Escalation must follow the patient's orders and agency policy; the following are representative thresholds.
🚩 Red flags — escalate
Active suicidal ideation with a plan or intent, or self-harm behavior — do not leave the patient alone; activate emergency response (911) and crisis services immediately, notify the provider, mobilize the 988 Suicide and Crisis Lifeline, and ensure safety per protocol.
Thoughts or threats of harm to others — activate emergency response and notify per protocol and applicable duty-to-warn requirements.
Acute psychosis or severe agitation posing a danger — urgent psychiatric and emergency evaluation.
An acute behavioral change suggesting delirium — urgent medical evaluation (detail in Cognitive / Mental Status).
Signs of a psychiatric-medication emergency (for example serotonin syndrome or neuroleptic malignant syndrome) — urgent evaluation.
A substance-use emergency — an overdose or severe withdrawal — activate emergency response (911).
