fix(clinical): red flags, one crisis rule, callback after a crisis, one table of numbers
Clinical review of the questionnaires (ADR-013):
- Red-flag block first in stage 1 (config/instruments/red_flags.yaml); any «Да» stops the
questionnaire with an acute alert and the help screen of its category.
- One crisis rule: the crisis screen opens at a HIGH C-SSRS risk only; moderate stops and goes
to a psychiatrist (24 h as a guide), low is a flag with the safety plan. PHQ-9 item 9 with a
negative screener is a discrepancy flag; without a completed screener it asks the C-SSRS at once.
config/questionnaire.yaml: cssrs_positive_policy graded (C01).
- Every crisis leaves a callback task for the doctor on duty (post_crisis_call, one per patient)
and the app asks how the person is the next day, the safety plan one tap away.
- Routing: risk and flags first, scales second; PCL-5 >= 50 no longer means a priority
appointment (pcl5_severe is moderate on the dashboard too).
- Crisis numbers live only in config/texts/crisis.yaml; texts and the agent prompt refer to them
via {phone:<key>}. Fixes the children's helpline offered to adults by the chat agent.
Refs #92
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
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@@ -53,11 +53,25 @@ def cssrs_answers(answers: dict) -> dict[str, int]:
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return {k.removeprefix("cssrs_"): v for k, v in answers.items() if k.startswith("cssrs_")}
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def red_flags() -> dict:
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return yaml.safe_load((get_settings().config_dir / "instruments/red_flags.yaml").read_text(encoding="utf-8"))
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def red_flag_category(item_id: str) -> str | None:
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return next((i["category"] for i in red_flags()["items"] if i["id"] == item_id), None)
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def next_intake(answers: dict, policy: IntakePolicy, sex: str | None) -> Question | None:
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"""Stage 1 in the fixed order of «Опросники для MVP»: PHQ-2, trauma filter → TSQ, RUS-AUDIT-S, C-SSRS screener,
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then the context questions; stage 2 (rest of PHQ-9, PCL-5, full RUS-AUDIT) only where stage 1 is positive.
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Items inside a scale keep the order of the source. The risk stop rules run after every answer (flows/intake.py),
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so a positive answer interrupts the questionnaire wherever it comes."""
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"""Stage 1: the red-flag block first (config/instruments/red_flags.yaml), then the fixed order of «Опросники
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для MVP»: PHQ-2, trauma filter → TSQ, RUS-AUDIT-S, C-SSRS screener, the context questions; stage 2 (rest of
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PHQ-9, PCL-5, full RUS-AUDIT) only where stage 1 is positive. Items inside a scale keep the order of the source.
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The risk stop rules run after every answer (flows/intake.py), so a positive answer interrupts the questionnaire
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wherever it comes."""
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flags = red_flags()
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for n, item in enumerate(flags["items"]):
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if item["id"] not in answers:
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text = (flags["intro"] + "\n\n" if n == 0 else "") + item["text"]
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return Question(item["id"], text, tuple((o["value"], o["label"]) for o in flags["options"]), "now")
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for item in ("phq9_1", "phq9_2"):
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if item not in answers:
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return scale_question("phq9", item)
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