Schedule follow-up care after a Brookhaven stay

Best first step: Before leaving Brookhaven, ask which follow-up appointments are already scheduled, which still need to be scheduled, who is responsible for scheduling them, and what to do if an appointment is delayed.

• Follow-up care helps continue therapy, medication review, safety planning, and discharge support after Brookhaven.
• Ask before discharge which appointments are scheduled and which still need to be scheduled.
• Follow-up may include therapy, psychiatry, medication review, primary care, outpatient programs, crisis care, or community support.
• If the first appointment is delayed, ask what to do about medications, symptoms, safety planning, and interim support.
• Support people may help schedule or attend appointments when the patient agrees or when legal authority applies.
• Do not wait for a scheduled appointment if symptoms become urgent or the patient cannot stay safe.

• Review symptoms after leaving the structure of the unit.
• Confirm medications are helping and side effects are manageable.
• Continue therapy goals or start outpatient therapy.
• Review safety planning and warning signs.
• Coordinate support people, transportation, school, work, or housing needs.
• Adjust the plan if symptoms return or new concerns appear.
• Reduce the chance of missed care, medication gaps, or avoidable crisis escalation.

Follow-up type	What it may support
Therapy or counseling	Coping skills, trauma support, mood symptoms, anxiety, relationships, relapse prevention, or continued treatment goals.
Psychiatry or medication management	Medication review, side effects, refills, dose changes, and ongoing medication planning.
Primary care	Medical follow-up, labs, medication interactions, general health concerns, or coordination with specialists.
Intensive outpatient or partial hospitalization	Structured care after discharge when regular outpatient care is not enough but inpatient care is no longer needed.
Community or case management support	Transportation, housing, benefits, care coordination, support-person planning, or access to local resources.
Crisis or urgent follow-up	Same-day support if symptoms return, safety worsens, medication access fails, or the patient cannot stay safe.

• Ask which follow-up appointments are already scheduled.
• Ask which appointments still need to be scheduled.
• Ask who is responsible for scheduling each appointment.
• Ask how soon the first follow-up should happen.
• Ask whether medication refills are available before the first appointment.
• Ask what to do if the clinic has no availability.
• Ask whether transportation or support-person help is needed.
• Ask what symptoms should prompt urgent care instead of waiting.

1. Review the discharge instructions for recommended follow-up care.
2. Confirm the provider, clinic, program, or phone number listed.
3. Call or request scheduling as soon as possible after discharge.
4. Tell the clinic the patient was recently discharged from Brookhaven.
5. Ask whether the appointment should be therapy, medication management, intake, crisis follow-up, or another visit type.
6. Ask what records, discharge paperwork, medication lists, or insurance information are needed.
7. Confirm the appointment date, time, location, format, and transportation plan.
8. Ask what to do if symptoms worsen before the appointment.

• Patient full name and date of birth.
• Brookhaven discharge date.
• Discharge instructions or recommended follow-up plan.
• Medication list and pharmacy information.
• Insurance information, if applicable.
• Preferred contact number.
• Transportation needs or accessibility needs.
• Support-person contact information, if the patient wants them involved.
• Any urgent symptoms, medication concerns, or safety concerns.

Access need	What to ask
Transportation	Ask whether family, rideshare, medical transport, public transportation, or program transport is realistic.
Telehealth	Ask whether video or phone follow-up is available if travel is difficult.
Accessibility	Ask for mobility, communication, interpreter, sensory, or disability support before the appointment.
Support person	Ask whether the patient wants someone to help schedule, attend, or remember next steps.
Weather, fog, or route concerns	Ask what to do if travel becomes unsafe or the patient feels disoriented before the appointment.

• Ask whether the first follow-up includes medication review.
• Ask how many days of medication were prescribed at discharge.
• Ask whether refills are available before the first appointment.
• Ask who to call if the pharmacy does not have the prescription.
• Ask what side effects should prompt faster care.
• Ask whether a support person can help with pickup or reminders.

Do not wait if symptoms worsen, medication is running out, the patient feels unsafe, or the discharge plan says faster care is needed.

• Ask the clinic whether there is a cancellation list.
• Ask whether a different provider, location, or telehealth option is available.
• Ask whether Brookhaven discharge planning can help route the referral.
• Ask who can review medications before the appointment.
• Ask what symptoms require urgent care or crisis support.
• Ask whether a higher level of care is needed while waiting.

Important: Being a visitor, emergency contact, or ride home does not automatically allow someone to receive follow-up details, medication information, safety-plan information, or records.

• Ask whether the patient wants a support person involved.
• Ask whether a release, proxy setting, or legal document is needed.
• Ask what information can be shared with the support person.
• Ask whether the support person can help with scheduling or transportation.
• Ask whether the support person should know warning signs or urgent steps.

Do not wait for a follow-up appointment, portal reply, referral call, or scheduled intake if the patient may not be able to stay safe or symptoms are escalating quickly.

• The patient has thoughts of self-harm or harm to others.
• The patient feels unable to stay safe or asks not to be left alone.
• There is severe confusion, hallucinations, paranoia, agitation, or unsafe behavior.
• There is a suspected overdose, severe medication reaction, withdrawal concern, or medical emergency.
• Medication is unavailable and missing it could create immediate safety or medical risk.
• The patient is missing, has left unexpectedly, or cannot be contacted after expressing safety concerns.
• Symptoms are escalating faster than the discharge plan can manage.

Use the crisis or emergency instructions listed in the discharge plan. If there is immediate danger, use emergency services.