I’m autistic and in mental health crisis. What can I do?

Content warning: This article mentions suicide, involuntary admittance to mental healthcare facilities, and police.

You’re autistic and in a mental health crisis. What can you do?  

It’s a complicated question because mental health crises and care options look different for everyone. Still, there are some coping mechanisms and resources that many of our autistic community members have found helpful.  

Signs of a mental health crisis for an autistic adult might include extreme emotional distress, irritability, communication difficulties, and social withdrawal, to name a few outward-facing symptoms.  

From a firsthand perspective, it can be painful and feel never-ending, but keeping a list of go-to strategies to reference when you’re in that kind of state of mind can be really beneficial. 

If you need urgent support, there are a few options you can consider.  

Seek professional help 

Nurses can provide information and guidance on your health if you call 4-1-1, but their mental health training is limited.  

Non-speaking folks might prefer to use a chat, like this Crisis Centre Chat available from noon until 1 AM in BC and Yukon. The Hope for Wellness Hotline for Indigenous people across the country has both a phone (1-855-242-3310 ) and chat option available 24/7. Another free chat-based option that never closes is the Hopeline chat, and in BC, young people under 25 can use the YouthInBC chat. 

There are several hotlines you can call that are run by people who are trained to talk to callers in mental health crises, although autism-related training is not guaranteed. 

310 Mental Health Support can be reached at 310-6789 (no area code required).  

In the Vancouver Coastal Health Region, the number for distress services is 604-872-3311, and the toll-free number for Howe Sound, the Sunshine Coast, and Bella Coola is 1-866-661-3311.  

Indigenous-specific crisis support is available at the KUU-US Crisis Line, 1-800-588-8717.  

If you’re a senior in crisis, you can contact the Seniors Distress Line at 604-872-1234. 

If you’re having suicidal thoughts, you can call Crisis Centre BC at 1-800-SUICIDE (1-800-784-2433), go to an emergency room, or call 9-1-1 if you think it will be helpful. 

The risks of calling 9-11 or being hospitalized 

Note that the staff you’re connected to through 9-11 and the hospital probably don’t have autism-specific training, which limits how well they can serve you as an autistic patient. Keep that in mind and adjust your expectations regarding receiving individualized care from emergency responders. 

Keeping communication cards on hand might be helpful to show to first responders, police, or nurses before things escalate. They could indicate that you’re autistic and in distress, non-verbal, or sensitive to sound, for example. If you don’t want to be touched, one that says “Don’t touch me, please” might be useful. 

Note that it can be challenging for many autistic people to be in places like ambulances and hospitals because they’re so noisy, chaotic, and unfamiliar. Consider how the stress of being there impacts the benefits of getting support. Consider bringing an advocate or support person with you. 

If you do call the police, it’s worthwhile to request that a community mental health nurse also attend. However, there’s no guarantee the nurse will be able to show up. After police assess the situation, they will determine whether or not the person in distress needs to go to the hospital, which could lead to involuntary or voluntary admittance.  

Being admitted to the hospital against your will can be traumatizing. However, some people request or need in-patient care in crisis. If you’re considering admitting yourself, keep these risks in mind. 

There are indeed compassionate and helpful hospital staff, but there are also times when people working in healthcare settings have a negative impact on their patients. It’s essential to be aware of that before you go in. 

Even with all these caveats, healthcare isn’t accessible to everybody. There are still options for folks looking for other kinds of help. 

Lean on your support network 

Sharing how you’re feeling with someone you know and love can alleviate the burden of being in a mental health crisis. Sometimes, having someone who cares close by is enough to help. Other times, asking for support with cooking, cleaning, or other daily tasks can lessen the load. If you need help getting out of the house, having someone to come with you can also be nice. 

Only you know what’s most helpful when you’re in crisis. Directly asking for it is an excellent habit to get into so your loved ones can better help you. 

If you don’t know anyone autistic whom you feel comfortable talking to, consider attending one of AutismBC’s Getting Together on the Spectrum online events. Every second and fourth Wednesday of the month, autistic adults meet on Zoom to share their experiences and get to know each other. Building relationships is complicated and takes time, but having someone to support you when you’re struggling can make a world of difference. 

Practice self-care strategies  

What calms you down? Whatever it may be, take as much time as you can to focus on it.

Some examples might be stimming, engaging with a special interest, or shutting out sensory input. Staying hydrated and keeping healthy snacks on you is another self-care tip that applies to everyone. More specific ones might involve your hobbies or interests — watch a comforting show or movie, take a nap, or spend time with someone you can relax with.  

When you discover a new self-care strategy that helps, write it down wherever you keep notes and thoughts. This might be a memo, journal, or voice note. FoundryBC has this practical self-care toolkit you can use as a template if you’d like.  

Another strategy you can try is keeping a “burnout box” full of fidgets, books, comforting notes and cards from friends and family, and other items that help you soothe your nervous system nearby. 

However you keep track of it, make sure you can return to the list when you’re struggling so you’re never short on ideas. 

Here’s a list of autistic self-care strategies that are worth a try: 

• Deep pressure activities: Use weighted blankets, compression clothing, sensory socks, etc. 
• Sensory deprivation: Put on earplugs or noise-cancelling headphones, a sleep mask or headache hat, turn off the lights, and so on. 
• Take “body breaks”: Drink ice water, have tea, eat safe snacks, use the bathroom, groom, bathe. 
• Engage in a special interest: Play a video game, read a book, watch a show/movie, make crafts, or do whatever else brings you joy. 
• Move your body: Stretch, walk, play a sport, etc. Stimming can also be a way to do this, whatever that means to you. 
• Use an alternative form of communication: If forcing speech is harmful, try using texting, AAC apps/devices, or notes on paper to share your preferred method of communication with family and friends.  

Take the time to add to your list regularly, and you’ll eventually have custom-made self-care strategies. Sharing it with people in your circle can also be helpful so they know what to suggest or facilitate when you can’t do it alone.

Give yourself grace 

If you’re safe after a crisis, that’s something to be proud of. Recognize and celebrate your achievements, no matter how small they may seem. 

Being an autistic adult can be hard, and it makes sense that crises happen. The sheer amount of stimulus many of us take in daily can be overwhelming. Try not to get upset with yourself for being in a crisis if it’s already happening. Instead, practice giving yourself some grace or rest. 

I used to get angry at myself when I’d have meltdowns in public. Having critical, harsh people around you doesn’t help; it can feel embarrassing and surreal when it happens with strangers. I would even get mad at myself when it happened while I was alone.  

By working on making my self-talk more positive, and learning which self-care strategies help me, I’ve gotten better at bouncing back from these moments. That lessens a crisis’s impact on me so I can get back to regulating my nervous system quicker. Now, I try to anticipate hard days, so I’m not setting myself up for disappointment when they inevitably happen, which makes it easier. 

It’s okay to need help, and asking for it when you do is important. Learning to stay safe takes time, but investing in self-care and building a solid support network is worth it. Be kind to yourself while trying out different strategies.