You should always have a crisis protocol in place when working with patients via telehealth (especially high risk patients like Veterans suffering from PTSD).


If you are working with Triwest patients, it is mandatory that you have a crisis protocol in place.


Below you will find an example of the crisis protocol step-by-step for Triwest patients:


Crisis Contact Step-by-Step:

  1. De-escalate the Veteran if at all possible. If unable to do so, please contact the appropriate police department immediately making sure to give them the emergency contact information and mentioning any unsecured weapons, if any. If you have front end staff, it is suggested that you create an internal messaging system to notify them when the police need to be called, so that you may remain on the call with the Veteran. Many of our providers use a messaging system with a quick code word and the last 4 of the SSN. That way the provider doesn’t appear distracted and the office staff can begin calling.
  2. Once the police have been contacted –
    1.   If you are still on the call with the Veteran, keep them engaged until the police arrive and the Veteran is secured. Move to step 3.
    2. If you are NOT on the call with the Veteran and are unable to get them on the phone, move to step 3
  3. Contact the VA’s Internal Crisis Contact to let them know what occurred. The VA will begin preparations to house the Veteran in an inpatient situation or take any additional steps. Please give them the emergency contact information. 
    1. The VA’s Internal Crisis Contact is located in the Veteran’s consult under the “Local VA Office of Community Care (OCC) Contact” header which tends to be near the very bottom of the authorization. You will look for “AOD/Emergency Contact After Hours Number”. Regardless of business hours, this is the Internal Crisis Contact number and will connect you with a Mental Health nurse within the facility.
  4. Only if requested by the Veteran:  Contact the Veteran’s emergency contact to let them know that the Veteran had a crisis situation and that the police and VA had to be called. Do not release sensitive information unless the Veteran has given you permission to do so. 
  5. It is recommended that you give the emergency contact information to the police/hospital/VA so that they might make contact instead of you.
  6.  Please email Hallena Hinkle (hhinkle@TriWest.com) a summary of events once you have a moment. She will notate the Veteran’s profile and alert the VA through our system.


Attached you will find a sample crisis protocol that you can use to put together a protocol for your patients.


Please access this link for additional resources presented by the VA regarding suicide risk and crisis protocol.