Why simple narratives don’t do justice to the complexity of autism and suicide

Anthony Tricarico loved Pokémon when he was young and weightlifting when he was older. By his junior year of high school, he’d earned a literal armload of medals at various competitions: marathons, martial arts tournaments, insane Spartan races where he navigated grueling obstacles and came out smiling at the end. He had hopes, secrets, frustrations, crushes, resentments and everything else that animates a teenager. He had a whole life. He was a whole person. 

I thought about this a lot while I was writing about Anthony, who I never got to meet. It felt very important to remember how full his short life was. For all this brilliant young man’s interests and complexities, and all of the true things that could be said about him, two facts in particular drove my decision to feature his story: He had been given a diagnosis of autism spectrum disorder at the age of 7, and he died by suicide at the age of 16. 

As a 2025 National Fellow for the USC Center for Health Journalism, I chose to report on the alarmingly high prevalence of suicide and suicidal ideation among autistic children and teenagers. A leading cause of death for kids aged 10 to 18, suicide is a U.S. public health crisis. About 20% of U.S. high schoolers disclosed suicidal thoughts in 2023, according to the Centers for Disease Control and Prevention. Autistic children and teens are even more likely to think about and die from suicide, and at earlier ages, than their neurotypical peers. When the Kennedy Krieger Institute in Baltimore asked caregivers of 900 autistic children if the children had thought about ending their lives, 35% said yes. Nearly one in five had made a plan. The youngest respondent was 8 years old.

I see this story as one of hope, though it may not look that way from a distance. There are researchers working right now to develop and test suicide screening forms, safety plans and other interventions designed specifically for autistic kids, and to understand who within that incredibly diverse population may be most at risk. There are vast networks of parents, psychologists, social workers and pediatricians who care deeply about children and are in a position to be able to help them through crises. Transporting information from research papers to the real world is where journalism can be useful. 

It just has to be carried out carefully.

We describe the reports we produce as “stories,” a word that suggests a series of connected events that lead to a logical conclusion. That’s how our brains make sense of experience; it’s why narrative is so effective at shaping thought and emotion. But real life often refuses to follow a satisfying formula.

There is no single reason why any one individual dies from suicide. There are some traits more likely than others to be associated with suicide deaths or attempts; certain actions or behavioral patterns often precede such crises. But within every demographic with a higher-than-average suicide rate — veterans, rural residents, white men, Native American men — the vast majority of individuals in that cohort never act to end their own lives.  “Why anyone kills himself or herself at a specific time is better not asked,” psychiatrist Avery Weisman wrote at the age of 90, after a lifetime of asking; “it is tricky, enigmatic, and futile.” 

For children and adolescents in particular, the decision to act on a suicidal thought can be extraordinarily impulsive. Irrevocable actions can be prompted by emotional crises so fleeting that even attentive parents or close friends aren’t aware of them. We know this from young people who survived such attempts and can offer insight into the minutes or days that preceded them. For those whose actions are fatal, those private final emotions remain forever a missing piece of the puzzle.

Autism is another layer of complexity. It’s a neurodevelopmental condition whose symptoms cluster around differences in communication, social interaction and sensory processing, and that looks different in essentially every person who has it. Even though all its different presentations share a single diagnosis, autism in real life defies generalization.

The question then is how to tell an honest story about autism, youth and suicide that doesn’t impose an artificially simple narrative onto the complexities of real life, but also doesn’t get so mired in caveats that it ceases to say anything at all. Here are some of the guidelines I followed.

Be transparent with readers about the choices you make. On the project’s landing page, I included a glossary of certain terms I chose to use in the reporting and linked to sources that influenced those decisions, such as the Reporting on Suicide guidelines and autistic advocates’ advice on person-first (“person with autism”) versus identity-first (“autistic person”) terminology. 

It discloses up front why certain details confirmed in the reporting were omitted, or why certain phrasings were chosen over others. I consider this a living document. As my reporting on this topic continues, I’ll learn new things that may change the language choices I make going forward, and I will update it accordingly. 

Correlation isn’t causation, in research or real life. Anthony Tricarico was autistic, male, between the ages of 15 and 24 and had a recent history of depression. All of these traits or characteristics are associated with higher risk for suicide or suicidal thoughts, but not a single one explains why he died. I didn’t want to suggest that autism is somehow responsible for suicide, because it isn’t. I did want to show that most suicide interventions are implicitly designed for neurotypical brains, and that autistic kids will often perceive these interventions differently than their neurotypical peers.

Personal stories and data complement each other, but neither tells the whole story. Good research studies disclose their own limitations, which means they make clear what questions they didn’t consider in the study design and what the paper’s conclusions can’t tell us. We can and should do this in our reporting too.

There are a lot of different reasons why autistic children think about and die by suicide more often than neurotypical peers. They experience trauma differently; they are more likely to be bullied, more likely to have co-occurring mental health diagnoses like depression or anxiety, more likely to have perseverating thoughts. That doesn’t mean any of these things are true for any individual autistic child or teen, or explain why their life unfolded as it did. 

When I wrote about Anthony, I tried to remind myself often that there were so many pieces of this young person’s inner world that I could never know. I tried to write about him as himself, not a stand-in for all autistic young people whose lives end too soon. I knew, as his insightful and generous parents told me, that it’s impossible to know whether understanding more about autism and suicide would have changed his trajectory. But it is also possible that for another child, another family, it might.