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>
This commit is contained in:
2026-10-04 16:21:16 +03:00
co-authored by Claude Opus 5.5
parent bde6ec6855
commit 44814b7293
29 changed files with 365 additions and 56 deletions
+12 -1
View File
@@ -22,11 +22,13 @@ from app.db import repo
from app.db.clinical import PatientProfile
from app.db.intake import QuestionnaireTask
from app.db.session import get_clinical_session
from app.dialog.contracts import Event, Reply, get_engine
from app.dialog.contracts import Button, Event, Reply, get_engine
from app.dialog.texts import load_dialog_texts
from app.integrations.base import integrations
from app.scheduler import demo
from app.services import monitoring
from app.services import questionnaire as service
from app.services.followup import next_day_check_due
log = logging.getLogger(__name__)
_worker = None
@@ -43,6 +45,15 @@ async def plan():
state = await repo.get_dialog_state(session, profile.token)
if not state or state.data.get("consent") is not True or state.data.get("adult") is not True:
continue
crisis = state.data.get("crisis")
if next_day_check_due(crisis, now):
# The day after a crisis the app asks how the person is, the safety plan one tap away.
texts = load_dialog_texts()
plan_button = Button(label=texts.safety_plan.title.rstrip(":"), data="safety_plan")
await integrations.outbox.push(
profile.token, [Reply(text=texts.reach_out.after_crisis, buttons=[[plan_button]], kind="question")]
)
state.data = {**state.data, "crisis": {**crisis, "followup_sent": now.isoformat()}}
rows = await service.records(session, profile.token)
initial = next((r for r in reversed(rows) if r.kind == "intake" and r.status == "complete"), None)
if initial is None: