What happens after a crisis referral or safety review

Important: A crisis referral should not be used instead of emergency help. If the patient may harm themselves or someone else, cannot stay safe, is missing, has a medical emergency, or symptoms are escalating quickly, use crisis or emergency support right away.

• A crisis referral or safety review helps determine what level of behavioral health support may be needed.
• Brookhaven may review symptoms, safety concerns, recent events, medications, support, medical needs, and discharge or crisis paperwork.
• A review may lead to inpatient care, observation, additional assessment, outpatient care, medication review, or a safety plan.
• Family, friends, and support people may share concerns, but Brookhaven may need permission before sharing patient information back.
• The patient may be asked questions about current safety, symptoms, substance use, medication, stressors, and support.
• Use immediate crisis or emergency support if the patient cannot stay safe or the situation is escalating quickly.

• It may be used after an emergency visit or crisis contact.
• It may be used when symptoms are worsening or safety is unclear.
• It may be used when a support person is worried about the patient.
• It may be used when a provider wants a higher level of care reviewed.
• It may be used when the patient may need observation, inpatient care, or urgent follow-up.
• It may be used when a discharge plan needs additional safety review.

Referral source	What they may provide
Emergency department or medical hospital	Medical notes, crisis assessment, transfer request, safety concerns, and medication information.
Crisis team or mobile response	On-scene assessment, risk concerns, support plan, and recommendation for further evaluation.
Outpatient provider or therapist	Clinical concerns, treatment history, recent symptom changes, safety concerns, and recommended level of care.
Family, friend, caregiver, or support person	Observed changes, safety concerns, missed medication, missing-person concerns, or support limitations.
Patient	Current symptoms, safety concerns, request for review, medication concerns, and what support feels possible.

• Current thoughts of self-harm or harm to others.
• Whether the patient has a plan, intent, access to means, or recent attempt.
• Recent hallucinations, paranoia, confusion, agitation, or unsafe behavior.
• Substance use, withdrawal concerns, medication misuse, or overdose risk.
• Medication changes, missed doses, side effects, or pharmacy access.
• Medical concerns that may affect behavioral health symptoms.
• Home environment, housing, transportation, and support availability.
• Recent emergency care, discharge instructions, or crisis contact.
• Whether outpatient care is available soon enough.
• Whether a higher level of care is recommended.

1. The patient may be contacted for more information.
2. A support person, provider, or referring team may be asked for more details when allowed.
3. The patient may be advised to seek emergency evaluation immediately.
4. The patient may be referred for Brookhaven assessment, observation, or inpatient care.
5. The patient may be referred to outpatient therapy, psychiatry, crisis follow-up, or a structured program.
6. The safety plan may be updated.
7. Medication review may be recommended.
8. The referral may be redirected if another service is more appropriate.

Outcome	What it means
Emergency evaluation	The patient should be evaluated immediately because safety or medical concerns cannot wait.
Brookhaven admission review	Brookhaven may review whether inpatient care is appropriate.
Observation or additional assessment	More time or clinical review is needed before deciding the safest next step.
Outpatient or crisis follow-up	The patient may follow up with therapy, psychiatry, crisis services, or another provider outside the hospital.
Higher level of outpatient care	A structured program such as partial hospitalization or intensive outpatient care may be recommended.
Safety plan update	The plan may be revised to include warning signs, support people, medication steps, and urgent instructions.

• Describe the specific behavior or safety concern.
• Share when the concern started and whether it is getting worse.
• Share whether the patient has access to unsafe items or medications.
• Share whether the patient is missing, unreachable, or has left unexpectedly.
• Share medication or substance-use concerns when relevant.
• Share what support is available at home.
• Ask what to do if the patient refuses help or symptoms worsen.

Important: Being a family member, friend, emergency contact, or ride home does not automatically allow someone to receive patient information.

• Ask whether the patient has authorized a support person.
• Ask whether a release, proxy setting, or legal document is needed.
• Ask what information can be shared.
• Share urgent safety concerns even if Brookhaven cannot share details back.
• Use emergency support if privacy limits delay information but safety is urgent.

• Referral source and reason for review.
• Safety concerns reported by the patient or others.
• Current symptoms and risk factors reviewed.
• Medication, substance-use, or medical concerns.
• Support people or collateral information, when included.
• Recommended level of care or follow-up plan.
• Safety plan or urgent instructions.
• Transfer, admission, observation, or referral details.

• Ask what safety concerns were identified.
• Ask what alternatives were considered.
• Ask whether outpatient care is available soon enough.
• Ask whether medication, transportation, housing, or support concerns affected the recommendation.
• Ask what would need to change for a different plan to be considered.
• Ask who can answer questions about rights, records, privacy, or next steps.

Do not wait for a referral review, portal reply, scheduled assessment, or routine callback if the patient may not be able to stay safe or the situation could become dangerous.

• The patient has thoughts of self-harm or harm to others.
• The patient has a plan, intent, or access to means for self-harm or harm to others.
• The patient feels unable to stay safe or asks not to be left alone.
• The patient is missing, has left unexpectedly, or cannot be contacted after expressing safety concerns.
• 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.
• Symptoms are escalating faster than the safety plan can manage.

Use crisis or emergency support right away. If there is immediate danger, use emergency services.