect the real-world needs and priorities of the autistic community, and to equip the healthcare sector with the tools and knowledge to better support autistic adults.
neuroaffirming training
& resources.
Practical, neuroaffirming training materials co-developed with autistic adults and mental health professionals. It includes short videos and fact sheets that introduce key concepts in autistic communication, distress, mental health care and suicide prevention.
suicide screening
& assessment.
Validated, autism-adapted tools for screening and assessment of suicidal thoughts and behaviour, training resources, and demonstration videos.
suicide safety planning.
Validated, autism-adapted safety planning tool, training resources, and demonstration videos.
policy.
Aimed at leaders in the healthcare sector using a real-world example of integrating autism practices into mainstream healthcare services. Associated policy guidelines and organisational recommendations.
applying the framework
Explore the key areas of this framework in more detail, with practical strategies for delivering neuro-affirming care. These fact sheets are free to download, print and share.
clinical insights.
clinical considerations.
There are a range of factors that can impact the risk of suicidal thoughts and behaviours in autistic adults. These information sheets outline some key areas for healthcare professionals to be aware of.
support tools.
These support tools are free to download, print and share. Designed to be used during intake, early engagement, or ongoing work, these can be adapted across different clinical and community contexts.
Identifying Support Needs
Jodie Wilson | A New Neuroaffirming Framework.
Jodie discusses her research on autistic adults’ experiences of seeking and receiving mental health support, and introduces a framework for developing trust and safety in four key areas: Communicate with Me, Understand Me, Help Me Understand Myself, Support Me
Dr Jodie Wilson, BVSc, MAPP is an autistic researcher & lived experience expert based at the Olga Tennison Autism Research Centre, La Trobe University.
neuroaffirming training & resources.
Clear, accessible guidance informed by lived experience and healthcare expertise. These videos and fact sheets are suitable for anyone supporting autistic adults, including allied health and medical professionals working independently or as part of a multidisciplinary team.
lived experience perspectives.
Wenn Lawson | Monotropism, Autistic Experiences, and How Clinicians can Bridge the Gap
Wenn challenges common myths about autism and unpacks monotropism, object permanence, masking, and sensory overwhelm. He shares advice for clinicians on creating safe and accessible environments, and validating autistic experiences.
Associate Professor Wenn Lawson, PhD is an autistic researcher, clinician, and lived experience expert based at Curtin University. Wenn is a consultant and peer worker for the Monash Health Mental Health and Adult Autism Project.
Stacey Rabba | Delayed Diagnosis and Suicide Risk.
Stacey discusses the impact of late or missed diagnoses on mental health, and how direct questions and visual tools can help to identify suicidal thoughts and behaviour in autistic people.
Dr Stacey Rabba, PhD is a senior psychologist and founding member of the Mental Health Care & Adult Autism Project at Monash Health.
Umesh Babu | Recognising Autism and Asessing the Risk of Suicide
Umesh outlines how autism is often missed in adult mental health assessments, why suicide risk assessments and safety plans should be adapted for autistic people, and key differences in autistic communication, sensory processing, and outward signs of distress.
Dr Umesh Babu, RANZCP is a consultant psychiatrist and founding member of the Mental Health Care and Adult Autism Project at Monash Health.
Tayla John | A New Model of Care for Autistic Adults
Tayla explores differences in outward displays of autistic distress and how to recognise it, modified approaches to suicide risk assessment, and what a multidisciplinary team can offer an autistic client.
Tayla John, BNurs, PGDip (Mental Health Nursing Practice), MAdvNursPrac, is a mental health nurse and adult autism clinical specialist in the Mental Health Therapy Services at Barwon Health
Jackie Chanzi | Autistic Communication, Safety, and Feeling Believed in Healthcare
Jackie shares her experiences of misinterpretations of autistic communication, the impact of not being believed, and what helps autistic people feel safe and respected in healthcare settings.
Jackie Chanzi is an autistic advocate & lived experience expert.
span.toolkit manual.
The span.toolkit provides autism-adapted tools for screening, assessment, and management of suicidal thoughts and behaviour, alongside training resources that demonstrate their use in clinical settings.
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Step-by-step guidance for using the Suicidal Ideation Attributes Scale - Modified (SIDAS-M), Suicide Assessment Kit - Modified Interview (SAK-MI), and Autism Adapted Safety Plan (AASP).
The span.toolkit manual includes psychometric properties, scoring and interpretation guidance, visual scales, and recommended next steps to support autistic adults who are experiencing or at risk of elevated suicidal thoughts and behaviour.
suicide screening and assessment.
This section provides mental health professionals with validated, autism-adapted tools for screening and assessment of suicidal thoughts and behaviour, along with training resources demonstrating their use in clinical settings.
screening.
Suicidal Ideation Attributes Scale, Modified (SIDAS-M)
The Suicidal Ideation Attributes Scale - Modified (SIDAS-M; Hedley et al. 2023) is a screening tool designed to identify and assess suicidal thoughts in autistic adults without intellectual disability. The SIDAS-M was co-developed with autistic people and has been validated as a self-report instrument. It can also be administered by a clinician as an interview, or completed with support if required. Because autistic people may interpret and respond to questions differently, the SIDAS-M was adapted to include more concrete language, explainers for complex or ambiguous terms, and a visual response scale.
The SIDAS-M consists of five items, each targeting a different attribute of suicidal thoughts: Frequency, Controllability, Closeness to attempt, Distress, and Interference with daily activities. Responses are measured on a 10-point scale, and items are coded so that a higher total score reflects more severe suicidal thoughts. We recommend that a score ≥1 is followed up by a suitably trained healthcare professional to assess possible suicide risk.
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Administering the SIDAS-M
A role-play activity demonstrating how to administer the SIDAS-M as an interview by using the visual response scales provided. We recommend you complete the coding as you view the video, and check your responses with those provided in the manual.
Professor Mark Stokes, PhD is a psychologist, autism researcher, and leader of the Healthy Autistic Life Lab at Deakin University. Mark is playing the role of administering clinician in this activity.
Alister is a lived experience autistic community member. Alister is playing the role of client in this activity.
Ensu Sahin, BPsych (Hons), MPsych (Clinical) is a clinical psychologist and autism researcher, and provides a clinical perspective along with some recommendations for further actions.
Reference
Hedley, D., Batterham, P. J., Bury, S. M., Clapperton, A., Denney, K., Dissanayake, C., Fox, P., Frazier, T. W., Gallagher, E., Hayward, S. M., Robinson, J., Sahin, E., Trollor, J., Uljarević, M., & Stokes, M. A. (2023). The Suicidal Ideation Attributes Scale-Modified (SIDAS-M): Development and preliminary validation of a new scale for the measurement of suicidal ideation in autistic adults. Autism: The International Journal of Research and Practice, 27(4), 1115–1131. https://doi.org/10.1177/13623613221131234
assessment.
The Suicide Assessment Kit-Modified Interview (SAK-MI)
The Suicide Assessment Kit - Modified Interview (SAK-MI; Hedley et al. 2025) is a structured clinical interview for assessing suicidal thoughts and behaviour in autistic adults without intellectual disability. The SAK-MI was co-developed with autistic people, clinicians, and suicide-prevention experts to ensure that the questions, wording, and response options are accessible, concrete, and neuroaffirming.
The SAK-MI guides clinicians through 11 standardised questions and follow-up prompts to support accurate assessment and clinical decision-making. Due to the difficulty in predicting suicide attempts, the SAK-MI does not provide risk stratification categories. Instead, it includes suggested clinical actions based on responses. Irrespective of a client’s responses, we recommend that all autistic people presenting to healthcare services be monitored for possible suicidal thoughts and behaviour.
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Administering the SAK-MI | Scenario 1
This role-play series demonstrates how to administer the SAK-MI, for training purposes. As you view each video, we recommend completing the coding algorithm and checking your responses against the scoring guidance provided in the manual. The three videos represent different clinical presentations and are designed to develop competence in coding client responses.
Professor Mark Stokes, PhD is a psychologist, autism researcher, and leader of the Healthy Autistic Life Lab at Deakin University. Mark is playing the role of administering clinician in this activity.
Dr Simon Bury, PhD is a clinical psychologist and autism researcher at the Olga Tennison Autism Research Centre at La Trobe University. Simon is playing the role of Luke, the client in this activity.
Ensu Sahin, MPsych (Clinical) is a clinical psychologist and autism researcher. Ensu provides a clinical perspective along with some recommendations for further actions.
Administering the SAK-MI | Scenario 2
Administering the SAK-MI | Scenario 3
Reference
Hedley, D., Williams, Z. J., Deady, M., Batterham, P. J., Bury, S. M., Brown, C. M., Robinson, J., Trollor, J. N., Uljarević, M., & Stokes, M. A. (2025). The Suicide Assessment Kit-Modified Interview: Development and preliminary validation of a modified clinical interview for the assessment of suicidal thoughts and behavior in autistic adults. Autism: The International Journal of Research and Practice, 29(3), 766–787. https://doi.org/10.1177/13623613241289493
suicide safety planning.
This section provides mental health professionals with a validated, autism-adapted safety planning tool, along with training resources demonstrating how to develop a plan in clinical settings.
Autism Adapted Safety Plan (AASP)
The Autism Adapted Safety Plan (AASP; Rodgers, Cassidy, Pelton et al. 2024) is a personalised safety plan developed for autistic adults experiencing suicidal thoughts and behaviour. It is intended for use before the person reaches a crisis point. The plan outlines the steps an autistic adult can take to stay safe when they are experiencing suicidal thoughts or urges. The AASP was modified with autistic people to include clearer instructions, examples, and prompts to improve usability, reduce ambiguity, and better reflect autistic experiences.
Each safety plan should be written in the person’s own words and can be completed independently or with support from a trusted person, such as a friend, family member, supporter, or healthcare professional.
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A Discussion of Safety Plans and Suicide Prevention
An overview of safety plans and suicide prevention focusing on the Autism Adapted Safety Plan (AASP) including the importance of personalisation, response to crises, risk factors and masking/camouflaging.
Associate Professor Sarah Cassidy, PhD is an autism researcher based at the University of Nottingham in the United Kingdom. Sarah’s research focuses on autistic mental health and suicide prevention.
Tips for Developing an Autism Adapted Safety Plan (AASP)
A guided discussion about each of the sections included in an AASP, and tips for developing a safety plan with an autistic client.
Reference
Goodwin, J., Gordon, I., O'Keeffe, S., Carling, S., Berresford, A., Bhattarai, N., Heslop, P., Nielsen, E., O'Connor, R. C., Ogundimu, E., Pelton, M., Ramsay, S. E., Rodgers, J., Townsend, E., Vale, L., Wilson, C., & Cassidy, S. (2025). Adapting Safety Plans for Autistic Adults with Involvement from the Autism Community. Autism in Adulthood, 7(3), 293–302. https://doi.org/10.1089/aut.2023.0124
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Rodgers, J., Cassidy, S., Pelton, M., Goodwin, J., Wagnild, J., Bhattarai, N., Gordon, I., Wilson, C., Heslop, P., Ogundimu, E., O'Connor, R. C., Ramsay, S. E., Townsend, E., & Vale, L. (2024). Feasibility and acceptability of autism adapted safety plans: an external pilot randomised controlled trial. EClinicalMedicine, 73, 102662. https://doi.org/10.1016/j.eclinm.2024.102662
Developing a Safety Plan
A role-play activity demonstrating how to develop an AASP. This demonstration does not include many of the possible adaptations that may be applied when developing the tool with or by an autistic person. When viewing the video, we recommend identifying possible adaptations or materials that could be used to support development of the safety plan. For further suggestions, review the AASP website and the span.toolkit manual.
Professor Mark Stokes, PhD is a psychologist, autism researcher, and leader of the Healthy Autistic Life Lab at Deakin University. Mark is playing the role of administering clinician in this activity.
Dr Simon Bury, PhD is a clinical psychologist and autism researcher at the Olga Tennison Autism Research Centre at La Trobe University. Simon is playing the role of Luke, the client in this activity.
policy.
Healthcare professionals, leaders, and executives are encouraged to incorporate the frameworks and principles presented in the span.toolkit to support the delivery of psychologically safe, neuro-affirming care for autistic adults.
While the clinical tools in the span.toolkit focus on suicide screening, assessment, and safety planning, this section focuses on the broader service-level practices and organisational conditions that support their effective use across clinical and community settings.
The accompanying video draws on real-world experience to highlight how leadership, workforce capability, and system design influence the successful integration of autism-adapted practices within mainstream mental health services.
policy position.
OTARC Suicide in Autism-Research Evidence and Policy Brief
OTARC Response to the Mental Health and Suicide Prevention Agreement
leadership, system change, & autism-informed mental health care.
Aimed at leaders and executives in the healthcare sector, Robyn draws on her experience of integrating autism expertise successfully into a large, mainstream mental health service. Robyn outlines why public mental health services should recognise and support autistic adults, and how system-level leadership can drive meaningful change. She discusses the importance of workforce capability, adapting suicide risk assessments, improving access, and the powerful role of peer experts in shaping a more responsive and effective service.
Robyn Humphries OAM, is Deputy Operations Manager of Clinical Operations for the Clayton Area Mental Health Service at Monash Health.
organisational recommendations.
The span.toolkit aligns with national suicide prevention priorities and best-practice approaches to autistic mental health. However, all information presented in the span.toolkit is intended to complement - not replace - existing organisational policies, clinical governance frameworks, and professional training.
We recommend that managers and service leaders review existing organisational policies and procedures, in consultation with staff, to ensure that appropriate systems, governance, and supports are in place for the safe and effective integration of span.toolkit resources.​