Why Brookhaven may recommend inpatient care or additional review

Best first step: Ask Brookhaven what concern led to the recommendation, what review is happening now, and what options may be considered before a final plan is made.

• Brookhaven may recommend inpatient care when symptoms, safety, medication needs, or support needs cannot be safely managed through routine outpatient care.
• Additional review can mean more assessment, observation, medication review, crisis planning, medical review, or level-of-care review.
• A recommendation is not the same as a final admission decision.
• Inpatient care may be voluntary, may involve legal review, or may require a more formal safety process depending on the situation.
• A support person can provide helpful information when allowed, but Brookhaven may still need to speak with the patient directly.
• Use emergency or crisis support if safety cannot wait for review.

Review type	What it may involve
Safety review	Questions about self-harm, harm to others, crisis symptoms, ability to stay safe, and what supports are available.
Clinical review	Review of symptoms, diagnosis history, functioning, recent events, and prior care.
Medication review	Review of current medications, side effects, missed doses, withdrawal concerns, interactions, or need for closer monitoring.
Substance-use review	Review of alcohol, cannabis, opioids, stimulants, sedatives, withdrawal risk, treatment needs, or program fit.
Level-of-care review	Review of whether outpatient care, urgent follow-up, day programming, inpatient care, emergency care, or another service is most appropriate.

• There are immediate or recent safety concerns.
• Symptoms are severe, rapidly worsening, or interfering with basic daily functioning.
• Medication changes, side effects, missed doses, or withdrawal concerns need closer monitoring.
• Outpatient appointments are not enough to safely manage the current concern.
• The patient needs a safe setting while a crisis plan, medication plan, or discharge plan is built.
• There is concern about confusion, psychosis, mania, severe depression, severe anxiety, trauma symptoms, or substance-related symptoms.
• Support at home is not available, not enough, or not safe for the current situation.
• A transfer from Alchemilla, emergency care, crisis services, or another facility needs Brookhaven review.

Care area	What may happen
Observation and safety checks	Staff may check symptoms, safety, sleep, medication response, and whether the care plan needs to change.
Medication review	A prescriber may review medications, side effects, missed doses, or new medication needs.
Therapeutic programming	Patients may be offered groups, coping-skill work, discharge education, or individual check-ins.
Discharge planning	Staff may help plan follow-up appointments, medications, transportation, support-person involvement, and crisis instructions.
Privacy and access review	Brookhaven may confirm who can receive updates, who can visit, and what information can be shared.

1. Staff confirm identity, contact information, and reason for evaluation.
2. Staff ask about current symptoms, safety, medications, substance use, and support at home.
3. A clinician reviews the information and may speak with the patient directly.
4. Brookhaven may review recent Alchemilla, Brookhaven, emergency, or outside records when available.
5. Staff may ask whether a support person can provide additional information.
6. The care team discusses whether outpatient care, urgent follow-up, inpatient care, transfer, or another option is safest.
7. Staff explain the next step, including whether admission, further observation, legal review, or discharge planning is recommended.

Ask staff directly what admission status applies, whether the patient is voluntary or under additional legal review, what paperwork should be provided, and who can explain patient rights or review options.

• Adult patients generally decide who may receive updates unless legal authority or emergency circumstances apply.
• Brookhaven may ask the patient before including a support person.
• Some teen, dependent, behavioral health, substance-use, or safety-related information may have extra privacy limits.
• A support person may be able to provide information even when Brookhaven cannot share details back.
• Visitor and phone access may depend on unit rules, safety review, patient preference, and admission status.

• What concern led to the recommendation?
• Is the recommendation for inpatient admission, further observation, urgent follow-up, or another review?
• What information is still needed before a decision is made?
• Who will make or review the next decision?
• What are the outpatient alternatives, if any?
• What happens if the patient agrees to admission?
• What happens if the patient does not agree?
• Can a support person be included in the discussion?
• What should the patient or family do if symptoms worsen before the next step?

Do not wait for intake, level-of-care review, portal messages, or scheduling if there is immediate danger, thoughts of self-harm, thoughts of harming someone else, possible overdose, severe withdrawal, severe confusion, or you cannot stay safe.

• Use emergency services if there is immediate danger.
• Call or text 988 in the U.S. for mental health, emotional distress, substance-use, or crisis support.
• Call Poison Control at 1-800-222-1222 in the U.S. for possible poisoning, overdose, or medication mistakes.
• Tell Brookhaven staff immediately if you are already on campus and feel unsafe.