Acute change in behavior from baseline — screen for a medical cause (infection, pain, hypoxia, constipation, medication) before attributing to psychiatric illness; escalate the medical workup.

Danger to self or others — ensure immediate safety, notify the provider, and follow the crisis pathway; for self-harm, use assessment and 988 resources (no means/methods).

Neuroleptic malignant syndrome (fever, rigidity, altered mentation, autonomic instability) on an antipsychotic — hold the drug and transfer.

New EPS, severe sedation, or a fall on a psychotropic — hold/notify and re-evaluate the regimen.