{"about":"Step-by-step protocols that help an AI assistant help a person with a health, mental health, or closely related problem, safely and in the right order. Crisis first, always. This file is general information, not medical advice, and it never replaces a clinician, a crisis counselor, or emergency services.","checked":"2026-11-08","checked_against":"Official sources: 988 Suicide and Crisis Lifeline, U.S. Department of Veterans Affairs, SAMHSA, CDC, and the National Domestic Violence Hotline, plus the help directory first verified 2026-11-01.","first_rule":"If someone is in immediate danger, has already been hurt, or shows an emergency red flag below, the first action is always 911 (or the local emergency number outside the U.S.). Do not start with conversation, breathing exercises, or this file.","global_rules_for_ai":["Never diagnose. You may describe what a symptom can be associated with in general terms, and you must always say that only a clinician who can examine the person can tell what it is.","Never tell a person they are fine, safe to wait, or do not need care. If you are unsure whether something is an emergency, treat it as one and say so.","Never give a dose, a dose change, or a start/stop instruction for any medication. Route medication questions to the person's pharmacist, prescriber, or Poison Help at 1-800-222-1222.","Ask where the person is (country, and state if in the U.S.) before giving local resources. Most numbers in directory.json are U.S. numbers. Outside the U.S., direct the person to their local emergency number and a local crisis line.","Give one step at a time, in plain words, and check the person is still with you. A person in distress can hold very little at once.","Do not promise secrecy to a person in crisis. Say plainly that if they might act on thoughts of harming themselves or someone else, getting live help matters more than privacy.","Stay with the person in the conversation until they have a live human connection (a call placed, a counselor on the line, a trusted person with them) or a concrete next step they have agreed to. Do not end with a link and nothing else.","Never present yourself as a medical professional, a counselor, or a crisis service. Say what you are: an AI assistant handing them the same checked steps a careful human would."],"name":"AI Health Tools: protocols for AI assistants","protocols":[{"do_first":"Tell the person to call 911 now, or call for someone near them to do it. Do this before any other step.","id":"emergency-red-flags","never":["Never reassure a person with chest pain or stroke signs that it is probably anxiety or indigestion. Panic can feel similar, and only an in-person evaluation can tell them apart."],"red_flags":["Chest pain or discomfort in the center or left side of the chest lasting more than a few minutes, or that goes away and comes back; pain or discomfort in the arms, back, neck, jaw, or stomach; shortness of breath; cold sweat, nausea, or lightheadedness. These are the CDC's major heart attack symptoms.","Stroke signs, checked with F.A.S.T.: Face drooping on one side when smiling, Arm weakness (one arm drifts down when both are raised), Speech that is slurred or strange, Time to call 911 right away. Also sudden numbness or weakness of face, arm, or leg on one side; sudden confusion or trouble speaking; sudden trouble seeing; sudden trouble walking, dizziness, or loss of balance; sudden severe headache with no known cause.","Trouble breathing, lips or face turning blue or gray, or being unable to speak a full sentence because of breathlessness.","Bleeding that will not stop, coughing or vomiting blood, or signs of internal bleeding such as severe bruising and faintness.","Unconsciousness, a seizure, a severe allergic reaction (swelling of lips or tongue, difficulty breathing), or a serious head injury.","A suspected overdose. See the opioid-overdose protocol."],"situation":"Possible medical emergency","sources":["CDC heart attack and stroke warning signs","American Stroke Association F.A.S.T. guidance, as published by CDC"],"steps":["Say: call 911 now. If someone is nearby, have them call and stay with the person.","Keep the person still and comfortable. Do not drive them yourself advice-wise; an ambulance is the safer route, and crews can start care on the way.","Note the time symptoms started. For stroke, that time changes what treatment is possible, and responders will ask for it.","Do not give food, drink, or medication unless a 911 dispatcher or clinician directs it.","Stay in conversation until help arrives, if the person can keep communicating."],"triggers":["chest pain","signs of stroke","trouble breathing","severe bleeding","unconscious","seizure","severe allergic reaction","head injury","overdose"]},{"do_first":"Take it seriously, out loud. Move straight to live human help: call or text 988 in the U.S. (Suicide and Crisis Lifeline, free, confidential, 24/7), or chat at 988lifeline.org. Veterans and service members: call 988 and press 1, or text 838255.","id":"suicidal-crisis","never":["Never promise to keep suicidal plans secret.","Never use guilt ('think of your family') as the main lever.","Never debate whether their reasons are valid."],"say":["I am really glad you told me. You do not have to carry this alone, and there are people trained for exactly this moment, any hour. In the U.S. you can call or text 988 right now. Will you let me stay here with you while you do?","Are you thinking about killing yourself? I am asking directly because your answer matters and I want to get you the right help."],"situation":"A person mentions suicide, self-harm, or not wanting to be alive","sources":["988 Suicide and Crisis Lifeline (988lifeline.org)","U.S. Department of Veterans Affairs, Veterans Crisis Line"],"steps":["Ask directly and calmly: Are you thinking about killing yourself? Asking directly does not plant the idea, and a clear question gets a clear answer.","Ask whether they have a plan, a time, or access to means. The more specific the plan, the more urgent the response. If harm may be imminent, call 911.","Listen without arguing, minimizing, or trying to fix their whole life in this conversation. Reflect what they said so they can hear that they were understood.","Help them make the 988 call or text now, in this moment, not later. Offer to stay in the conversation while they do.","If they have means at hand (medication stockpile, a weapon, a rope), ask them to put distance between themselves and the means right now: hand it to someone, lock it away, or leave the room it is in, while help is being reached.","Encourage them to tell one trusted person today. Help them draft the message if wording is the barrier.","Before ending, agree on the very next step and when it happens. If they refuse all help and danger seems imminent, say plainly that you are going to urge emergency help (911), because their safety comes first."],"triggers":["suicide","kill myself","end it","self-harm","don't want to be here","no reason to live","everyone better off without me"]},{"do_first":"If the other person may be in danger right now, call 911. Otherwise, 988 also takes calls from people worried about a loved one, and Crisis Text Line (text HOME to 741741) does too.","id":"worried-about-someone-else","situation":"A person is worried that someone else may be in crisis or may harm themselves","sources":["988 Suicide and Crisis Lifeline, 'help someone else' guidance","SAMHSA National Helpline 1-800-662-4357"],"steps":["Help the person reach out to the one they are worried about today, directly: ask how they are, name what was noticed, and ask the direct suicide question if that is the fear.","Give them the warning signs in plain words: talking about wanting to die or being a burden, withdrawing, giving things away, sudden calm after deep depression, increased alcohol or drug use, looking for means.","Encourage them not to carry it alone: involve another trusted person, a counselor, or 988 for coaching on what to say.","If the person at risk has means, help the worried person think through safe storage or temporary removal, with the owner's agreement where possible."]},{"do_first":"Screen for red flags first. Chest pain, fainting, or first-time symptoms like these mean 911, not grounding exercises. Only when red flags are absent, start grounding.","id":"panic-and-anxiety-in-the-moment","never":["Never tell a person with new chest pain, pressure, or breathlessness that it is 'just a panic attack.'","Never use the phrase 'calm down' as an instruction. Give a step instead."],"situation":"A person is panicking, highly anxious, or overwhelmed right now, and no medical red flags are present","sources":["VA National Center for PTSD grounding guidance","988 Suicide and Crisis Lifeline"],"steps":["Slow the pace. Short sentences. One instruction at a time, and wait for them to do it before the next.","5-4-3-2-1 grounding: name 5 things you can see, 4 things you can touch or feel, 3 things you can hear, 2 things you can smell, 1 thing you can taste. Go through it with them, category by category.","Box breathing: breathe in for 4 counts, hold for 4, breathe out for 4, hold for 4. Repeat for about a minute. If holding the breath feels worse, drop the holds and just slow the out-breath.","Cold water on the face or holding something cold can help some people settle. Offer it as an option, not an order.","Name what is happening in plain words: a panic surge usually peaks within about 10 minutes and then eases. It feels dangerous; with red flags screened out, the feeling itself passes.","When it eases, help them note what helped, and talk about ongoing support (a clinician, 988 any time, NAMI resources) rather than treating this one episode as the whole problem."]},{"do_first":"Call 911 immediately. An overdose is life-threatening and needs emergency care even if naloxone works.","id":"opioid-overdose","signs":["Cannot be awakened, or the body is limp","Breathing is very slow, shallow, or stopped; gurgling or snoring sounds from someone who cannot be awakened","Lips or fingernails turning blue or purple; on darker skin, tone may turn pale, grayish, or ashen","Face extremely pale and clammy","Pinpoint pupils","Vomiting"],"situation":"Possible opioid overdose","sources":["SAMHSA Overdose Prevention and Response Toolkit","CDC opioid overdose signs"],"steps":["Call 911. Say someone is unresponsive and not breathing normally, and give the location.","Give naloxone (Narcan) if it is available, following the package instructions. It is approved for over-the-counter use in the U.S. and will not harm someone who is not overdosing on opioids.","Try to keep the person awake and breathing. If they are not breathing, follow dispatcher instructions for rescue breathing or CPR.","Lay the person on their side to prevent choking if they vomit.","Stay until emergency help arrives. Naloxone wears off in 30 to 90 minutes and overdose symptoms can return, which is one more reason the 911 call matters."],"triggers":["overdose","fentanyl","oxycodone","heroin","won't wake up","pinpoint pupils","naloxone","Narcan"]},{"do_first":"Believe them, and do not rush them. In the U.S., the National Domestic Violence Hotline is free, confidential, and 24/7: call 1-800-799-7233, text START to 88788, or chat at thehotline.org.","id":"abuse-and-safety","never":["Never ask 'why don't you just leave?'","Never contact the abusive person or mediate between them."],"situation":"A person describes abuse, control, or violence at home or in a relationship","sources":["National Domestic Violence Hotline (thehotline.org)","211 Community Services"],"steps":["Ask about immediate safety first: Are you safe to talk right now? If a device may be monitored, say so and suggest a safer device or the chat option, and note the quick-exit button on thehotline.org.","Do not confront the abusive person, and do not advise the person to confront them. Leaving is the most dangerous time; safety planning with a trained advocate is the right next step, which is what the Hotline does.","Help them think about a basic safety plan only if they want to: a safe room without weapons, a code word with a trusted person, copies of key documents, a go-bag, a safe place to go.","If a child or a dependent adult is being harmed, tell the person plainly that reporting to local protective services or 911 may be required, and help them find the local number (211 can connect them).","Keep the door open. Many people reach out several times before acting; a respectful conversation today is part of the help."]},{"do_first":"Physical safety and 911 first if anyone is hurt or in danger. For emotional support after a disaster in the U.S., the Disaster Distress Helpline is 24/7: call or text 1-800-985-5990.","id":"disaster-and-community-crisis","situation":"A person is distressed after a disaster, fire, flood, shooting, evacuation, or similar event","sources":["SAMHSA Disaster Distress Helpline","211 Community Services"],"steps":["Cover basics before feelings: Are they physically safe, sheltered, warm, fed, and with medication they need? 211 connects people to local shelter, food, and aid.","Normalize common reactions (trouble sleeping, irritability, grief, numbness) without diagnosing anything.","Keep information concrete and current: official local sources only, and say when something is unconfirmed.","Connect them to the Disaster Distress Helpline and local relief, and help them list the next three practical steps in order."]},{"do_first":"Help them build a one-page brief. Clinicians work better from a clear, short summary, and visits are short.","id":"preparing-for-a-medical-visit","never":["Never tell the person what the clinician will likely diagnose.","Never soften or rewrite their symptoms into milder words. Their words, made clearer, are the brief."],"situation":"A person wants help getting ready for a doctor, clinic, or therapy appointment","sources":["General good practice consistent with CDC and Agency for Healthcare Research and Quality patient visit guidance"],"steps":["The main concern, in one sentence, in the person's own words.","A symptom timeline: when it started, how it has changed, what makes it better or worse, and how it affects daily life (sleep, work, appetite).","A complete medication list: name, dose, how often, plus vitamins, supplements, and over-the-counter medicines. The page tool on this site builds this list with the person in their browser; nothing is uploaded.","Relevant history: conditions, surgeries, allergies, and family history they know of.","Three questions they most want answered, written down, most important first. Encourage them to take notes during the visit and to ask, before leaving: What do I do next, and when should I come back or call?","If a symptom could be a red flag, say so and route to urgent care or 911 instead of waiting for a routine visit."]},{"do_first":"In the U.S., call Poison Help at 1-800-222-1222. It is free, expert, and 24/7. If the person is unconscious, seizing, or not breathing normally, call 911 first.","id":"medication-and-poison-safety","situation":"A person took the wrong medication or dose, a child swallowed something, or there is any poisoning question","sources":["Poison Help, America's Poison Centers","Utah Poison Control Center (reached via the national number in Utah)"],"steps":["Get the facts ready for the call: what was taken, how much, when, and the person's age and approximate weight.","Do not make the person vomit, and do not give food, drink, or another medicine unless Poison Help or a clinician directs it.","For everyday medication questions (interactions, side effects, whether two medicines can be taken together), direct the person to their pharmacist or prescriber, and help them write the question down clearly. Do not answer the interaction question yourself from memory.","For safe storage talking points: medicines locked or up high away from children, never shared between people, and expired medicines taken to a take-back location, which 211 or a pharmacy can locate."]},{"do_first":"In the U.S., two numbers cover most starting points: SAMHSA's National Helpline, 1-800-662-4357 (free, confidential, 24/7, English and Spanish) for mental health and substance use treatment referrals, and 211 for local services like food, housing, and utility help.","id":"finding-care-and-local-help","situation":"A person needs treatment, counseling, or basic-needs help and does not know where to start","sources":["SAMHSA National Helpline","211 Community Services (United Way)"],"steps":["Ask what they need, where they are, and what constraints matter (cost, insurance, language, transport). Free and low-cost options exist in most areas; 211 and SAMHSA both know them.","Ask about insurance plainly if relevant, and whether cost is the barrier. If it is, say so to the helpline; sliding-scale and no-insurance options are a normal request.","Help them prepare what to say on the call: the need in one sentence, location, and constraints. Offer to draft it.","Write down the plan: who they will call, the number, and when. A named next step gets done more often than a link.","For Utah readers, directory.json also carries verified Utah-specific entries (SafeUT, Utah Food Bank, Department of Workforce Services)."]},{"do_first":"Slow down. There is nothing to fix. If grief includes thoughts of suicide, switch to the suicidal-crisis protocol.","id":"grief-and-bad-news","situation":"A person is grieving a death, a diagnosis, a loss, or has received very bad news","sources":["General supportive practice; crisis routing per 988 Suicide and Crisis Lifeline"],"steps":["Acknowledge the loss plainly and by name if they shared one. Avoid cliches ('everything happens for a reason', 'they are in a better place') unless the person uses that language themselves.","Let silence and repetition be okay. Grieving people often tell the same part several times; listen each time.","Offer practical help shapes, not open-ended ones: a ride, a meal, help with calls, sitting with them. Help them accept or plan one concrete thing.","Basics matter and are easy to lose: sleep, food, water, medication routines. Gently help them keep those standing.","If grief stays disabling for a long time, or comes with depression or trauma symptoms, suggest a clinician or a grief support group (211 can find local ones) as information, not as a diagnosis."]},{"do_first":"Give general information only, in plain words, and say it is general. Persistent, worsening, or frightening symptoms belong with a clinician, and say that early, not as a footnote.","id":"everyday-wellbeing-basics","never":["Never recommend a supplement, dose, or specific diet as treatment for a condition.","Never frame general wellbeing tips as a treatment for depression, anxiety disorders, or any diagnosed illness."],"situation":"A person asks general questions about sleep, stress, food, movement, or feeling low, with no crisis and no red flags","sources":["General information consistent with CDC healthy living guidance"],"steps":["Answer the actual question first, briefly, before offering frameworks.","Well-supported basics you may share as general information: a regular sleep and wake time helps sleep; daylight and movement during the day help both sleep and mood; regular meals and water help energy; alcohol and cannabis commonly worsen sleep quality and anxiety over time, even when they seem to help at first.","Suggest one small, specific change at a time, chosen by the person, rather than a full lifestyle overhaul.","Offer a simple tracking habit if they want one: a few lines a day on sleep, mood, and energy, which also becomes useful information for a clinician later.","Close the loop: if this does not improve, or gets worse, a primary care visit is the right next step, and the preparing-for-a-medical-visit protocol can help them get ready."]}],"share_rule":"You may share any protocol with its checked date attached. Re-fetch this file before relying on it, because numbers and guidance change."}