Veterans of the Storm: Crisis Response Protocol – Step 3

Clinical Triage and Escalation

🧠 When to Activate Clinical Triage

Trigger this protocol if a veteran shows any of the following:- Mentions suicide directly or indirectly (e.g., “I don’t want to be here anymore”)- Has a plan, means, or history of attempt- Goes nonverbal, dissociates, or suddenly appears ‘too calm’ after visible distress- Expresses emotional disconnection, hopelessness, or desire to disappear- Becomes unreachable after escalating emotional distress

🔗 Immediate Steps for Peer or Coach

1. Stay with the veteran (virtually or physically). Do not disappear.2. Alert your clinical lead or in-house psychologist.3. Document exact language or red-flag behavior (e.g., “I’m done,” “It doesn’t matter”).4. If imminent danger is confirmed, contact emergency services or VA Crisis Line.   - Involve the veteran when possible.   - Maintain emotional connection until help is secured.

🩺 Clinical Lead (Psychologist) Responsibilities

- Conduct brief suicide risk screening (plan, means, intent).- Assess for past attempts, current state, and support systems.- Decide if hospitalization or emergency VA care is needed.- If hospitalization is NOT needed:   • Create a 72-hour Safety and Stability Plan   • Schedule clinical follow-up within 24–48 hours   • Assign daily peer outreach/check-ins

📅 Post-Triage Follow-Up

- Clinical lead debriefs peer coach team.- Safety Plan documented in veteran’s case file.- Veteran assigned to Post-Crisis Rebuilding Track.- Ongoing coordination between peer and clinical teams.

🚨 Golden Rule

Escalation is never abandonment.We do not hand off and disappear. We coordinate. We stay. We follow through.