The system is not safe for everyone; Non-Carceral Crisis Resources for Autistic People

Apr 30

I have been working as a therapist and social worker for more than two decades. Over the last decade I have become more aware of similarities in the people I most appreciate working with, many of them are similar to myself and people I am close to. As time goes on I have realized just how unprepared I was by my formal graduate training many years ago to support these people in a holistic way. Before I even chose the path of psychology and social work in college, I had experienced friends and family members with various mental health differences and challenges. And I observed the many ways in which the systems that existed to support people were over worked, under funded and more importantly not informed enough. That lack of information, lack of understanding that there was information missing, that crisis support needed to look different for a variety of different human experiences, it still exists today - more than thirty years later. And it causes harm to individuals, families, communities and generations.

Throughout the time I have been working as a social worker and therapist, I have worked to support parents and individuals with suicidal ideation in sessions, between sessions and after hospitalizations. The presentation of some clients after crisis hospitalizations can be more dysregulated, traumatized, and more distrustful of help-seeking than before. I have worked with Autistic adults who called crisis lines in a moment of genuine desperation and were met with responders who didn’t understand them, misread their communication style. Or in some cases inadvertently escalated the situation rather than de-escalating it. These are not rare stories. They are patterns.

A recent Los Angeles Times investigation brought renewed attention to what many in the Autistic and disability communities have long known: crisis lines, police, and hospital systems have caused disproportionate harm to Autistic people. The training gaps for health professionals and crisis workers are real. The consequences are real. And for Autistic people who are also LGBTQ+, the compounded marginalization makes the stakes even higher. In our county almost two months ago, we lost 25 year old Alexander LaMorie, a member of the Autistic community, due to gaps in understanding, knowledge and follow through.

Autistic people face significantly elevated rates of suicidal ideation and suicide attempts compared to the general population. This has been shown in recent research to be a predictable outcome of living in a world built for neurotypes other than your own. A world that often pathologizes difference, demands masking, and offers little room for sensory, social, or regulatory needs. The crisis is real. What has not kept pace is the infrastructure of care.

That is what this post is about. Not the crisis itself, but the gap between the crisis and the care. And what actually exists, right now, that may be safer, more affirming, and more effective for Autistic people in distress.

Why Standard Crisis Systems Often Fall Short

One of my first jobs as an undergraduate was working for a crisis line. Training on communication, listening, assessment and triage were provided. And now I know so many things were missing. Standard crisis infrastructure was not designed with Autistic people in mind. Crisis lines rely heavily on verbal communication, linear narrative, and the ability to quickly establish rapport with a stranger. These are all things that can be genuinely difficult or impossible for Autistic people in a state of acute distress. Responders may interpret flat affect, non-standard phrasing, or communication differences as resistance, intoxication, or a threat rather than what they often are: signs of a nervous system in shutdown.

Psychiatric hospitalization carries its own risks for this population: sensory overwhelm, loss of routine and predictability, exposure to unfamiliar social demands, and for LGBTQ+ Autistic people in particular, the possibility of encountering staff who are not trained in affirming care. These are not hypothetical concerns. They are documented harms, and clinicians who work with Autistic clients know them well.

This does not mean crisis intervention is never appropriate or necessary. It means the default pathways carry real risks, and Autistic people and their support networks deserve to know that alternatives exist.

What “Non-Carceral” Means and Why It Matters

Non-carceral crisis support refers to approaches that do not rely on involuntary detention, police involvement, or systems that prioritize containment over care. This framing comes from disability justice and liberation movements, and it centers a core question: does this intervention actually help the person in front of us, on their terms, in ways that preserve their dignity and autonomy?

For Autistic people, this often means support that is asynchronous or text-based, predictable in structure, allows for communication differences, does not require rapid verbal articulation under pressure, and is provided by people with genuine training in Autistic experience. It means being believed about one’s own sensory and regulatory needs. It means not being pathologized for how distress looks in an Autistic body.

Resources Worth Knowing

The following resources represent some of what currently exists. This list is not exhaustive, and no resource is perfect for every person. But these are starting points that have been developed with Autistic and LGBTQ+ communities in mind. In a landscape where so little has been, it matters.

A Guide to Suicide Crisis Support for LGBTQ+ Autistic Individuals

Developed by the Autism and Suicide Prevention Workgroup, specifically for LGBTQ+ autistic people, this guide addresses the intersection of gender identity, sexual orientation, and Autism in the context of suicidal crisis. It offers grounding strategies, communication scaffolding, and guidance for both individuals and supporters.