No Good Options — Field Guide

Weapon, fire, traffic, active assault, severe self-injury, medical instability, unsafe location.

Welfare check, investigation, transport, arrest, missing-person recovery, medical assessment.

Speakers, proximity, wording, lights, touch, pace, eye-contact demand, communication channel.

Baseline, current change, safety risk, communication, medical information, what helps, next owner.

What is normal? What changed? What medical red flags exist?

Speech, writing, AAC, visuals, one question, processing time, support person.

Quiet area where feasible, fewer room changes, lower unnecessary noise/light, familiar regulation tools if safe.

Owner, medication changes, warning signs, referral, date, fallback.

Define PACE and the difference between immediate danger, required task, avoidable pressure, and handoff. State that accommodation never means ignoring a weapon, traffic hazard, medical instability, or lawful duty.

Use examples: delayed speech, no eye contact, pacing, reaching for a phone/AAC device, bolting, shutdown, sudden self-injury. Ask what each behavior proves—and what it does not prove.

Run the same scene twice: command-heavy and then one lead voice + concrete instruction + processing time + usable communication method. Compare observable results without assuming one method always works.

Do not announce the diagnosis or the correct answer. Learners must identify threat, medical uncertainty, communication access, caregiver evidence, autonomy, and next destination.

Practice a 30-second handoff to EMS/ED/crisis staff: what happened, actual hazard, baseline/current change, communication method, relevant medical information, interventions tried, and unresolved concerns.

Ask what added pressure, what reduced uncertainty, what evidence changed the decision, and what must be documented for the next team and supervisor.

911, 988, CMHC crisis response, CSU, EMS, ED, outpatient services, and what each role can and cannot do. Identify local gaps rather than teaching an imaginary statewide response.

Use four rapid vignettes. Learners name the actual hazard, required task, and one avoidable pressure. Instructor challenges unsupported assumptions.

Rotate speech, delayed response, typing/AAC, gesture, and caregiver-supported communication. Practice one lead voice, concrete language, processing time, and confirmation of understanding.

Present new self-injury, agitation, shutdown, or confusion without telling learners whether the cause is pain, seizure, intoxication, panic, overload, victimization, or psychiatric illness.

Teams decide what destination/service is actually appropriate based on the facts and local capability, then deliver a 30-second handoff.

Practice using caregiver baseline evidence while directly communicating with an adult through their usable method and recognizing when legal authority or safeguarding requires clarification.

Score the scenario, identify avoidable escalation, document observations, and name one policy/system problem the individual responder could not solve alone.

“We responded for elopement near traffic. No weapon seen. The person is currently non-speaking but uses a phone to type. Parent reports this is below baseline. No known injury. We reduced voices/proximity and they stopped running.”

Include pain/injury/seizure/medication/allergy facts, usable communication, sensory/touch factors, restraints or medications used if relevant, and what remains unexplained.

Diagnosis/treatment when known, medication changes, warning signs, next referral, responsible team, timing/check-back, and fallback if follow-up fails.

“She is speaking less than baseline. She may bolt if crowded. One person speaking and no sudden touch usually lowers the overload. No weapon; she hit her head on the wall twice.”