988 Lifeline Adapts to Better Serve Autistic Callers in Crisis

Autistic people are more likely to experience suicidal thoughts, but misunderstandings with crisis counselors can make reaching out especially difficult.

Apr. 4, 2026 at 8:58am

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A glowing, neon outline of a person's head with a brain-like structure inside, representing the unique communication and sensory processing needs of autistic individuals. The vibrant colors and minimalist design convey the importance of providing better crisis support for this vulnerable population.Specialized crisis support aims to bridge the communication gap and provide a lifeline for autistic people in distress.Towson Today

The 988 Lifeline, formerly the National Suicide Prevention Lifeline, has become one of the most accessible and effective suicide prevention tools in the U.S. However, for autistic people, the decision to reach out can be especially complicated. Many autistic individuals require additional time to process verbal information, and some have reported being hung up on or having their needs misunderstood by crisis counselors. Researchers and advocates are now working to ensure that 988 counselors have the tools to better support autistic callers, and that autistic people understand what to expect from the service before they need to use it.

Why it matters

Autistic people of all ages are significantly more likely than neurotypical peers to experience suicidal thoughts and attempt suicide. In the compressed world of a 988 call, the potential for miscommunication is high, as autistic individuals may have difficulty conveying their needs in a way that crisis counselors can fully understand. This can leave callers feeling frustrated and alone, and in some cases, even inadvertently escalate the situation.

The details

Many autistic people require additional time to process verbal information, particularly in stressful or overwhelming situations. Some have reported being hung up on when a 988 counselor misinterpreted their silence as meaning they had walked away. Others have struggled to make their needs understood, or found that the encounter unfolded in a way that unintentionally caused further harm. For example, one autistic man, Rae Waters Haight, contacted a text crisis line during a challenging period and was asked a routine question to assess his safety. Haight, whose mind interprets language in its most literal sense, answered truthfully that there were objects in his home that could be used to hurt himself, even though he had no intention of using them. This led to police being dispatched to his home, which was a frightening experience.

  • In July 2022, the previous 10-digit telephone number for the National Suicide Prevention Lifeline officially converted to the shorter and more memorable 988.
  • In 2023, researchers Lisa Morgan and Brenna Maddox published a guide to help crisis workers assess whether the person they are talking to could be on the autism spectrum and offered specific conversation strategies to improve the call.
  • In 2024, Morgan and Maddox published a detailed guide for autistic adults on what to expect when contacting 988.
  • Earlier this year, the researchers released a version of the guide for autistic youth and their caregivers.
  • Last year, Morgan and Maddox conducted three one-hour webinars for Vibrant, the nonprofit organization that administers 988, covering the fundamentals of autism, autism-specific suicide warning signs, and support strategies for autistic people in crisis.

The players

Rae Waters Haight

An autistic man who contacted a text crisis line during a challenging period and had a frightening encounter with police after his literal interpretation of a safety question was misunderstood.

Lisa Morgan

The founder and co-chair of the Autism and Suicide Prevention Workgroup, a research collective dedicated to the issue of autistic people and suicide.

Brenna Maddox

A clinical psychologist and co-chair of the Autism and Suicide Prevention Workgroup, who has worked with Lisa Morgan to develop resources and training to help 988 counselors better support autistic callers.

Kayla Rodriguez

A 29-year-old autistic woman from the Greater Atlanta area who has had negative experiences contacting 988 and is hesitant to use the service again due to concerns about police involvement and hospitalization.

Andrea Bleifuss

A 43-year-old autistic woman from Portland, Oregon, who has worked in mental health care facilities and called the crisis line herself, and believes crisis counselors should adapt their approach to the individual caller.

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What they’re saying

“Autistic people are misunderstood and have difficulty conveying what they're going through in a way that's productive. The crisis counselors try to help, but end up kind of just landing wrong.”

— Lisa Morgan, Founder and co-chair of the Autism and Suicide Prevention Workgroup

“I've called 988, I've texted 988 before, and my experience was I don't want to do it anymore. You know why? Because the police will come. And they'll take me to the hospital.”

— Kayla Rodriguez

“Adapt to the person [calling]. Don't make the person adapt.”

— Andrea Bleifuss

What’s next

Rae Waters Haight is now pursuing a doctorate in autism studies at Towson University in Maryland and hosts meetings for autistic peer support groups. His long-term goal is to create a crisis hotline specifically for people on the autism spectrum, staffed by counselors who are either autistic themselves or have been trained by autistic people.

The takeaway

This story highlights the need for the 988 Lifeline to continue adapting its approach to better serve autistic individuals, who are at a higher risk of suicidal thoughts and attempts. By providing specialized training for crisis counselors and resources for autistic callers, the 988 system can work to reduce misunderstandings and ensure that autistic people in crisis receive the support they need.