Assess the mental and physical state
- Sleep, mood, voices, unusual perceptions, confusion, and degree of conviction.
- Suicide risk, weapons, confrontation, driving, travel, finances, and self-care.
- Substances, withdrawal, prescriptions, supplements, and recent medication changes.
- Fever, seizure, head injury, neurological changes, postpartum status, and other medical red flags.
- Change from baseline and observations from trusted people.
A clinical assessment does not require dismissing every external concern. It addresses the distress and risk while the facts are evaluated.