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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@@ -30,6 +30,7 @@ from app.db.audit import audit
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from app.db.session import get_clinical_session
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from app.integrations.base import integrations
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from app.services.contracts import register_monitoring
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from app.services.followup import schedule_post_crisis_call
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from app.services.snapshot import build_snapshot
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log = logging.getLogger(__name__)
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@@ -93,6 +94,7 @@ class RuleMonitoring:
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ts=now,
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)
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notify.append((ON_DUTY_DOCTOR, level, action.reason_ru))
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await schedule_post_crisis_call(s, token, now, source=f"rule:{action.code}")
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await refresh_status(s, token)
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log.info("monitoring token=%s actions=%s", token, [a.code for a in actions])
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for doctor_id, level, text in notify:
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