Telepsychiatry crisis review and local team liaison — CASC/communication station

Open. Introduce role; confirm identity; obtain exact residential address and callback number before deep risk work; confirm who is in the room; state purpose: safety plan today. If address was missing from the record, fix that first — this is the Shore/Mishkind process priority. [1][2]

Assess. Ideation, intent, plan, timing, prior attempts, tablet inventory and storage, alcohol, sleep, hopelessness, protective factors, capacity for safety decisions, children or dependants. Ask about who can stay with her if discharged. Document video limitations if freezes impair affect observation. [1][5]

Decide. If high imminent risk with accessible means and insufficient supports → secure environment, remove/secure remaining tablets via lawful local processes, consider transfer under mental health law if criteria met. If risk can be mitigated (means secured, support person, agrees to plan, medical clearance done) → may stay with strict local plan and early tele/GP review — document uncertainty and review triggers. [1][4]

Local plan elements. ED observation period; toxicology/medical work-up as indicated; same-week GP review; booked telepsychiatry follow-up; crisis line and ED return precautions; friend education without breaching confidentiality; tech backup phone number if video drops. [4][8]

Close. Summarise shared plan; invite ED concerns; name that telepsychiatry is evidence-supported when process-safe, but continuity needs primary care integration — treatment gaps kill when people never re-engage. [3][6][7][8]