crisis-response-protocol

✅ USE this skill for:

• Implementing crisis detection in recovery/mental health apps
• Building safety planning features
• Integrating hotline and emergency resource displays
• Designing risk assessment interfaces
• Creating escalation protocols for AI chat systems

❌ DO NOT use for:

• Responding to an actual crisis yourself → Call 988 or emergency services
• General mental health content → use sober-addict-protector or recovery-coach-patterns
• Medical advice or diagnosis → Always defer to licensed professionals
• Replacing human crisis counselors → AI should augment, never replace

> AI should NEVER be the sole responder in acute crisis situations.

> Always provide pathways to human support and emergency services.

Risk Indicator Categories

```typescript

interface RiskIndicators {

// PRIMARY - Immediate escalation required

primary: {

suicidalIdeation: string[]; // "want to die", "end it all"

selfHarmIntent: string[]; // "hurt myself", "cutting"

homicidalIdeation: string[]; // "hurt someone"

activeSubstanceEmergency: string[]; // "overdosed", "can't stop"

};

// SECONDARY - Elevated monitoring

secondary: {

severeDepression: string[]; // "hopeless", "no point"

panicSymptoms: string[]; // "can't breathe", "heart racing"

psychoticSymptoms: string[]; // "hearing voices"

severeAnxiety: string[]; // "terrified", "losing control"

};

// TERTIARY - Check-in triggers

tertiary: {

isolationPatterns: string[]; // "no one cares", "alone"

substanceRelapse: string[]; // "started using", "slipped"

hopelessness: string[]; // "never get better"

};

}

```

Detection Implementation

```typescript

// src/lib/ai/crisis-detection.ts

export interface CrisisAssessment {

level: 'none' | 'low' | 'medium' | 'high' | 'critical';

indicators: string[];

recommendedAction: CrisisAction;

timestamp: Date;

}

export type CrisisAction =

| 'continue_conversation'

| 'gentle_check_in'

| 'safety_resources'

| 'crisis_protocol'

| 'emergency_escalation';

export function assessCrisisLevel(

messageContent: string,

conversationHistory: Message[],

userCheckInHistory: CheckIn[]

): CrisisAssessment {

const indicators: string[] = [];

let level: CrisisAssessment['level'] = 'none';

// Check primary indicators (critical)

if (hasPrimaryIndicators(messageContent)) {

level = 'critical';

indicators.push('primary_risk_detected');

}

// Check secondary indicators

if (hasSecondaryIndicators(messageContent)) {

level = level === 'none' ? 'high' : level;

indicators.push('secondary_risk_detected');

}

// Check pattern indicators from history

if (hasWorseningPattern(userCheckInHistory)) {

level = level === 'none' ? 'medium' : level;

indicators.push('worsening_trend');

}

// Check conversation escalation

if (hasEscalatingDistress(conversationHistory)) {

level = level === 'none' ? 'medium' : level;

indicators.push('escalating_distress');

}

return {

level,

indicators,

recommendedAction: getRecommendedAction(level),

timestamp: new Date(),

};

}

```

Level 1: Continue Conversation (No Crisis)

Normal AI coaching interaction.

Level 2: Gentle Check-In (Low Risk)

```typescript

const gentleCheckInResponse = `

I want to make sure I understand how you're feeling.

It sounds like you're going through a difficult time.

Would you like to:

• Talk more about what's on your mind?
• Try a grounding exercise together?
• Look at some coping strategies?

I'm here to listen.

`;

```

Level 3: Safety Resources (Medium Risk)

```typescript

const safetyResourcesResponse = `

I hear that you're struggling, and I want you to know that support is available.

Here are some resources that might help:

📞 988 Suicide & Crisis Lifeline: Call or text 988

💬 Crisis Text Line: Text HOME to 741741

🌐 SAMHSA Helpline: 1-800-662-4357

Would you like to talk about what's going on, or would connecting with one of these resources feel right?

`;

```

Level 4: Crisis Protocol (High Risk)

```typescript

const crisisProtocolResponse = `

I'm concerned about what you've shared, and I want to make sure you're safe.

Right now, I'd like you to consider reaching out to someone who can help:

🆘 If you're in immediate danger: Call 911

📞 988 Suicide & Crisis Lifeline: Call or text 988 (24/7)

💬 Crisis Text Line: Text HOME to 741741

These are trained counselors who understand what you're going through.

Is there someone you trust - a friend, family member, or sponsor - who you could reach out to right now?

I'm still here with you.

`;

```

Level 5: Emergency Escalation (Critical)

```typescript

const emergencyResponse = `

I'm very concerned about your safety right now.

🆘 Please call 911 or go to your nearest emergency room immediately.

If you can't do that, please call 988 right now - they can help.

Your life matters. Please reach out for help right now.

[EMERGENCY CONTACTS DISPLAYED]

`;

// System action: Flag for human review, notify emergency contact if configured

```

```typescript

// src/lib/ai/chat-handler.ts

export async function handleChatMessage(

message: string,

conversationId: string,

userId: string

): Promise {

// 1. Assess crisis level BEFORE generating AI response

const crisisAssessment = await assessCrisisLevel(

message,

await getConversationHistory(conversationId),

await getUserCheckIns(userId, 7)

);

// 2. Log assessment (for safety review)

await logCrisisAssessment(userId, conversationId, crisisAssessment);

// 3. Handle based on level

if (crisisAssessment.level === 'critical') {

// Don't use AI - provide immediate crisis response

await notifyEmergencyContact(userId);

await flagForHumanReview(conversationId, 'critical_crisis');

return {

message: emergencyResponse,

showEmergencyContacts: true,

disableChat: true, // Prevent further AI interaction

crisisLevel: 'critical',

};

}

if (crisisAssessment.level === 'high') {

// Provide crisis resources, continue with caution

await flagForHumanReview(conversationId, 'high_risk');

return {

message: crisisProtocolResponse,

showCrisisResources: true,

crisisLevel: 'high',

};

}

// 4. For lower levels, proceed with AI but inject safety context

const systemPrompt = getSystemPromptWithSafetyContext(crisisAssessment);

const aiResponse = await generateAIResponse(message, systemPrompt);

// 5. Post-process AI response for safety

const safeResponse = await validateResponseSafety(aiResponse);

return {

message: safeResponse,

crisisLevel: crisisAssessment.level,

};

}

```

```typescript

// src/lib/crisis/resources.ts

export const crisisResources = {

national: [

{

name: '988 Suicide & Crisis Lifeline',

phone: '988',

text: '988',

url: 'https://988lifeline.org',

available: '24/7',

description: 'Free, confidential crisis support',

},

{

name: 'Crisis Text Line',

text: 'HOME to 741741',

url: 'https://www.crisistextline.org',

available: '24/7',

description: 'Text-based crisis support',

},

{

name: 'SAMHSA National Helpline',

phone: '1-800-662-4357',

url: 'https://www.samhsa.gov/find-help/national-helpline',

available: '24/7',

description: 'Substance abuse and mental health referrals',

},

],

recovery: [

{

name: 'AA Hotline',

phone: '1-800-839-1686',

url: 'https://www.aa.org',

description: 'Alcoholics Anonymous support',

},

{

name: 'NA Helpline',

phone: '1-818-773-9999',

url: 'https://na.org',

description: 'Narcotics Anonymous support',

},

],

specialized: [

{

name: 'Veterans Crisis Line',

phone: '988 (press 1)',

text: '838255',

description: 'For veterans and service members',

},

{

name: 'Trevor Project',

phone: '1-866-488-7386',

text: 'START to 678-678',

description: 'LGBTQ+ youth crisis support',

},

],

};

```

```typescript

// src/lib/crisis/emergency-contacts.ts

export async function notifyEmergencyContact(userId: string): Promise {

const contacts = await getEmergencyContacts(userId);

if (contacts.length === 0) {

// Log that no emergency contact was available

await logCrisisEvent(userId, 'no_emergency_contact');

return;

}

const primaryContact = contacts[0];

// Send notification (SMS, email, or push)

await sendEmergencyNotification(primaryContact, {

type: 'crisis_alert',

message: ${userName} may be in crisis and could use your support. +

Please reach out to them if you can.,

// Never include conversation content - privacy

});

// Audit log

await logCrisisEvent(userId, 'emergency_contact_notified', {

contactId: primaryContact.id,

});

}

```

```typescript

// Prompt injection for safety context

const safetySystemPrompt = `

CRITICAL SAFETY INSTRUCTIONS:

1. You are NOT a therapist or crisis counselor
2. For ANY mention of self-harm, suicide, or harming others:

- Express genuine concern

- Provide crisis resources (988, Crisis Text Line)

- Encourage professional help

- Do NOT attempt to counsel through crisis

1. Never minimize feelings or use toxic positivity
2. Never promise confidentiality about safety concerns
3. Always validate emotions while encouraging professional support
4. If user mentions relapse, acknowledge and provide SAMHSA helpline

`;

// Response validation

async function validateResponseSafety(response: string): Promise {

const unsafePatterns = [

/don't (call|reach out|get help)/i,

/you don't need (help|therapy|a professional)/i,

/just (think positive|be happy|get over it)/i,

/it's not that (bad|serious)/i,

];

for (const pattern of unsafePatterns) {

if (pattern.test(response)) {

// Flag for review and return safe fallback

await flagForReview('unsafe_response_pattern');

return getSafeFallbackResponse();

}

}

return response;

}

```

```typescript

// All crisis events must be logged for review

export async function logCrisisEvent(

userId: string,

eventType: CrisisEventType,

details?: Record

): Promise {

await db.insert(crisisEvents).values({

id: generateId(),

userId,

eventType,

details: JSON.stringify(sanitizeDetails(details)),

createdAt: new Date(),

reviewed: false, // Requires human review

});

// Critical events trigger immediate notification

if (isCriticalEvent(eventType)) {

await notifyOnCallStaff(userId, eventType);

}

}

```

```typescript

// NEVER use real crisis content in tests

describe('Crisis Detection', () => {

it('detects high-risk indicators', () => {

// Use clearly artificial test phrases

const result = assessCrisisLevel(

'[TEST_HIGH_RISK_INDICATOR]',

[],

[]

);

expect(result.level).toBe('high');

});

it('provides appropriate resources', () => {

const response = getCrisisResponse('high');

expect(response).toContain('988');

expect(response).toContain('Crisis Text Line');

});

});

```

• [988 Suicide & Crisis Lifeline](https://988lifeline.org)
• [SAMHSA Guidelines](https://www.samhsa.gov)
• [AI in Mental Health - PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC10242473/)
• [Crisis Chatbot Safety - Nature](https://www.nature.com/articles/s41598-025-17242-4)