While the clinician/cm is meeting with the participant and it becomes evident that the participant’s safety, or the safety of others, may be in jeopardy, the clinician/cm should try to get as much information regarding the participant’s suicidal/homicidal ideation as possible. This includes, but is not limited to, the participant’s plan, means to carry-out the plan, any auditory, visual, olfactory hallucinations the participant may be having, and any weapons the participant may have access to.
Once the clinician/cm has finished speaking to the participant, they should politely ask the participant to remain at their desk and go immediately to their supervisor (Clinical Director, Clinical Coordinator, or other supervising staff). Intake Specialists may go to the Coordinator of Intake and Resource Coordinators may go to the Senior Resource Coordinator, who will involve supervisory clinical staff. A Deputy Project Director or the Project Director should be notified that 911 is being called as well.
Once the decision has been made to call 911 by the supervisor, the clinician/cm will return to the participant and inform them that our goal is to insure their safety and the safety of others. Acknowledge that they are having a difficult time, they are in pain, and that we want to help them through this. In an effort to get them help as quickly as possible, 911 will be called so they can receive immediate attention.
As the clinician/case manager is speaking to the participant about the next steps, the supervisor will call 911. When making this call, the supervisor should have the participant’s demographic information from JCA, any prescribed medications the participant is taking, and an explanation for why the participant’s safety is at risk.
After calling 911, the supervisor should inform the building major’s office that 911 has been called. BJI staff should notify the major’s office if a court officer is required to wait in BJI while EMS is called, or not.
Inform the participant of the next steps: 911 will be called and EMS and the NYPD will be arriving. NYPD always accompanies EMS, and the police are coming only coming to ensure everyone’s safety. Many participants will get increasingly agitated and/or upset if they see the police coming, as their initial thought is that they are going to be arrested. It is imperative that the participant understand they have done nothing wrong and the police are just here to make sure everything is ok. It’s helpful to explain to the participant that if 911 had to be called for anyone in the building, NYPD would come as well.)
While waiting for EMS to arrive, the participant and his/her assigned clinician/case manager should relocate, if possible, to a private setting within the office, so as not to disrupt the other business.
If this occurs in room 308e, ideally, the waiting area should be cleared for the participant’s privacy and to prevent alarming other participants waiting to meet with staff.
If the participant is calm, the assigned clinician/case manager should wait with the participant . If the participant is agitated or becomes upset with the assigned clinician/case manager, that person should remove themselves. At this point, the court officers can take over to maintain safety and the supervisor or assigned clinician/case manager should remain and be available for NYPD, EMS and the participant.
After the court officer has been informed and 911 has been called, all other BJI management staff should be notified of the situation via Slack, so as to be aware of what’s happening in the office. Other managers can respond or assist/direct staff and participant’s.
The assigned clinician/case manager and/or the supervisor should speak with NYPD and EMS when they arrive about the need to contact 911 (NYPD generally arrives before EMS).
It is helpful if the clinician/case manager can prepare a brief summary of the events that led to the EMS call and attach their contact information to the summary. This is especially helpful for the psych ER staff. The summary should be brief and include any medications, diagnosis (if known) and events that led up to the 911 call. This step is not mandatory, but merely helpful in ensuring the participant gets the best treatment possible.
Before EMS leaves with the participant, find out what hospital they will be bringing the participant to. Where appropriate, ask the participant to sign consent (if there is not one on file) so as to locate the participant and speak to any physicians/hospital staff treating the participant .
To the clinician/case manager: the participant may be too agitated and/or psychotic to sign consent. If this is the case, do not force the participant to sign.]
If the participant is a minor: the social worker/case manager working with the participant should contact the participant’s parent/guardian immediately and inform them of the situation, as well as what hospital EMS will be bringing the participant to.
Once the participant has been taken by EMS, the clinician/case manager and/or supervisor should immediately document the events in JCA/Salesforce, and inform the court (if the participant is on the Court calendar that day).
The assigned clinician/case manager should follow-up with the participant/hospital over the next few days to determine what happened with the participant and what next steps should be taken, if any.