Notice early, act within role, and complete the handoff.
Use this page as a controlled working guide. Adapt language and activities to the population, verify local resources, assign ownership, and preserve the clinical and life-safety boundaries described throughout the model.
Early identification without amateur diagnosis
Teachers, coaches, peers, caregivers, supervisors, outreach workers, and community leaders may notice change before a clinician does. Their role is to observe, document within policy, hold a respectful conversation, consult, and connect—not to diagnose, investigate beyond authority, or promise an outcome.
Observable warning domains
Functioning
Attendance decline, missed work or school, falling performance, abandoned responsibilities, poor self-care, or repeated inability to complete ordinary tasks.
Behavior
Sudden secrecy, risky driving, repeated intoxication, theft, escalating conflict, unusual spending, unsafe sexual behavior, or abrupt peer changes.
Physical
Changes in sleep, appetite, coordination, speech, appearance, injuries, withdrawal symptoms, overdose signs, medication confusion, or unexplained illness.
Emotional
Marked anxiety, depression, irritability, hopelessness, agitation, emotional numbness, panic, grief, or rapid shifts from baseline.
Cognitive
Confusion, memory problems, paranoia, disorganization, impaired judgment, concentration decline, or unusual beliefs.
Relational
Isolation, coercive relationships, violence, exploitation, repeated rupture, loss of supports, or conflict that places safety or housing at risk.
Objective language standard
| Avoid | Document instead |
|---|---|
| “Unmotivated” | “Participant declined the activity, stated it would not help, and left the room after five minutes.” |
| “Drug seeking” | “Participant requested an early refill twice this week and reported the medication was lost.” |
| “Manipulative” | “Participant gave different accounts of the transportation barrier to two staff members and requested an exception to the attendance rule.” |
| “Bad attitude” | “Participant raised their voice, used profanity, and declined redirection.” |
| “Relapsed” without evidence | “Participant reported using alcohol on Saturday after 21 days without use.” |
| “Fine” | “Participant denied current safety concerns, maintained eye contact, spoke coherently, and identified two supports.” |