For many years, it was assumed that individuals with intellectual and developmental disabilities (IDD) rarely experienced suicidal ideations and behaviors. Unfortunately, however, recent research has shown otherwise. In fact, young adults with IDD report suicidal ideation and behaviors at higher rates than their peers without disabilities (Fields et al., 2025). These findings challenge outdated assumptions, and emphasize the need for suicide prevention efforts that include people with disabilities, utilizing strategies that are accessible to the individual.
This truth is heavy, but acknowledging this reality is an essential step towards prevention. A
widely used mnemonic for recognizing potential warning signs is IS PATH WARM:
- Ideation
- Substance abuse
- Purposelessness
- Anger
- Trapped
- Hopelessness
- Withdrawal
- Anxiety
- Recklessness
- Mood change
While it is important to look for these signs, it is also vital to note that signs of suicidal ideation in individuals with IDD may not be displayed as traditional verbal cues. The signs can also appear through shifts in body language, gestures, and posture. For individuals with IDD, changes in behavior, routines, or emotional expression can be signs that something is “off.” Caregivers, peers, and professionals should remain attentive to sudden changes and trust their instincts if they think something is wrong.
Suicide prevention is never one-size-fits-all. The CDC outlines broad strategies for suicide prevention, such as creating protective environments, teaching coping and problem-solving skills, improving access to care, and reducing risk factors. While these provide a foundation, prevention efforts for individuals with IDD also require adaptation, aiming to build support systems that are accessible and purposeful.
For caregivers:
Caregivers are often the first to notice when something is different. Because of this, it’s crucial for caregivers to have the proper training and support to act swiftly and with compassion.
Ask the hard questions - After noticing warning signs of suicidal ideation, ask the individual how they’re feeling. Caregivers can use alternative communication strategies, adapting questions to fit the communication needs of the individual.
Safety Planning - Safety planning is a brief intervention designed to help individuals work through a suicidal crisis by creating a step-by-step plan to lower the risk of engaging in suicidal behavior and taking action steps towards regulating themselves (Stanley et al., 2018). The Stanley-Brown safety plan utilizes six key steps:
- Warning signs - intervene before it becomes a crisis.
- Internal coping strategies - identify techniques that can be used to manage stress or distress before it escalates.
- Use people and social settings to provide distractions.
- Reach out to friends, family or caretakers that can provide support during a crisis.
- Contact professionals or agencies who can provide support during a crisis
- Making the environment safe - Reduce or remove items that can be used for physical harm.
For individuals with IDD:
Empowering individuals themselves is central to prevention. This can look like:
Practicing self-advocacy - Asking for help isn’t easy, but it is vital. Educating individuals with IDD on suicide and suicidal ideation enables them to recognize warning signs and know when/how to ask for help.
Developing and internal coping strategies - Internal coping strategies are techniques that individuals can use to manage any escalation of suicidal thoughts or behaviors. They can include breathing exercises, distraction (hobbies, music, tv.), physical activities, creative activities, or cognitive reframing.
Building a “circle of support” - No one should go through things alone. Identifying a trusted group of people gives individuals a clear list of who they can reach out to when things begin to feel overwhelming,
Suicide prevention for individuals with IDD is not only possible, it is essential. With awareness, adaptation, and strong support networks, warning signs can be recognized early and responded to with compassion. By reducing stigma, expanding access to resources, and equipping both caregivers and individuals with practical tools, suicide prevention for people with IDD becomes more effective. Mental health matters for everyone and no one should struggle alone.
If you or someone you know is in crisis, call or text the 988 Suicide & Crisis Lifeline at 988.
Resources:
1. https://www.ajpmonline.org/article/S0749-3797(21)00371-8/abstract
2. https://www.cdc.gov/suicide/prevention/index.html
3. https://www.relias.com/blog/disability-and-suicide
