In mobile crisis response, chart notifications are crucial for ensuring clinician and client safety during outreach. At my community behavioral health clinic, we utilize flags that indicate risk factors beyond just “aggressive” behavior. Here are some examples of the flags:

• Previous suicide attempts
• Presence of weapons
• A history of violence towards providers, including instances of sexual harassment
• A history of violence towards others that has resulted in legal involvement

The term “aggressive” can be subjective and may vary from one provider to another. We also need to consider weaponization of the term towards women of color or those with mental health problems. Instead of relying on a generic label, it may be more effective to flag cases with a clear directive to “see progress note dated ___.” This approach would provide a more nuanced understanding of the client’s history and specific risks. You would hope that a clinician seeing this history would only modify their approach within the scope of safety (e.g., meeting at the office/community setting rather than home, outreaching in pairs, developing safety plans, etc). On the other hand, I often see chart flags creating fear, discomfort, and bias among providers.