Training for 988 Counselors

In an effort to build linkages and enhance capacity, the National Center for START Services has recently released a training for 988 Suicide & Crisis Lifeline counselors. This online, on-demand training enables 988 Suicide & Crisis Lifeline counselors to provide improved support and assistance to people with intellectual/developmental disabilities (including Autism Spectrum Disorder, ASD) and mental health needs who contact the Lifeline seeking help. While originally designed for 988 counselors, it is highly relevant for any professional who is interested in learning more about providing support and assistance to people with ASD-IDD/MH in crisis.

To create prevention strategies and build resilience, we need to understand not only the risk factors, but the protective factors. These include access to a variety of clinical interventions and support, family and community support (connectedness and belonging), support from medical and mental health care relationships, and skills in problem solving.

September is Suicide Prevention Awareness Month

September is Suicide Prevention Awareness Month which provides a time to raise the awareness of this often-stigmatized topic. Prevalence of serious suicidal thoughts is 5% in adults, over 11% in young adults, and over 18% in high school students. These numbers have been even higher during the pandemic. This month we can increase understanding, share information, and spread hope through focusing on treatment and prevention.

There was a time when it was thought that having a developmental disability was a protective factor in relation to suicide. The reality is that suicidal thoughts, like mental health conditions, can affect anyone regardless of age, gender, background, or disability. And studies are showing that there may be an increased risk for people with intellectual disability or autism spectrum disorder. Risk factors for suicide in this population include history of prior psychiatric hospitalization, comorbid physical disabilities, loneliness, sadness, depression, or anxiety. 
Consider these additional statistics:

  • The highest rates of suicide in the U.S. are among American Indian/Alaska Natives followed by non-Hispanic whites.
  • Lesbian, gay and bisexual youth are nearly 4x more likely to attempt suicide than straight youth.
  • Transgender adults are nearly 9x more likely to attempt suicide than the general population.
  • Suicide is the leading cause of death for people held in local jails.

The intersection of ID and ASD with other identities may further increase the risk for suicidal thoughts and actions. 


As a START network, we work to mitigate risk factors through reducing unnecessary hospitalizations, addressing underlying medical concerns, and identifying underlying depression and anxiety. Protective factors are built up through ensuring access to appropriate clinical interventions, enhancing natural relationships to create feelings of belonging, and increasing problem solving and emotional regulation through coaching. In addition, the linkages with other crisis services and responders are critical to ensure that people with developmental disabilities receive timely and appropriate response and treatment. 

The objectives of this short training are:

  • Describe at least five (5) key factors related to the prevalence, signs & symptoms of suicidality amongst people with ASD-IDD
  • Utilize skills and approaches outlined within presentations to effectively engage with people with ASD-IDD who contact the 988 lifeline
  • Identify and describe suicide screening tools that can be utilized when engaging with people with ASD-IDD

The goal this month, and every month, is ensuring that all people, their friends, and their families have access to the resources they need to discuss suicide prevention and to seek help.
Chen, M. H., Pan, T. L., Lan, W. H., Hsu, J. W., Huang, K. L., Su, T. P., . . . Bai, Y. M. (2017). Risk of suicide attempts among adolescents and young adults with autism spectrum disorder: A nationwide longitudinal follow-up study. The Journal of Clinical Psychiatry, 78(9), e1174-e1179. doi:10.4088/JCP.16m11100
Bertolote, J. M., & Fleischmann, A. (2002). Suicide and psychiatric diagnosis: a worldwide perspective. World psychiatry1(3), 181.