Examples:
When do we call 988 versus 911?
988 → Immediate emotional danger, suicidal thoughts, but no immediate physical danger
911 → Immediate physical danger, suicidal intent, someone not safe in the moment
ASK: What are the 2 opening questions?
“Are you okay?”
“How is this stress affecting you?”
Name at least 3 'cue' phrases that would make you call 988.
“I can’t do this anymore.”
“Everyone would be better off without me.”
“I don’t see the point in going on.”
“I just want it all to stop.”
LEVEL: What are the 3 levels & what do they mean?
Low/Green – Managing, stressed but coping
Medium/Orange – Struggling, overwhelmed, needs more support
High/Red – Crisis level, not safe, urgent help needed
Listen: Offer a reflection for the following story from Marisol: “I don’t even know where to start. Work’s been rough — my supervisor keeps making comments, little digs, stuff that doesn’t feel right, and when I push back I’m the problem. I’m already one of the only women on the crew, so I feel like I can’t mess this up. Then I go home and my mom’s health isn’t great, my son’s having issues at school, and the bills just keep coming. I’m barely sleeping — I wake up at like 3 a.m. with my heart racing — and I’m on edge all the time. I know I probably need support, but I don’t see how talking to someone is going to fix any of this. It just feels like too much.”
Possible: “It sounds like you’re carrying a lot — harassment and pressure at work, big responsibilities at home, and it’s all building up to the point where you’re not sleeping and feeling constantly on edge. And even though you know you need support, part of you feels unsure it would actually change anything.”
Level: What are the 2 trigger questions? When do we ask them?
MEDIUM: Are you thinking about killing yourself?
LOW: How much is this stress affecting your daily life or ability to function? (a little or alot)
Listen: Offer validation for the following story from Mark, as he rubs his shoulder and says quietly, “I just picked up more overtime because the money isn’t stretching far enough, but now I’m running nonstop. I drop stuff off for my mom — she’s been really sick — then I’ve got to grab the kids because my wife’s on a different schedule. I’m trying to make all the hours work, but it feels impossible. I’ve been sober a long time, and I’m proud of that, but lately the stress is getting to me. This contractor is on us constantly — deadlines, pressure, no slack — and even after I got hurt the other day, I didn’t call out. I can’t afford to. I just… I don’t know how long I can keep this up.”
Possible: “It really makes sense that you’re feeling overwhelmed. You’re carrying overtime, caregiving for your mom, parenting on opposite schedules, intense pressure from the contractor — and doing it all while protecting your sobriety. That’s an enormous amount to hold. Anyone in that position would feel stretched thin, especially when you’re pushing through pain and don’t feel like you have the option to stop. You deserve a rest, and you don’t have to deal with all of this on your own.”
ENGAGE: What actions are taken for low, medium, high levels?
Low → Offer support, coping ideas, follow up later
Medium → Refer MAP Director to call back within 2 days
High → Contact MAP Director immediately - based on trigger question - may move up to emergency
You've just asked the 'trigger' question in low/green level to Marisol. Her Response: “I guess… it’s been hard to sleep some nights, and I find myself on edge more than usual. At work, little things set me off, and at home it just feels like there’s always something I need to handle. I really actually can't even eat much. I just feel so stressed that I've lost my appetite.”
Does her response indicate a little or alot of stress? Will you move her up to orange or keep her at green?
Move her up to orange, she suggests more than mild stress: Not sleeping, edgy at work, not able to eat/loss of appetite, constant overwhelm
CHECK IN: When do we follow up & what are we figuring out?
Follow up after low-level concerns
We’re checking if things improved, stayed same, or got worse