How often are patients with psychiatric emergencies needlessly hospitalized because of the admitting physician's inexperience, fatigue, or lack of knowledge about alternative resources?

Is the client likely to benefit from inpatient treatment?

Are there potential adverse consequences of inpatient treatment?

Is the client likely to benefit from outpatient treatment?

Are there potential adverse consequences of outpatient treatment?

Has the client engaged in any aggressive behavior (including homicidal and assaultive behavior, or domestic violence) in the present episode?

Is the client currently expressing signs of homicidal, assaultive, or violent ideations or intentions? (If no, skip questions DO5, ES5, DO6)

(If the client has expressed homicidal, assaultive or violent ideations or intentions,)

Does the client have a concrete plan? (If the client has expressed homicidal, assaultive or violent ideations or intentions,)

Have the clients thoughts of harming others recently become more frequent or specific?

Has the client previously engaged in aggressive behavior (including homicidal and assaultive behavior or domestic violence)?

Has the client engaged in suicidal or self-destructive behavior in the present episode? (If yes and unintentional go to Functional Impairment category)

Is the client currently expressing signs of suicidal or self-destructive ideations or intentions? (If no, skip questions DS5, ES5, DS6)

(If the client has expressed suicidal or self-destructive ideations or intentions,) Does the client have a concrete plan?

(If the client has expressed suicidal or self-destructive ideations or intentions,)

Have the client's thoughts of self-harm recently become more frequent or specific?

Has the client previously engaged in suicidal or other self-destructive behavior (e.g. substance overdoses)?

Does the client have a friend/family member/significant other who has completed or attempted suicide?

What level of emotional and practical support can be expected from interested family, friends and others (including treatment providers)?

How well can interested family, friends and others (including treatment providers) be expected to help to protect the client from harming him/herself or others?

What is the degree of stress in the client's family and social environment (e.g. Is there current or a history of abuse/domestic violence)?

Does the client have ready access to a weapon or other means of harming him/herself or others?

Has the client been a victim of abuse or domestic violence?

Estimate the overall quality of the client's social and family environment. fi3Is the client able to carry out fundamental activities of daily life (e.g., eating, dressing, hygiene, etc.)?

Does the client unintentionally do things that put him or her at risk of self harm?

Estimate the overall seriousness of the client's functional impairment (analogous to GAF).

Are there appropriate outpatient treatments and services readily available in a timely fashion?

Might the client have a medical condition that is presenting as __________?

Does the client have acute or chronic medical conditions which require referral?

Does the client exhibit lack of impulse control related to violent or self destructive behavior (e.g., as evidenced by substance abuse or violence toward others)?

Does the client express feelings or report symptoms that reflect depression (e.g., weight loss, loss of appetite, sleeplessness, loss of sex drive, crying, hopelessness, helplessness, low self-esteem)?

Does client have hallucinations involving suicidal or self-destructive behavior?

Does client have hallucinations or fantasies involving violent behavior toward others?

Hostility - animosity, contempt, belligerence, disdain for others.

Suspiciousness - mistrust, belief others harbor malicious or discriminatory 1intent.

Hallucinatory Behavior - perceptions without normal external stimulus correspondence.

Motor Retardation - slowed, weakened movements or speech, reduced body tone.

Uncooperativeness - resistance, guardedness, rejection of authority.

Unusual Thought Content - unusual, odd, strange, bizarre thought content.

Blunted Affect - reduced emotional tone, reduction in normal intensity of feelings, flatness.

Excitement - heightened emotional tone, agitation, increased reactivity.

Disorientation - confusion or lack of proper association for person, place or time.

Anxiety - worry, fear, overconcern for present or future.

Emotional Withdrawal - lack of spontaneous interaction, isolation, deficiency in relating to others.

Conceptual Disorganization - thought processes confused, disconnected, disorganized, disrupted.

Guilt Feelings - self blame, shame, remorse for past behavior.

Tension - physical and motor manifestations or nervousness, overactivation, tension.

Mannerisms and Posturing - peculiar, bizarre, unnatural motor behavior (not including tics).

Grandiosity - exaggerated self-opinion, arrogance, conviction of unusual power or abilities.

Depressive Mood - sorrow, sadness, despondency, pessimism.

To what degree is the client willing and able to cooperate with proposed outpatient treatment or services?

To what degree is the client's family or significant others (e.g., treatment providers) willing and able to cooperate with proposed outpatient treatment or services?

How beneficial does the client think the proposed outpatient treatment or services will be?

How beneficial does the client's family or significant others think the proposed outpatient treatment or services will be?

To what degree is the client willing and able to cooperate with proposed inpatient treatment or services?

To what degree is the client's family or significant others (e.g. treatment providers) willing and able to cooperate with the proposed inpatient treatment or services?

How beneficial does the client think the proposed inpatient treatment or services will be?

How beneficial does the client's family or significant others think the proposed inpatient treatment or services will be?

Within the past sixty days, has the client presented at an emergency room, been hospitalized for psychiatric reasons or are there other signs suggesting that the client's problems are becoming more acute or current treatment is ineffective?

Has the client received treatment (detox or rehab) for substance use during the past year?

Has the client had previous overdoses or other substance abuse related accidents?

Is there a history of suicidal or self-destructive ideation or behavior when intoxicated or under the influence of drugs?

Is there a history of homicidal, assaultive or violent behavior when intoxicated or under the influence of drugs?

Estimate the overall seriousness of the client's substance abuse problem. sa3Is client currently or has he/she recently been abusing substances?

Is the client presently intoxicated or in the state of withdrawal?

What is the estimated frequency/quantity of use within the past week?

Does the client's substance abuse adversely affect social functioning (e.g. use at work or while driving)?

Has the usage increased recently (during the past 30 days)?