fix(web): offer anonymous screening and doctor contact without identity

Refs #95, #96

.env.example

@@ -6,6 +6,11 @@ GIGACHAT_CREDENTIALS=
 GIGACHAT_SCOPE=GIGACHAT_API_PERS
 GIGACHAT_MODEL=GigaChat
 
+# --- Chat agent: auto | off | mock | openrouter | gigachat. OpenRouter = temporary, synthetic data only.
+CHAT_AGENT=auto
+OPENROUTER_API_KEY=
+OPENROUTER_MODEL=google/gemini-2.5-flash-lite
+
 # --- Pseudonymisation key: 32+ random bytes, hex. Generate: python -c "import secrets;print(secrets.token_hex(32))"
 PSEUDO_KEY=
 
@@ -22,6 +27,9 @@ DOCTOR_NOTIFY_CHAT_ID=
 
 # --- Demo virtual clock (ADR-005)
 DEMO_CLOCK=true
+# Questionnaires of the intake (#53) on synthetic data, demo only (needs DEMO_CLOCK). The clinical release gate in
+# config/intake_runtime.yaml stays closed; without a signed routing policy every finished intake goes to review.
+INTAKE_DEMO=false
 TZ=Europe/Moscow
 
 # --- Gitea (for Claude Code / team workflow, not used by the app)
@@ -29,3 +37,13 @@ GITEA_URL=https://gitea.24studbank.ru
 GITEA_REPO=MedITron/PTSRaiAgent
 GITEA_USER=
 GITEA_TOKEN=
+# MAX notifications: keep disabled until the backend/channel PRs and a real bot are installed.
+MAX_ENABLED=false
+MAX_BOT_TOKEN=
+MAX_BOT_USERNAME=
+MAX_WEBHOOK_SECRET=
+MAX_WEBHOOK_URL=
+MAX_SITE_URL=
+# Optional path to a trusted PEM CA bundle; never disable TLS verification.
+MAX_CA_BUNDLE=
+MAX_LINK_TTL_SECONDS=600

.gitattributes

@@ -0,0 +1,2 @@
+# Shell scripts run inside Linux containers: never check them out with CRLF (bash fails on the carriage return).
+*.sh text eol=lf

.streamlit/config.toml

@@ -0,0 +1,18 @@
+# Dashboard-only Streamlit settings (doctor dashboard + demo console).
+[theme]
+base = "light"
+primaryColor = "#285E4E"
+backgroundColor = "#F6F7F3"
+secondaryBackgroundColor = "#FFFFFF"
+textColor = "#213B38"
+borderColor = "#E1E7E3"
+baseRadius = "medium"
+# Falls back to the system sans-serif when offline (ADR-004).
+font = "sans-serif"
+headingFontWeights = 600
+
+[client]
+toolbarMode = "minimal"
+
+[browser]
+gatherUsageStats = false

app/api/demo.py

@@ -0,0 +1,89 @@
+"""Demo-console helpers (#12, ADR-005): scripted personas, reset, connect links, outbox access.
+
+Synthetic data only. Scenario files live in `data/synthetic/<slug>.jsonl` (#18); a patient is a scripted persona
+when the transliterated first word of the display name equals the slug ("Андрей С." → `andrey.jsonl`).
+"""
+
+import inspect
+import logging
+from importlib import import_module, util
+from pathlib import Path
+
+from app.config import get_settings
+from app.integrations.base import MemoryOutbox, Outbox, integrations
+
+log = logging.getLogger(__name__)
+
+SEED_MODULE = "scripts.seed_demo"
+CONSOLE_PATH = "/console"
+
+_TRANSLIT = {
+    "а": "a", "б": "b", "в": "v", "г": "g", "д": "d", "е": "e", "ё": "e", "ж": "zh", "з": "z", "и": "i",
+    "й": "y", "к": "k", "л": "l", "м": "m", "н": "n", "о": "o", "п": "p", "р": "r", "с": "s", "т": "t",
+    "у": "u", "ф": "f", "х": "kh", "ц": "ts", "ч": "ch", "ш": "sh", "щ": "shch", "ъ": "", "ы": "y", "ь": "",
+    "э": "e", "ю": "yu", "я": "ya",
+}  # fmt: skip
+
+
+def persona_slug(display_name: str) -> str:
+    first = (display_name.split() or [""])[0].lower()
+    return "".join(_TRANSLIT.get(ch, ch if ch.isascii() and ch.isalnum() else "") for ch in first)
+
+
+def scenario_files(data_dir: Path | None = None) -> dict[str, str]:
+    """slug → scenario path relative to the project root, e.g. {"andrey": "data/synthetic/andrey.jsonl"}."""
+    root = data_dir or get_settings().data_dir
+    folder = root / "synthetic"
+    if not folder.is_dir():
+        return {}
+    return {f.stem: f"data/synthetic/{f.name}" for f in sorted(folder.glob("*.jsonl"))}
+
+
+async def bot_username() -> str | None:
+    """Username of the running Telegram bot (deep links); None when the bot is not started (no TG_BOT_TOKEN)."""
+    from app.channels import telegram
+
+    bot = getattr(telegram, "_bot", None)
+    if bot is None:
+        return None
+    try:
+        me = await bot.me()  # aiogram caches getMe
+    except Exception as exc:  # noqa: BLE001 — network / auth errors: fall back to the web console link
+        log.warning("bot username unavailable error=%s", type(exc).__name__)
+        return None
+    return me.username or None
+
+
+async def deep_link(code: str) -> str:
+    username = await bot_username()
+    return f"https://t.me/{username}?start={code}" if username else f"{CONSOLE_PATH}?code={code}"
+
+
+def memory_outbox() -> MemoryOutbox | None:
+    """The in-memory outbox polled by the web console, also when wrapped (Telegram keeps it as `fallback`)."""
+    box: Outbox | None = integrations.outbox
+    for _ in range(5):
+        if isinstance(box, MemoryOutbox):
+            return box
+        box = getattr(box, "fallback", None)
+    return None
+
+
+async def reset_demo() -> bool:
+    """Clock reset is done by the caller; re-seed via `scripts.seed_demo.reset()` (#18) when it exists."""
+    box = memory_outbox()
+    if box is not None:
+        box._q.clear()
+    try:
+        spec = util.find_spec(SEED_MODULE)
+    except ModuleNotFoundError:  # no `scripts` package on the path (e.g. installed app without scripts/)
+        spec = None
+    if spec is None:
+        return False
+    reset = getattr(import_module(SEED_MODULE), "reset", None)
+    if reset is None:
+        return False
+    result = reset()
+    if inspect.isawaitable(result):
+        await result
+    return True

app/api/doctor_views.py

@@ -0,0 +1,378 @@
+"""Doctor dashboard read models (#12): clinical DB rows → frozen API schemas (`app/api/schemas.py`).
+
+Everything shown to the doctor is derived from stored structured data — no LLM decides colours, trends or the
+discontinuation risk (ADR-007). Time comes in as `now` (from `app.core.clock`, ADR-005).
+
+Identity data (guardrail #5): the API is the doctor's display boundary, so it reads exactly two identity fields —
+`display_name` (minimal identification for the treating doctor) and `birth_year` (age). SNILS, phone and chat
+id are never selected into a response model.
+"""
+
+from collections.abc import Iterable, Sequence
+from dataclasses import dataclass
+from datetime import date, datetime, timedelta
+from typing import Any, Literal, cast, get_args
+
+from sqlalchemy import select
+from sqlalchemy.ext.asyncio import AsyncSession
+
+from app.api.schemas import (
+    AlertOut,
+    Color,
+    DiscontinuationRisk,
+    DoseOut,
+    LevelName,
+    Metric,
+    Module,
+    PatientCard,
+    PatientListItem,
+    SeriesPoint,
+)
+from app.core.rules import color, patient_status
+from app.core.types import AlertLevel
+from app.db import repo
+from app.db.clinical import Alert, DailyCheckin, Dose, PatientProfile, Prescription, SafetyPlan, ScaleResult
+from app.db.identity import Patient
+from app.integrations.base import Prescription as PrescriptionOut
+from app.services.anonymous_care import display_name as anonymous_name
+
+COLOR_ORDER: dict[str, int] = {"red": 0, "yellow": 1, "grey": 2, "green": 3}
+_MODULES = frozenset(get_args(Module))
+_METRICS = frozenset(get_args(Metric))
+_SCALE_LABELS = {"phq9": "PHQ-9", "pcl5": "PCL-5", "gad7": "GAD-7", "auditc": "AUDIT-C", "dar5": "DAR-5"}
+
+# Daily check-in buckets → numbers for charts. Sleep: bucket midpoints in hours ("<4" plotted as 3, ">8" as 9).
+SLEEP_HOURS = {"<4": 3.0, "4-6": 5.0, "6-8": 7.0, ">8": 9.0}
+# Alcohol: 0 = none, 1 = 1–2 drinks, 2 = more (same coding as app/llm/summary.py expects).
+ALCOHOL_LEVEL = {"none": 0.0, "1-2": 1.0, "more": 2.0}
+
+# Trend: the last two complete results of one scale. A change smaller than about half of the minimal clinically
+# important difference (PHQ-9: 5 points, PCL-5: 10 points) is reported as "flat" so noise does not flip arrows.
+TREND_MIN_CHANGE = {"phq9": 3, "pcl5": 5}
+
+CARD_DAYS = 60  # how far back the card series / dose log reach
+
+
+# --------------------------------------------------------------------------- discontinuation risk index
+#
+# Rule-based index (NOT a trained model) of the risk that the patient drops the therapy, 0–100, for sorting the
+# list and for the "talk about adherence" hint. Each factor is a deterministic check over the clinical DB with a
+# fixed weight; the score is the capped sum. Weights reflect the known predictors of early antidepressant
+# discontinuation (non-adherence, side effects in the first weeks, expressed intent to stop, low mood, alcohol):
+#
+#   factor                                            weight   label for the doctor
+#   missed/skipped doses on >= 3 of the last 7 days     30     "пропуски приёма N/7 дн."
+#   ... on 1–2 of the last 7 days                       15     "пропуски приёма N/7 дн."
+#   side effects reported >= 3 days in a row            20     "побочные эффекты N дн. подряд"
+#   ... 1–2 days in a row                               10     "побочные эффекты N дн. подряд"
+#   intent to stop medication voiced in last 14 days    25     "хотел бросить (день N)"
+#   open, unacknowledged quit_intent alert             +15     "не разобран сигнал «хочет бросить»"
+#   mood <= 3 for >= 3 days in a row                    15     "настроение ≤ 3 N дн. подряд"
+#   alcohol on >= 3 of the last 7 days                  15     "алкоголь N дн. из 7"
+#   ... on 1–2 of the last 7 days                        5     "алкоголь N дн. из 7"
+#
+# Level: >= 60 high, >= 30 medium, otherwise low. "Day" = calendar day in the clinic time zone; streaks end today
+# if today's check-in exists, otherwise yesterday (same anchor as app.core.rules), and a day without a check-in
+# breaks a streak — we never assume a symptom the patient did not report.
+
+RISK_WINDOW_DAYS = 7
+QUIT_WINDOW_DAYS = 14
+MOOD_LOW = 3
+W_MISSED_MANY, W_MISSED_SOME = 30, 15
+W_SIDE_EFFECTS_LONG, W_SIDE_EFFECTS_SHORT = 20, 10
+W_QUIT_INTENT, W_QUIT_ALERT_OPEN = 25, 15
+W_MOOD_LOW = 15
+W_ALCOHOL_MANY, W_ALCOHOL_SOME = 15, 5
+STREAK_DAYS = 3
+RISK_HIGH, RISK_MEDIUM = 60, 30
+
+
+@dataclass
+class PatientData:
+    """Everything the list item and the card are computed from (one patient, loaded once)."""
+
+    profile: PatientProfile
+    checkins: Sequence[DailyCheckin]
+    results: Sequence[ScaleResult]
+    doses: Sequence[Dose]
+    prescriptions: Sequence[Prescription]
+    alerts: Sequence[Alert]  # newest first
+    contact_requested_at: datetime | None = None
+
+
+async def load_patient_data(session: AsyncSession, profile: PatientProfile) -> PatientData:
+    token = profile.token
+    doses = (await session.scalars(select(Dose).where(Dose.token == token).order_by(Dose.planned_at))).all()
+    rx = (
+        await session.scalars(select(Prescription).where(Prescription.token == token).order_by(Prescription.id))
+    ).all()
+    dialog = await repo.get_dialog_state(session, token)
+    requests = (dialog.data.get("contact_requests") or []) if dialog else []
+    contact_at = datetime.fromisoformat(requests[-1]["ts"]) if requests else None
+    return PatientData(
+        profile=profile,
+        checkins=await repo.list_checkins(session, token),
+        results=await repo.list_scale_results(session, token),
+        doses=doses,
+        prescriptions=rx,
+        alerts=await repo.list_alerts(session, token=token),
+        contact_requested_at=contact_at,
+    )
+
+
+def _local(ts: datetime, now: datetime) -> date:
+    return ts.astimezone(now.tzinfo).date()
+
+
+def _streak_days(checkins: Iterable[DailyCheckin], today: date, pred: Any) -> int:
+    """Length of the run of consecutive check-in days satisfying `pred`, ending at the anchor day."""
+    by_day = {c.day: c for c in checkins if c.day <= today}
+    day = today if today in by_day else today - timedelta(days=1)
+    n = 0
+    while (c := by_day.get(day)) is not None and pred(c):
+        n += 1
+        day -= timedelta(days=1)
+    return n
+
+
+def _therapy_day(profile: PatientProfile, day: date) -> int:
+    return (day - profile.therapy_start).days if profile.therapy_start else 0
+
+
+def _missed_days(d: PatientData, now: datetime, first: date) -> set[date]:
+    # Same sources as rule missed_doses_7d: dose records and the check-in answer "did not take".
+    days = {_local(x.planned_at, now) for x in d.doses if x.status in ("missed", "skipped") and x.planned_at <= now}
+    days |= {c.day for c in d.checkins if c.med_taken is False}
+    return {x for x in days if first <= x <= now.date()}
+
+
+def discontinuation_risk(d: PatientData, now: datetime) -> DiscontinuationRisk:
+    """Deterministic discontinuation-risk index; see the weight table above."""
+    today = now.date()
+    first = today - timedelta(days=RISK_WINDOW_DAYS - 1)
+    score = 0
+    factors: list[str] = []
+
+    missed = len(_missed_days(d, now, first))
+    if missed:
+        score += W_MISSED_MANY if missed >= STREAK_DAYS else W_MISSED_SOME
+        factors.append(f"пропуски приёма {missed}/{RISK_WINDOW_DAYS} дн.")
+
+    side = _streak_days(d.checkins, today, lambda c: bool(c.side_effects))
+    if side:
+        score += W_SIDE_EFFECTS_LONG if side >= STREAK_DAYS else W_SIDE_EFFECTS_SHORT
+        factors.append(f"побочные эффекты {side} дн. подряд")
+
+    quit_since = today - timedelta(days=QUIT_WINDOW_DAYS - 1)
+    quit_days = [c.day for c in d.checkins if c.quit_intent and quit_since <= c.day <= today]
+    if quit_days:
+        score += W_QUIT_INTENT
+        factors.append(f"хотел бросить (день {_therapy_day(d.profile, max(quit_days))})")
+    if any(a.code == "quit_intent" and a.acked_at is None for a in d.alerts):
+        score += W_QUIT_ALERT_OPEN
+        factors.append("не разобран сигнал «хочет бросить»")
+
+    low = _streak_days(d.checkins, today, lambda c: c.mood is not None and c.mood <= MOOD_LOW)
+    if low >= STREAK_DAYS:
+        score += W_MOOD_LOW
+        factors.append(f"настроение ≤ {MOOD_LOW} {low} дн. подряд")
+
+    drinking = sum(1 for c in d.checkins if first <= c.day <= today and c.alcohol_bucket not in (None, "none"))
+    if drinking:
+        score += W_ALCOHOL_MANY if drinking >= STREAK_DAYS else W_ALCOHOL_SOME
+        factors.append(f"алкоголь {drinking} дн. из {RISK_WINDOW_DAYS}")
+
+    score = min(score, 100)
+    level: Literal["low", "medium", "high"] = (
+        "high" if score >= RISK_HIGH else "medium" if score >= RISK_MEDIUM else "low"
+    )
+    return DiscontinuationRisk(score=score, level=level, factors=factors)
+
+
+# --------------------------------------------------------------------------- list item
+
+
+def _complete(d: PatientData, scale: str) -> list[ScaleResult]:
+    return [r for r in d.results if r.scale == scale and r.complete]  # repo returns them oldest first
+
+
+def trend(d: PatientData) -> Literal["up", "down", "flat", "unknown"]:
+    """Direction of symptom scores (up = worse) from the scale with the most recent pair of results."""
+    pairs = [(s, rs[-2:]) for s in TREND_MIN_CHANGE if len(rs := _complete(d, s)) >= 2]
+    if not pairs:
+        return "unknown"
+    scale, (prev, last) = max(pairs, key=lambda p: p[1][-1].ts)
+    delta = last.total - prev.total
+    if abs(delta) < TREND_MIN_CHANGE[scale]:
+        return "flat"
+    return "up" if delta > 0 else "down"
+
+
+def adherence_7d(d: PatientData, now: datetime) -> float | None:
+    """Taken / planned doses of the last 7 days; doses still `pending` (not resolved yet) are not counted."""
+    since = now - timedelta(days=RISK_WINDOW_DAYS)
+    resolved = [x for x in d.doses if since < x.planned_at <= now and x.status != "pending"]
+    if not resolved:
+        return None
+    return round(sum(1 for x in resolved if x.status == "taken") / len(resolved), 2)
+
+
+def _drug_label(rx: Prescription) -> str:
+    return f"{rx.drug} {rx.dose}".strip()
+
+
+def _active_rx(d: PatientData, today: date) -> Prescription | None:
+    active = [
+        r
+        for r in d.prescriptions
+        if (r.start_date is None or r.start_date <= today) and (r.end_date is None or r.end_date >= today)
+    ]
+    return (active or list(d.prescriptions) or [None])[-1]
+
+
+def _last_event(d: PatientData, now: datetime) -> str:
+    alert = d.alerts[0] if d.alerts else None
+    scales = [r for r in d.results if r.complete and r.scale in _SCALE_LABELS]
+    scale = scales[-1] if scales else None
+    if d.contact_requested_at is not None and all(
+        d.contact_requested_at >= ts for ts in [x.ts for x in (alert, scale) if x is not None]
+    ):
+        return "Пациент просит врача связаться"
+    if scale is not None and (alert is None or scale.ts > alert.ts):
+        day = _therapy_day(d.profile, _local(scale.ts, now))
+        return f"{_SCALE_LABELS[scale.scale]} = {scale.total} (день {day})"
+    return alert.reason if alert is not None else ""
+
+
+def _age(patient: Patient | None, profile: PatientProfile, today: date) -> int:
+    birth_year = (patient.birth_year if patient else None) or profile.birth_year
+    return today.year - birth_year if birth_year else 0
+
+
+def list_item(d: PatientData, patient: Patient | None, now: datetime) -> PatientListItem:
+    p = d.profile
+    today = now.date()
+    open_alerts = [a for a in d.alerts if a.acked_at is None]
+    # ADR-006: the colour is derived from open alert levels (the source of truth), not from the cached column.
+    status = patient_status(AlertLevel[a.level.upper()] for a in open_alerts)
+    phq9, pcl5 = _complete(d, "phq9"), _complete(d, "pcl5")
+    rx = _active_rx(d, today)
+    return PatientListItem(
+        token=p.token,
+        display_name=patient.display_name if patient else anonymous_name(p.token),
+        age=_age(patient, p, today),
+        modules=[cast(Module, m) for m in p.modules or [] if m in _MODULES],
+        drug=_drug_label(rx) if rx else None,
+        therapy_day=_therapy_day(p, today),
+        next_visit=p.next_visit,
+        status_color=status.color,
+        top_alert_level=cast(LevelName, status.top_level.name.lower()) if status.top_level is not None else None,
+        open_alerts=len(open_alerts),
+        phq9_last=phq9[-1].total if phq9 else None,
+        pcl5_last=pcl5[-1].total if pcl5 else None,
+        trend=trend(d),
+        adherence_7d=adherence_7d(d, now),
+        discontinuation_risk=discontinuation_risk(d, now),
+        last_event=_last_event(d, now),
+    )
+
+
+def sort_key(item: PatientListItem) -> tuple[int, int, str]:
+    """red → yellow → grey → green, then discontinuation risk (desc), then name for a stable order."""
+    return (COLOR_ORDER[item.status_color], -item.discontinuation_risk.score, item.display_name)
+
+
+# --------------------------------------------------------------------------- card
+
+
+def alert_out(a: Alert, patient_name: str) -> AlertOut:
+    level = cast(LevelName, a.level)
+    return AlertOut(
+        id=a.id,
+        token=a.token,
+        patient_name=patient_name,
+        ts=a.ts,
+        level=level,
+        color=cast(Color, color([AlertLevel[a.level.upper()]])),
+        code=a.code,
+        reason=a.reason,
+        acked_by=a.acked_by,
+        acked_at=a.acked_at,
+    )
+
+
+def series(d: PatientData, now: datetime) -> list[SeriesPoint]:
+    since = now.date() - timedelta(days=CARD_DAYS)
+    out: list[SeriesPoint] = []
+    for c in d.checkins:
+        if not since <= c.day <= now.date():
+            continue
+        if c.mood is not None:
+            out.append(SeriesPoint(day=c.day, metric="mood", value=float(c.mood)))
+        if c.sleep_bucket in SLEEP_HOURS:
+            out.append(SeriesPoint(day=c.day, metric="sleep_hours", value=SLEEP_HOURS[c.sleep_bucket]))
+        if c.alcohol_bucket in ALCOHOL_LEVEL:
+            out.append(SeriesPoint(day=c.day, metric="alcohol", value=ALCOHOL_LEVEL[c.alcohol_bucket]))
+    for r in d.results:
+        day = _local(r.ts, now)
+        if r.complete and r.scale in _METRICS and since <= day and r.ts <= now:
+            out.append(SeriesPoint(day=day, metric=cast(Metric, r.scale), value=float(r.total), scheduled=r.scheduled))
+    return sorted(out, key=lambda p: (p.day, p.metric))
+
+
+def doses(d: PatientData, now: datetime) -> list[DoseOut]:
+    labels = {r.id: _drug_label(r) for r in d.prescriptions}
+    since = now - timedelta(days=CARD_DAYS)
+    return [
+        DoseOut(planned_at=x.planned_at, drug=labels.get(x.prescription_id, ""), status=x.status)  # type: ignore[arg-type]
+        for x in d.doses
+        if since <= x.planned_at <= now + timedelta(days=1)
+    ]
+
+
+def prescriptions(d: PatientData) -> list[PrescriptionOut]:
+    out = []
+    for r in d.prescriptions:
+        schedule = dict(r.schedule or {})
+        out.append(
+            PrescriptionOut(
+                drug=r.drug,
+                dose=r.dose,
+                schedule={"times": [str(t) for t in schedule.get("times", [])]},
+                instructions=" ".join(str(t) for t in _as_list(schedule.get("instructions"))),
+                start_date=r.start_date,
+                end_date=r.end_date,
+            )
+        )
+    return out
+
+
+def _as_list(value: Any) -> list[Any]:
+    if value is None:
+        return []
+    return list(value) if isinstance(value, list) else [value]
+
+
+def _plan_line(step: Any) -> str:
+    # Same rendering as the dialog's safety-plan reply (app/dialog/actions.py).
+    if isinstance(step, dict):
+        return ": ".join(str(v) for v in step.values() if v)
+    return str(step)
+
+
+async def safety_plan(session: AsyncSession, token: str) -> list[str] | None:
+    row = await session.get(SafetyPlan, token)
+    return [_plan_line(s) for s in row.steps] if row is not None and row.steps else None
+
+
+async def build_card(session: AsyncSession, d: PatientData, patient: Patient | None, now: datetime) -> PatientCard:
+    """Card without the summary (the caller adds it: the LLM call must not hold the DB session)."""
+    item = list_item(d, patient, now)
+    return PatientCard(
+        patient=item,
+        prescriptions=prescriptions(d),
+        series=series(d, now),
+        doses=doses(d, now),
+        alerts=[alert_out(a, item.display_name) for a in d.alerts],
+        safety_plan=await safety_plan(session, d.profile.token),
+    )

app/api/fixtures.py

@@ -9,18 +9,25 @@ from zoneinfo import ZoneInfo
 
 from app.api.schemas import (
     AlertOut,
+    DemoPersona,
     DiscontinuationRisk,
     DoseOut,
     PatientCard,
     PatientListItem,
     SeriesPoint,
 )
+from app.core.safety import fill_phones
 from app.integrations.base import Prescription
 
 TZ = ZoneInfo("Europe/Moscow")
 TODAY = date(2026, 10, 3)
 DOCTOR_ID = "doc-smirnova"
 
+# Synthetic personas for the demo console and the demo ЕМИАС sign-in of the patient web app.
+DEMO_PERSONAS: list[DemoPersona] = [
+    DemoPersona(token="tok-andrey", display_name="Андрей С.", therapy_day=13, scenario="data/synthetic/andrey.jsonl"),
+]
+
 
 def _risk(score: int, factors: list[str]) -> DiscontinuationRisk:
     level = "high" if score >= 60 else "medium" if score >= 30 else "low"
@@ -256,7 +263,7 @@ def andrey_card() -> PatientCard:
             "Что помогает: прогулка с собакой, душ",
             "Люди и места: брат Олег, спортзал",
             "Кому звонить: жена, сослуживец Миша",
-            "Специалисты: д-р Смирнова, 8-800-2000-122, 112",
+            fill_phones("Специалисты: д-р Смирнова, {phone:helpline}, 112"),
             "Безопасная среда: ружьё хранится у брата",
         ],
         summary="За 13 дней: приверженность 12/13, эпизод намерения бросить на 5-й день (снят после звонка врача). "

app/api/max_notifications.py

@@ -0,0 +1,115 @@
+"""Server API for a future MAX connect UI; webhook processing is supplied by the channel adapter."""
+
+import hmac
+import json
+import re
+from datetime import datetime
+from typing import Annotated, Literal
+
+from fastapi import APIRouter, Depends, HTTPException, Request
+from fastapi.security import HTTPAuthorizationCredentials, HTTPBearer
+from pydantic import BaseModel, ConfigDict
+from sqlalchemy import select
+from sqlalchemy.exc import SQLAlchemyError
+
+from app.config import get_settings
+from app.core import clock
+from app.db import repo
+from app.db.max_notifications import MaxBinding, MaxDelivery
+from app.db.session import get_clinical_session, get_identity_session
+from app.integrations import max_store
+
+router = APIRouter(tags=["max-notifications"])
+bearer = HTTPBearer(auto_error=False)
+
+
+async def patient_token(auth: Annotated[HTTPAuthorizationCredentials | None, Depends(bearer)]) -> str:
+    if auth is None or auth.scheme.lower() != "bearer" or not re.fullmatch(r"[A-Za-z0-9_-]{1,64}", auth.credentials):
+        raise HTTPException(401, "patient authentication required", headers={"WWW-Authenticate": "Bearer"})
+    async with get_clinical_session() as session:
+        if await repo.get_profile(session, auth.credentials) is None:
+            raise HTTPException(401, "patient authentication required")
+    return auth.credentials
+
+
+PatientToken = Annotated[str, Depends(patient_token)]
+
+
+class MaxStatus(BaseModel):
+    available: bool
+    connected: bool
+    last_delivery: str | None = None
+
+
+class LinkConsent(BaseModel):
+    model_config = ConfigDict(extra="forbid")
+    consent: Literal[True]
+
+
+class MaxLink(BaseModel):
+    url: str
+    expires_at: datetime
+
+
+@router.get("/me/notifications/max", response_model=MaxStatus)
+async def status(token: PatientToken) -> MaxStatus:
+    async with get_identity_session() as session:
+        binding = await session.get(MaxBinding, token)
+        last = await session.scalar(
+            select(MaxDelivery.state)
+            .where(MaxDelivery.token == token)
+            .order_by(MaxDelivery.created_at.desc(), MaxDelivery.id.desc())
+            .limit(1)
+        )
+    return MaxStatus(
+        available=get_settings().max_enabled, connected=bool(binding and binding.enabled), last_delivery=last
+    )
+
+
+@router.post("/me/notifications/max/link", response_model=MaxLink)
+async def link(body: LinkConsent, token: PatientToken) -> MaxLink:
+    settings = get_settings()
+    if not settings.max_enabled:
+        raise HTTPException(503, "MAX is not configured")
+    if not await max_store.active_patient(token):
+        raise HTTPException(403, "active consent and adult confirmation required")
+    async with get_identity_session() as session:
+        raw, expires = await max_store.issue_code(session, token, clock.now(), settings.max_link_ttl_seconds)
+    return MaxLink(url=f"https://max.ru/{settings.max_bot_username}?start={raw}", expires_at=expires)
+
+
+@router.delete("/me/notifications/max", response_model=MaxStatus)
+async def unlink(token: PatientToken) -> MaxStatus:
+    async with get_identity_session() as session:
+        await max_store.disconnect(session, token)
+    return MaxStatus(available=get_settings().max_enabled, connected=False)
+
+
+@router.post("/webhooks/max")
+async def webhook(request: Request) -> dict[str, bool]:
+    settings = get_settings()
+    if not settings.max_enabled:
+        raise HTTPException(503, "MAX is not configured")
+    expected = settings.max_webhook_secret.get_secret_value().encode()
+    supplied = request.headers.get("X-Max-Bot-Api-Secret", "").encode()
+    if not expected or not hmac.compare_digest(supplied, expected):
+        raise HTTPException(403, "invalid webhook secret")
+    raw = bytearray()
+    async for chunk in request.stream():
+        raw.extend(chunk)
+        if len(raw) > 65536:
+            raise HTTPException(413, "event is too large")
+    try:
+        event = json.loads(raw)
+    except (ValueError, UnicodeError) as exc:
+        raise HTTPException(400, "invalid JSON") from exc
+    if not isinstance(event, dict):
+        raise HTTPException(422, "event must be an object")
+    from app.channels.max_bot import handle_update
+
+    try:
+        await handle_update(event)
+    except SQLAlchemyError:
+        # Let MAX retry; do not log DB exception parameters containing identity data.
+        raise HTTPException(503, "notification storage unavailable") from None
+    return {"success": True}

app/api/patient_web.py

@@ -0,0 +1,429 @@
+"""Patient web app: sign-in, the patient's own plan and public reference data (`/api/v1/auth/*`, `/me/*`,
+`/crisis/resources`, `/instruments/catalog`, `/meds/reference`).
+
+The web app is one more channel of the same dialog engine: after sign-in it talks to `/dialog/{token}/...`
+exactly like the web console, and consent, onboarding, scales and check-ins come from the engine.
+
+Two ways in:
+- **ЕМИАС** (demo): the doctor's one-time connect code via `EmiasMock`, or a synthetic demo persona. The
+  patient is linked to the attending doctor, who sees the data on the dashboard.
+- **Anonymous**: a random pseudonymous token, no identity record, and access to the prototype care team.
+  Clinical answers are stored on the server and visible to the assigned doctor under a pseudonym.
+  Consent is kept in the dialog state. Existing doctor-less profiles require explicit care opt-in.
+
+The token returned here is the session credential of the prototype. Production needs short-lived sessions
+issued by the server instead of handing out the pseudonymous token itself.
+"""
+
+import logging
+import secrets
+from collections import defaultdict
+from datetime import date, datetime, time, timedelta
+from typing import Any, Literal
+from zoneinfo import ZoneInfo
+
+from fastapi import APIRouter, HTTPException
+from pydantic import BaseModel, ConfigDict, Field
+from sqlalchemy import select
+
+from app.api import fixtures
+from app.api.schemas import DemoPersona
+from app.core import clock
+from app.core.instrument_catalog import Catalog, catalog
+from app.core.intake_questions import DIARY_KINDS
+from app.core.intake_runtime import intake_enabled, load_runtime
+from app.core.interpretation import texts as results_texts
+from app.core.meds_reference import find_drug, indication_for, load_reference
+from app.core.safety import CrisisResource, crisis_reply
+from app.db import repo
+from app.db.audit import audit
+from app.db.clinical import DailyCheckin, Dose, Prescription
+from app.db.identity import TOKEN_LEN
+from app.db.intake import QuestionnaireRecord
+from app.db.session import get_clinical_session
+from app.integrations.emias_mock import CODE_MAX_LEN, EmiasMock
+from app.services import anonymous_care
+
+log = logging.getLogger(__name__)
+
+router = APIRouter(tags=["patient-web"])
+_emias = EmiasMock()
+
+
+class AuthOut(BaseModel):
+    token: str
+    mode: Literal["emias", "anonymous"]
+    display_name: str | None = None  # only for ЕМИАС sign-in; anonymous has none by design
+
+
+class EmiasCodeIn(BaseModel):
+    model_config = ConfigDict(extra="forbid", str_strip_whitespace=True)
+    code: str = Field(min_length=1, max_length=CODE_MAX_LEN)
+
+
+class AnonymousIn(BaseModel):
+    model_config = ConfigDict(extra="forbid")
+    focus: Literal["depression", "ptsd"] | None = None  # what the person suspects; picks the module
+
+
+# Self-selected focus of an anonymous person → clinical module (PTSD is the veteran module, ADR-010).
+_FOCUS_MODULE = {"depression": "depression", "ptsd": "veteran"}
+
+
+class EmiasDemoIn(BaseModel):
+    model_config = ConfigDict(extra="forbid")
+    persona_token: str = Field(min_length=1, max_length=64)
+
+
+async def _attach_doctor(token: str, doctor_id: str) -> None:
+    async with get_clinical_session() as s:
+        if await repo.get_profile(s, token) is None:
+            await repo.upsert_profile(s, token=token, doctor_id=doctor_id)
+
+
+async def _seed_demo_persona(token: str) -> None:
+    """Synthetic clinical start for a demo persona (no `make seed` yet): profile, prescription, today's doses.
+
+    Idempotent: only missing pieces are created. Data mirror the dashboard fixtures, so the patient app and the
+    doctor's card tell the same story.
+    """
+    card = fixtures.card(token)
+    item = next((p for p in fixtures.PATIENTS if p.token == token), None)
+    if card is None or item is None:
+        return
+    now = clock.now()
+    today = now.date()
+    async with get_clinical_session() as s:
+        if await repo.get_profile(s, token) is None:
+            await repo.upsert_profile(
+                s,
+                token=token,
+                doctor_id=fixtures.DOCTOR_ID,
+                modules=list(item.modules),
+                therapy_start=min((p.start_date for p in card.prescriptions if p.start_date), default=today),
+                next_visit=today + timedelta(days=15),
+            )
+        if await s.scalar(select(Prescription.id).where(Prescription.token == token)) is not None:
+            return
+        for p in card.prescriptions:
+            rx = Prescription(
+                token=token, drug=p.drug, dose=p.dose, schedule=p.schedule, start_date=p.start_date or today
+            )
+            s.add(rx)
+            await s.flush()
+            # The dose history of the dashboard story (days before today), so the week marks match the doctor's card.
+            for d in card.doses:
+                if d.drug == p.drug and d.planned_at.astimezone(now.tzinfo).date() < today:
+                    s.add(Dose(token=token, prescription_id=rx.id, planned_at=d.planned_at, status=d.status))
+            for t in p.schedule.get("times", []):
+                hh, mm = (int(x) for x in t.split(":"))
+                s.add(
+                    Dose(
+                        token=token, prescription_id=rx.id, planned_at=datetime.combine(today, time(hh, mm), now.tzinfo)
+                    )
+                )
+
+
+@router.post("/auth/emias", response_model=AuthOut)
+async def auth_emias(body: EmiasCodeIn) -> AuthOut:
+    """Sign-in through ЕМИАС (demo: one-time connect code from the doctor)."""
+    person = await _emias.verify(body.code)
+    if person is None:
+        log.info("web auth: emias code rejected")
+        raise HTTPException(401, "code not accepted")
+    await _attach_doctor(person.token, person.doctor_id)
+    log.info("web auth: emias tok=%s", person.token[:6])
+    return AuthOut(token=person.token, mode="emias")
+
+
+@router.get("/patient/demo-personas", response_model=list[DemoPersona])
+async def patient_demo_personas() -> list[DemoPersona]:
+    """Synthetic ЕМИАС accounts for the patient app sign-in (the demo console has its own `/demo/personas`)."""
+    return fixtures.DEMO_PERSONAS
+
+
+@router.post("/auth/emias/demo", response_model=AuthOut)
+async def auth_emias_demo(body: EmiasDemoIn) -> AuthOut:
+    """Demo ЕМИАС account: signs in as one of the synthetic personas (`/patient/demo-personas`)."""
+    persona = next((p for p in fixtures.DEMO_PERSONAS if p.token == body.persona_token), None)
+    if persona is None:
+        raise HTTPException(404, "persona not found")
+    await _seed_demo_persona(persona.token)
+    log.info("web auth: emias demo tok=%s", persona.token[:6])
+    return AuthOut(token=persona.token, mode="emias", display_name=persona.display_name)
+
+
+@router.post("/auth/anonymous", response_model=AuthOut)
+async def auth_anonymous(body: AnonymousIn | None = None) -> AuthOut:
+    """Anonymous sign-in: a fresh random token; care without an identity record.
+
+    The clinical side gets a pseudonymous profile assigned to the prototype care team. It holds
+    no identity fields. Legacy clients may supply `focus`; the common stage 1 screening sets modules itself.
+    """
+    token = secrets.token_hex(TOKEN_LEN // 2)
+    focus = body.focus if body is not None else None
+    async with get_clinical_session() as s:
+        await repo.upsert_profile(
+            s, token=token, doctor_id=anonymous_care.doctor_id(), modules=[_FOCUS_MODULE[focus]] if focus else []
+        )
+    log.info("web auth: anonymous tok=%s", token[:6])
+    return AuthOut(token=token, mode="anonymous")
+
+
+@router.get("/patient/capabilities")
+async def patient_capabilities() -> dict[str, bool]:
+    """Expose availability without leaking clinical policy or server configuration."""
+    return {"primary_screening": intake_enabled()}
+
+
+@router.post("/me/{token}/doctor/connect")
+async def connect_anonymous_doctor(token: str) -> dict[str, bool]:
+    """Explicit opt-in for old doctor-less profiles; never reassign an existing doctor."""
+    async with get_clinical_session() as s:
+        profile = await repo.get_profile(s, token)
+        if profile is None:
+            raise HTTPException(404, "patient not found")
+        if not profile.doctor_id:
+            profile.doctor_id = anonymous_care.doctor_id()
+            await audit(s, actor=token, action="anonymous_care_opt_in", token=token, ts=clock.now())
+    return {"has_doctor": True}
+
+
+class DoseItem(BaseModel):
+    id: int
+    drug: str
+    dose: str
+    time: str  # HH:MM, patient's local time
+    status: Literal["taken", "missed", "skipped", "pending"]
+
+
+class WeekDay(BaseModel):
+    day: date
+    status: Literal["taken", "missed", "pending", "none"]
+
+
+class PrescriptionItem(BaseModel):
+    drug: str
+    dose: str
+    times: list[str]
+    week: list[WeekDay]  # Mon..Sun of the current week
+    ref_id: str | None = None  # entry of /meds/reference, if the drug is covered
+    indication: Literal["depression", "ptsd"] | None = None
+    start_date: date | None = None
+    therapy_day: int | None = None  # 1 on the start date (spec: M5, «ожидаемый эффект» cards on days 1/7/14)
+
+
+class Questionnaires(BaseModel):
+    """Questionnaire state for the home screen. Answers and scores are not exposed here."""
+
+    enabled: bool
+    intake: Literal["none", "active", "paused", "complete", "review"]
+    diary_done: bool  # both parts of today's diary
+    diary_next: Literal["morning", "evening"] | None = None  # the part still open today
+
+
+class TodayOut(BaseModel):
+    today: date
+    now: str  # HH:MM on the (demo) clock — the client never uses its own clock
+    has_doctor: bool
+    checkin_done: bool
+    next_visit: date | None
+    doses: list[DoseItem]
+    prescriptions: list[PrescriptionItem]
+    questionnaires: Questionnaires
+
+
+def _intake_state(records: list[QuestionnaireRecord]) -> Literal["none", "active", "paused", "complete", "review"]:
+    intake = [r for r in records if r.kind == "intake"]
+    if any(r.status == "complete" for r in intake):
+        return "complete"
+    if not intake:
+        return "none"
+    last = max(intake, key=lambda r: r.started_at).status
+    if last in ("active", "paused"):
+        return last
+    return "review" if last in ("review_required", "interrupted") else "none"
+
+
+def _day_status(statuses: list[str]) -> Literal["taken", "missed", "pending", "none"]:
+    if not statuses:
+        return "none"
+    if any(s in ("missed", "skipped") for s in statuses):
+        return "missed"
+    return "taken" if all(s == "taken" for s in statuses) else "pending"
+
+
+@router.get("/me/{token}/today", response_model=TodayOut)
+async def my_today(token: str) -> TodayOut:
+    """The patient's own plan for today (home screen) and this week's dose marks (medication screen).
+
+    Only the patient's own prescription data; no scores, no alerts. Anonymous tokens have no profile → empty plan.
+    """
+    now = clock.now()
+    today = now.date()
+    week_start = today - timedelta(days=today.weekday())
+    async with get_clinical_session() as s:
+        profile = await repo.get_profile(s, token)
+        prescriptions = (await s.scalars(select(Prescription).where(Prescription.token == token))).all()
+        doses = (
+            await s.scalars(
+                select(Dose)
+                .where(Dose.token == token, Dose.planned_at >= datetime.combine(week_start, time.min, now.tzinfo))
+                .order_by(Dose.planned_at)
+            )
+        ).all()
+        checkin = await s.scalar(select(DailyCheckin).where(DailyCheckin.token == token, DailyCheckin.day == today))
+        records = list((await s.scalars(select(QuestionnaireRecord).where(QuestionnaireRecord.token == token))).all())
+
+    by_rx: dict[int, Prescription] = {p.id: p for p in prescriptions}
+    today_doses: list[DoseItem] = []
+    marks: dict[tuple[int, date], list[str]] = defaultdict(list)
+    for d in doses:
+        local = d.planned_at.astimezone(now.tzinfo)
+        marks[(d.prescription_id, local.date())].append(d.status)
+        rx = by_rx.get(d.prescription_id)
+        if local.date() == today and rx is not None:
+            today_doses.append(
+                DoseItem(id=d.id, drug=rx.drug, dose=rx.dose, time=local.strftime("%H:%M"), status=d.status)
+            )
+    week = [week_start + timedelta(days=i) for i in range(7)]
+    modules = list(profile.modules or []) if profile else []
+    diary_day = now.astimezone(ZoneInfo(load_runtime().timezone)).date()
+    done_parts = {r.kind for r in records if r.day == diary_day and r.status == "complete"}
+    open_parts = [k.removeprefix("diary_") for k in DIARY_KINDS if k not in done_parts]
+    diary_done = not open_parts
+
+    def item(p: Prescription) -> PrescriptionItem:
+        ref = find_drug(p.drug)
+        return PrescriptionItem(
+            drug=p.drug,
+            dose=p.dose,
+            times=list((p.schedule or {}).get("times", [])),
+            week=[WeekDay(day=d, status=_day_status(marks[(p.id, d)])) for d in week],
+            ref_id=ref["id"] if ref else None,
+            indication=indication_for(modules, ref) if ref else None,
+            start_date=p.start_date,
+            therapy_day=(today - p.start_date).days + 1 if p.start_date else None,
+        )
+
+    return TodayOut(
+        today=today,
+        now=now.strftime("%H:%M"),
+        has_doctor=profile is not None and bool(profile.doctor_id),
+        checkin_done=(checkin is not None and checkin.mood is not None) or diary_done,
+        next_visit=profile.next_visit if profile else None,
+        doses=today_doses,
+        prescriptions=[
+            item(p)
+            for p in prescriptions
+            if (p.end_date is None or p.end_date >= today) and (p.start_date is None or p.start_date <= today)
+        ],
+        questionnaires=Questionnaires(
+            # Stage 1 needs no profile: the screening creates it (anonymous people have none before it).
+            enabled=intake_enabled(),
+            intake=_intake_state(records),
+            diary_done=diary_done,
+            diary_next=open_parts[0] if open_parts else None,
+        ),
+    )
+
+
+class ResultFinding(BaseModel):
+    code: str
+    title: str
+
+
+class Conclusion(BaseModel):
+    """Preliminary conclusion of stage 1 — a screening result, not a diagnosis."""
+
+    day: date
+    title: str
+    lines: list[str]
+    findings: list[ResultFinding]
+    modules: list[str]
+    disclaimer: str
+
+
+class HistoryItem(BaseModel):
+    id: str
+    kind: str
+    kind_title: str
+    status: str
+    status_title: str
+    day: date
+    started_at: datetime
+    completed_at: datetime | None
+    title: str | None  # interpretation shown to the patient when the form was finished
+    lines: list[str]
+
+
+class ResultsOut(BaseModel):
+    conclusion: Conclusion | None
+    history: list[HistoryItem]
+
+
+@router.get("/me/{token}/results", response_model=ResultsOut)
+async def my_results(token: str) -> ResultsOut:
+    """The patient's own questionnaire log: every administration with its date, status and the interpretation that
+    was shown when it was finished (stored with the record, so it never changes afterwards). No raw answers."""
+    async with get_clinical_session() as s:
+        records = list(
+            (
+                await s.scalars(
+                    select(QuestionnaireRecord)
+                    .where(QuestionnaireRecord.token == token)
+                    .order_by(QuestionnaireRecord.started_at.desc(), QuestionnaireRecord.id)
+                )
+            ).all()
+        )
+    t = results_texts()
+    intake = next((r for r in records if r.kind == "intake" and r.status == "complete"), None)
+    conclusion = None
+    if intake and intake.details.get("interpretation"):
+        i = intake.details["interpretation"]
+        conclusion = Conclusion(
+            day=intake.day,
+            title=i["title"],
+            lines=i["lines"],
+            findings=[ResultFinding(**f) for f in i.get("findings", [])],
+            modules=i.get("modules", []),
+            disclaimer=i.get("disclaimer", t["disclaimer"]),
+        )
+    history = [
+        HistoryItem(
+            id=r.id,
+            kind=r.kind,
+            kind_title=t["kinds"].get(r.kind, r.kind),
+            status=r.status,
+            status_title=t["status"].get(r.status, r.status),
+            day=r.day,
+            started_at=r.started_at,
+            completed_at=r.completed_at,
+            title=(r.details.get("interpretation") or {}).get("title"),
+            lines=(r.details.get("interpretation") or {}).get("lines", []),
+        )
+        for r in records
+    ]
+    return ResultsOut(conclusion=conclusion, history=history)
+
+
+@router.get("/crisis/resources", response_model=list[CrisisResource])
+async def crisis_resources() -> list[CrisisResource]:
+    """Help lines for the always-visible «help now» button — the same list as the fixed crisis script."""
+    return crisis_reply([], "patient").resources
+
+
+@router.get("/instruments/catalog", response_model=Catalog)
+async def instruments_catalog() -> Catalog:
+    """Form, position and recall period of every questionnaire item, for the question screen header."""
+    return catalog()
+
+
+@router.get("/meds/reference")
+async def meds_reference() -> dict[str, Any]:
+    """Patient drug reference (draft from the Minzdrav guidelines): expected effect, course, side effects, red flags.
+
+    The internal rule parameters stay on the server.
+    """
+    ref = load_reference()
+    return {k: v for k, v in ref.items() if k != "rules"}

app/api/questionnaire.py

@@ -0,0 +1,98 @@
+"""Audited questionnaire review for the synthetic prototype.
+
+Like the existing API, doctor_id is supplied by the caller; production must put
+these routes behind authenticated staff identity. No clinical data cross into identity.
+"""
+
+from typing import Literal
+
+from fastapi import APIRouter, HTTPException
+from pydantic import BaseModel, ConfigDict, Field
+
+from app.core import clock
+from app.db import repo
+from app.db.audit import audit
+from app.db.intake import QuestionnaireRecord
+from app.db.session import get_clinical_session
+from app.services import questionnaire as service
+
+router = APIRouter(tags=["questionnaire-review"])
+
+
+class ReviewIn(BaseModel):
+    model_config = ConfigDict(extra="forbid", str_strip_whitespace=True)
+    doctor_id: str = Field(min_length=1)
+    assessment_performed: Literal[True]
+    decision: Literal["resume", "keep_hold"]
+    reference: str = Field(min_length=1, max_length=200, pattern=r"^[A-Za-z0-9_./:#-]+$")
+
+
+async def require_doctor(session, token, doctor_id):
+    profile = await repo.get_profile(session, token)
+    if profile is None or profile.doctor_id != doctor_id:
+        raise HTTPException(404, "patient not found")
+
+
+@router.get("/patients/{token}/questionnaires")
+async def history(token: str, doctor_id: str):
+    async with get_clinical_session() as session:
+        await require_doctor(session, token, doctor_id)
+        rows = await service.records(session, token)
+        await audit(session, actor=doctor_id, action="view_questionnaires", token=token, ts=clock.now())
+        return [
+            {
+                "id": r.id,
+                "kind": r.kind,
+                "status": r.status,
+                "version": r.version,
+                "policy_version": r.policy_version,
+                "started_at": r.started_at,
+                "completed_at": r.completed_at,
+                "answers": r.answers,
+                "details": r.details,
+            }
+            for r in rows
+        ]
+
+
+@router.post("/patients/{token}/questionnaires/{record_id}/review")
+async def review(token: str, record_id: str, body: ReviewIn):
+    now = clock.now()
+    async with get_clinical_session() as session:
+        await service.lock_patient(session, token)
+        await require_doctor(session, token, body.doctor_id)
+        state = await repo.get_dialog_state(session, token)
+        row = await session.get(QuestionnaireRecord, record_id)
+        if row is None or row.token != token:
+            raise HTTPException(404, "record not found")
+        if not state or state.data.get("consent") is not True:
+            raise HTTPException(409, "consent required")
+        if row.status not in ("review_required", "interrupted"):
+            raise HTTPException(409, "record does not require review")
+        if body.decision == "resume" and (state.data.get("crisis") or {}).get("open"):
+            raise HTTPException(409, "close the acute episode after assessment before resuming routine work")
+        detail = {
+            "doctor_id": body.doctor_id,
+            "decision": body.decision,
+            "reference": body.reference,
+            "at": now.isoformat(),
+        }
+        row.details = {**row.details, "clinician_review": detail}
+        if body.decision == "resume":
+            row.status = "reviewed"
+            remaining = [
+                r
+                for r in await service.records(session, token)
+                if r.id != row.id and r.status in ("review_required", "interrupted")
+            ]
+            if not remaining:
+                state.data = {**state.data, "intake_review_required": False, "questionnaire_record": None}
+        await audit(
+            session,
+            actor=body.doctor_id,
+            action="review_questionnaire",
+            token=token,
+            details={"record_id": row.id, "decision": body.decision, "reference": body.reference},
+            ts=now,
+        )
+        return {"id": row.id, "status": row.status, "review": detail}

app/api/routes.py

@@ -1,12 +1,23 @@
-"""API routes `/api/v1` (#34 stubs → #12 implementation).
+"""API routes `/api/v1` (#34 contract → #12 implementation).
 
-Stubs return deterministic fixtures (`app/api/fixtures.py`) so the dashboard can be built immediately.
+Paths and schemas are the frozen contract (`app/api/schemas.py`); bodies read the identity and clinical DBs.
-Lane B replaces bodies in #12 without changing paths or schemas (those are the frozen contract).
+Read models live in `app/api/doctor_views.py`, demo-console helpers in `app/api/demo.py`.
+Every doctor access to patient data is written to `audit_log` (guardrail #6): `view_patient_list`,
+`view_patient` (also a denied attempt: `view_patient_denied`), `view_alerts` (only when new alerts are
+disclosed — the dashboard polls every 2–3 s), `ack_alert` (in `repo.ack_alert`), `connect_patient`.
+`app/api/fixtures.py` is kept for tests and as the demo cabinet reference (doctor id).
 """
 
-from fastapi import APIRouter, HTTPException
+import secrets
 
-from app.api import fixtures
+from fastapi import APIRouter, HTTPException
+from sqlalchemy import select
+
+from app.api import demo as console
+from app.api import doctor_views as views
+from app.api import fixtures, max_notifications
+from app.api.patient_web import router as patient_web_router
+from app.api.questionnaire import router as questionnaire_router
 from app.api.schemas import (
     AckIn,
     AlertOut,
@@ -22,67 +33,206 @@ from app.api.schemas import (
     PatientListItem,
 )
 from app.core import clock
-from app.dialog.contracts import get_engine
+from app.core.privacy import pseudo_id
-from app.integrations.base import MemoryOutbox, integrations
+from app.db import identity_repo, repo
+from app.db.audit import audit
+from app.db.clinical import Alert, Message, PatientProfile
+from app.db.clinical import Prescription as PrescriptionRow
+from app.db.identity import Patient
+from app.db.session import get_clinical_session, get_identity_session
+from app.dialog.contracts import Event, get_engine
+from app.integrations.base import integrations
+from app.scheduler import jobs as scheduler
+from app.services.anonymous_care import display_name as anonymous_name
+from app.services.monitoring import refresh_status
 
 router = APIRouter(prefix="/api/v1")
+router.include_router(max_notifications.router)
+router.include_router(questionnaire_router)
+router.include_router(patient_web_router)
+
+DEFAULT_CLINIC = "clinic-demo"
+CODE_ALPHABET = "ABCDEFGHJKLMNPQRSTUVWXYZ23456789"  # no 0/O/1/I: the code may be typed by hand
+CODE_LEN = 8
+
+
+async def _patients(tokens: list[str]) -> dict[str, Patient]:
+    """Identity rows for display name / age only (never put SNILS or phone into a response)."""
+    if not tokens:
+        return {}
+    async with get_identity_session() as s:
+        rows = (await s.scalars(select(Patient).where(Patient.token.in_(tokens)))).all()
+    return {p.token: p for p in rows}
+
+
+def _name(patients: dict[str, Patient], token: str) -> str:
+    p = patients.get(token)
+    return p.display_name if p else anonymous_name(token)
 
 
 # ------------------------------------------------------------------ doctor dashboard
 @router.get("/doctors/{doctor_id}/patients", response_model=list[PatientListItem], tags=["doctor"])
 async def list_patients(doctor_id: str) -> list[PatientListItem]:
     """Doctor's patients sorted red → yellow → grey → green, then by discontinuation risk."""
-    order = {"red": 0, "yellow": 1, "grey": 2, "green": 3}
+    now = clock.now()
-    return sorted(fixtures.PATIENTS, key=lambda p: (order[p.status_color], -p.discontinuation_risk.score))
+    async with get_clinical_session() as s:
+        profiles = await repo.patients_of_doctor(s, doctor_id)
+        data = [await views.load_patient_data(s, p) for p in profiles]
+        await audit(s, actor=doctor_id, action="view_patient_list", token=None, details={"count": len(data)}, ts=now)
+    patients = await _patients([p.token for p in profiles])
+    items = [views.list_item(d, patients.get(d.profile.token), now) for d in data]
+    return sorted(items, key=views.sort_key)
 
 
 @router.get("/patients/{token}", response_model=PatientCard, tags=["doctor"])
 async def patient_card(token: str, doctor_id: str) -> PatientCard:
-    """Patient card. Every call is written to audit_log as `view_patient` (#12)."""
+    """Patient card. Every call is written to audit_log as `view_patient`; only the attending doctor may read it."""
-    card = fixtures.card(token)
+    now = clock.now()
-    if card is None:
+    patient = (await _patients([token])).get(token)
+    async with get_clinical_session() as s:
+        profile = await repo.get_profile(s, token)
+        if profile is None:
             raise HTTPException(404, "patient not found")
+        if profile.doctor_id != doctor_id:
+            await audit(s, actor=doctor_id, action="view_patient_denied", token=token, ts=now)
+            await s.commit()
+            raise HTTPException(403, "not your patient")
+        data = await views.load_patient_data(s, profile)
+        card = await views.build_card(s, data, patient, now)
+        await audit(s, actor=doctor_id, action="view_patient", token=token, ts=now)
+    # Summary after the commit: the (possibly slow) LLM call must not hold the DB transaction.
+    from app.llm.summary import build_summary  # summary imports app.api.schemas; avoid an import cycle
+
+    card.summary = await build_summary(card, today=now.date())
     return card
 
 
 @router.get("/doctors/{doctor_id}/alerts", response_model=list[AlertOut], tags=["doctor"])
 async def list_alerts(doctor_id: str, since_id: int = -1, open_only: bool = False) -> list[AlertOut]:
     """Polled every 2–3 s by the dashboard: alerts with id > since_id, newest first."""
-    alerts = [a for a in fixtures.all_alerts() if a.id > since_id]
+    async with get_clinical_session() as s:
-    return [a for a in alerts if a.acked_at is None] if open_only else alerts
+        tokens = list(await s.scalars(select(PatientProfile.token).where(PatientProfile.doctor_id == doctor_id)))
+        stmt = select(Alert).where(Alert.token.in_(tokens), Alert.id > since_id)
+        if open_only:
+            stmt = stmt.where(Alert.acked_at.is_(None))
+        alerts = (await s.scalars(stmt.order_by(Alert.ts.desc(), Alert.id.desc()))).all()
+        if alerts:
+            await audit(
+                s,
+                actor=doctor_id,
+                action="view_alerts",
+                token=None,
+                details={"alert_ids": [a.id for a in alerts][:50], "count": len(alerts)},
+                ts=clock.now(),
+            )
+    patients = await _patients(sorted({a.token for a in alerts}))
+    return [views.alert_out(a, _name(patients, a.token)) for a in alerts]
 
 
 @router.post("/alerts/{alert_id}/ack", response_model=AlertOut, tags=["doctor"])
 async def ack_alert(alert_id: int, body: AckIn) -> AlertOut:
     """Doctor acknowledges an alert (written to audit_log). Acking an acute alert lets the patient leave crisis."""
-    alert = next((a for a in fixtures.all_alerts() if a.id == alert_id), None)
+    now = clock.now()
+    async with get_clinical_session() as s:
+        alert = await s.get(Alert, alert_id)
         if alert is None:
             raise HTTPException(404, "alert not found")
-    return alert.model_copy(update={"acked_by": body.doctor_id, "acked_at": clock.now()})
+        profile = await repo.get_profile(s, alert.token)
+        if profile is None or profile.doctor_id != body.doctor_id:
+            raise HTTPException(403, "not your patient")
+        await repo.ack_alert(s, alert_id=alert_id, doctor_id=body.doctor_id, ts=now)
+        await refresh_status(s, alert.token)
+        open_acute = [a for a in await repo.list_alerts(s, token=alert.token, open_only=True) if a.level == "acute"]
+        out = views.alert_out(alert, "")
+    # The crisis ends only when no acute alert is left open (another acute signal keeps the patient in crisis).
+    if alert.level == "acute" and not open_acute:
+        replies = await get_engine().handle(alert.token, Event(type="system", system="doctor_ack"))
+        if replies:
+            await integrations.outbox.push(alert.token, replies)
+    return out.model_copy(update={"patient_name": _name(await _patients([alert.token]), alert.token)})
 
 
 @router.post("/patients/connect", response_model=ConnectPatientOut, tags=["doctor"])
 async def connect_patient(body: ConnectPatientIn) -> ConnectPatientOut:
     """Doctor connects a patient after the in-person visit (323-FZ art. 36.2): prescription → МИС mock, code/QR."""
-    return ConnectPatientOut(token="tok-new", code="DEMO-0001", deep_link="https://t.me/ptsr_demo_bot?start=DEMO-0001")
+    now = clock.now()
+    try:
+        token = pseudo_id(body.snils)
+    except ValueError as exc:
+        raise HTTPException(422, "SNILS must contain 11 digits") from exc
+    code = "".join(secrets.choice(CODE_ALPHABET) for _ in range(CODE_LEN))
+    async with get_identity_session() as ids:
+        if await identity_repo.get_patient(ids, token) is not None:
+            raise HTTPException(409, "patient already connected")
+        doctor = await identity_repo.get_doctor(ids, body.doctor_id)
+        await identity_repo.create_patient(
+            ids,
+            token=token,
+            display_name=body.display_name,
+            snils=body.snils,
+            clinic_id=doctor.clinic_id if doctor else DEFAULT_CLINIC,
+            doctor_id=body.doctor_id,
+            now=now,
+            birth_year=body.birth_year,
+            sex=body.sex,
+        )
+        await identity_repo.create_connect_code(ids, code=code, token=token, doctor_id=body.doctor_id, now=now)
+        # Clinical writes nested inside the identity unit of work: if they fail, the identity row rolls back too.
+        async with get_clinical_session() as s:
+            await repo.upsert_profile(
+                s,
+                token=token,
+                doctor_id=body.doctor_id,
+                modules=list(body.modules),
+                therapy_start=now.date(),
+                next_visit=body.next_visit,
+                birth_year=body.birth_year,
+                sex=body.sex,
+            )
+            schedule: dict[str, list[str]] = {"times": list(body.times)}
+            if body.instructions:
+                schedule["instructions"] = [body.instructions]
+            s.add(
+                PrescriptionRow(token=token, drug=body.drug, dose=body.dose, schedule=schedule, start_date=now.date())
+            )
+            await audit(
+                s,
+                actor=body.doctor_id,
+                action="connect_patient",
+                token=token,
+                details={"modules": list(body.modules), "drug": body.drug},
+                ts=now,
+            )
+    return ConnectPatientOut(token=token, code=code, deep_link=await console.deep_link(code))
 
 
 # ------------------------------------------------------------------ patient dialog (web console / any channel)
+async def _require_patient(token: str) -> None:
+    async with get_clinical_session() as s:
+        if await repo.get_profile(s, token) is None:
+            raise HTTPException(404, "patient not found")
+
+
 @router.post("/dialog/{token}/events", response_model=DialogOut, tags=["dialog"])
 async def dialog_event(token: str, body: DialogIn) -> DialogOut:
+    await _require_patient(token)
     return DialogOut(replies=await get_engine().handle(token, body))
 
 
 @router.get("/dialog/{token}/outbox", response_model=DialogOut, tags=["dialog"])
 async def dialog_outbox(token: str) -> DialogOut:
     """System-initiated replies (reminders, check-ins) waiting for the web console."""
-    box = integrations.outbox
+    box = console.memory_outbox()
-    return DialogOut(replies=box.drain(token) if isinstance(box, MemoryOutbox) else [])
+    return DialogOut(replies=box.drain(token) if box is not None else [])
 
 
 @router.get("/dialog/{token}/history", response_model=list[MessageOut], tags=["dialog"])
 async def dialog_history(token: str, limit: int = 100) -> list[MessageOut]:
-    return []
+    """Stored dialog (texts are scrubbed before storage, ADR-003), oldest first, the last `limit` messages."""
+    async with get_clinical_session() as s:
+        stmt = select(Message).where(Message.token == token).order_by(Message.ts.desc(), Message.id.desc())
+        rows = (await s.scalars(stmt.limit(max(1, min(limit, 1000))))).all()
+    return [MessageOut(ts=m.ts, direction=m.direction, text=m.text_scrubbed) for m in reversed(rows)]  # type: ignore[arg-type]
 
 
 # ------------------------------------------------------------------ demo controls (ADR-005)
@@ -97,21 +247,44 @@ async def get_clock() -> ClockOut:
 
 @router.post("/demo/clock/advance", response_model=ClockOut, tags=["demo"])
 async def advance_clock(body: ClockAdvanceIn) -> ClockOut:
-    """Moves the virtual clock; #13 makes the scheduler replay all events up to the new time."""
+    """Moves the virtual clock and replays the scheduler up to the new time (#13)."""
     clock.advance(days=body.days, hours=body.hours)
+    await scheduler.run_until_now()
     return _clock_out()
 
 
 @router.post("/demo/reset", tags=["demo"])
 async def demo_reset() -> dict[str, str]:
+    """Clock back to the wall clock, console outbox emptied, demo data re-seeded by `scripts.seed_demo` (#18)."""
     clock.reset()
-    return {"status": "ok"}
+    seeded = await console.reset_demo()
+    return {"status": "ok", "seed": "reset" if seeded else "skipped"}
 
 
 @router.get("/demo/personas", response_model=list[DemoPersona], tags=["demo"])
 async def demo_personas() -> list[DemoPersona]:
-    return [
+    """Patients with a scripted scenario `data/synthetic/<slug>.jsonl`; the demo cabinet's doctor first."""
+    scenarios = console.scenario_files()
+    if not scenarios:
+        return []
+    async with get_identity_session() as ids:
+        patients = (await ids.scalars(select(Patient))).all()
+    scripted = [(p, scenarios[slug]) for p in patients if (slug := console.persona_slug(p.display_name)) in scenarios]
+    if not scripted:
+        return []
+    today = clock.today()
+    async with get_clinical_session() as s:
+        profiles = {p.token: await repo.get_profile(s, p.token) for p, _ in scripted}
+    out = []
+    for p, path in sorted(scripted, key=lambda x: (x[0].doctor_id != fixtures.DOCTOR_ID, x[0].display_name)):
+        profile = profiles.get(p.token)
+        start = profile.therapy_start if profile else None
+        out.append(
             DemoPersona(
-            token="tok-andrey", display_name="Андрей С.", therapy_day=13, scenario="data/synthetic/andrey.jsonl"
+                token=p.token,
+                display_name=p.display_name,
+                therapy_day=(today - start).days if start else 0,
+                scenario=path,
             )
-    ]
+        )
+    return out

app/channels/MAX_SETUP.md

@@ -0,0 +1,150 @@
+# Подключение будущего бота MAX
+
+Серверная часть готова к подключению. Сам бот ещё не создан, секреты не заполнены,
+реальная отправка не включена. Изменений интерфейса сайта в этой поставке нет.
+Интеграция уведомляет **самого пациента**; врачебные оповещения остаются в существующем канале проекта.
+
+## Что реализовано
+
+- Одноразовая ссылка для привязки аккаунта MAX к текущему пациенту сайта, срок по умолчанию 10 минут.
+- Подтверждение подключения, `/help`, `/stop`, отключение при остановке или удалении бота в MAX.
+- Нейтральные напоминания из существующего планировщика сайта: тесты, дневник, приём лекарств и другие события outbox.
+- Уведомление о завершении теста: сервер каждые примерно 30 секунд находит новые завершённые
+  `QuestionnaireRecord` и `ScaleResult`, начиная с момента подключения MAX. Незавершённые и старые тесты не отправляются.
+- Постоянная очередь, восстановление после перезапуска, ограниченные повторы при сетевых ошибках и ответах 429/5xx.
+- В сообщении только короткий текст и кнопка на сайт. Ответы, оценки, диагнозы, назначения и ключ входа на сайт
+  в MAX не передаются. Переписка с ботом не сохраняется и не отправляется в LLM.
+
+## 1. Создать бота — будущему владельцу
+
+1. Открыть [MAX для партнёров](https://business.max.ru/) и пройти регистрацию/проверку профиля.
+   Условия допуска зависят от типа владельца; актуальный порядок — в
+   [официальной инструкции подключения](https://dev.max.ru/help/platform_connection).
+2. Создать чат-бота, оформить описание и пройти требуемую MAX модерацию.
+3. В настройках бота получить токен и скопировать имя из его публичной ссылки `https://max.ru/ИМЯ`.
+4. Передать администратору сервера имя бота, а токен — через защищённое хранилище секретов.
+   Токен не нужен в переписке, MR или репозитории.
+
+## 2. Заполнить настройки сервера
+
+Нужны доступная identity/clinical БД проекта, публичный HTTPS-адрес сайта и HTTPS-адрес API на порту 443.
+Входящие POST от MAX должны доходить до API без браузерной CAPTCHA или страницы авторизации.
+Прокси должен передавать заголовок `X-Max-Bot-Api-Secret` и не журналировать тело webhook/Authorization.
+Дополнительные таблицы identity создаются существующим `init_db()` при запуске приложения.
+
+В `.env` сервера (вне Git) заполнить:
+
+```dotenv
+MAX_ENABLED=false
+MAX_BOT_TOKEN=
+MAX_BOT_USERNAME=
+MAX_WEBHOOK_SECRET=
+MAX_WEBHOOK_URL=https://api.example.org/api/v1/webhooks/max
+MAX_SITE_URL=https://patient.example.org/
+MAX_LINK_TTL_SECONDS=600
+# При необходимости — PEM-файл доверенного CA, доступный внутри контейнера:
+MAX_CA_BUNDLE=
+DEMO_CLOCK=false
+```
+
+- `MAX_BOT_USERNAME` — только имя, без `@`, домена или параметров ссылки.
+- `MAX_WEBHOOK_SECRET` — отдельная случайная строка, не токен бота: 32–256 символов из `A–Z a–z 0–9 _ -`.
+  Сгенерировать локально, например `python -c 'import secrets; print(secrets.token_urlsafe(32))'`, сохранить в секреты.
+- `MAX_SITE_URL` ведёт в обычный личный кабинет; не добавлять в адрес ключи доступа или данные пациента.
+- Исходящие запросы идут на `https://platform-api2.max.ru`, токен передаётся заголовком `Authorization`.
+  Верификация TLS всегда включена. Если системе нужен корневой сертификат Минцифры, установить его по
+  официальной инструкции MAX и указать PEM-путь в `MAX_CA_BUNDLE`; не отключать проверку TLS.
+- Переменные должны попасть именно в окружение API-контейнера/процесса, а не только панели сайта.
+  В текущем Compose сервис `app` уже получает `.env` через `env_file`.
+  После изменения окружения пересоздать процесс/контейнер API. Новые зависимости не требуются.
+
+## 3. Проверить и включить
+
+В каталоге проекта, в том же окружении, где работает API:
+
+```sh
+uv run python -m app.channels.max_setup check
+```
+
+Команда проверит токен и совпадение имени бота. Сообщений пользователям она не отправляет.
+Затем установить `MAX_ENABLED=true`, перезапустить API и выполнить:
+
+```sh
+uv run python -m app.channels.max_setup subscribe
+uv run python -m app.channels.max_setup status
+```
+
+`subscribe` регистрирует только заданный webhook с секретом и событиями
+`bot_started`, `message_created`, `bot_stopped`, `dialog_removed`. Старые чужие подписки автоматически
+не удаляются: при переносе сервера владелец должен проверить их отдельно через MAX API.
+`status` проверяет регистрацию адреса; это ещё не проверка доступности сервера из MAX.
+Команды не печатают токены, секрет webhook или сырые ответы платформы.
+
+При запуске через Compose вместо `uv run python ...` использовать
+`docker compose exec app python -m app.channels.max_setup check` (также `subscribe` и `status`).
+После изменения `.env` пересоздать API: `docker compose up -d --build --force-recreate app`.
+
+Запускать один процесс API с MAX на один токен бота: его worker отправляет до одного сообщения в секунду.
+БД защищает очередь от параллельного захвата, но общий лимит скорости нескольких процессов не координируется.
+Планировщик и MAX worker запускаются вместе с FastAPI, отдельный процесс бота не нужен.
+При `MAX_ENABLED=false` сетевых вызовов MAX и фонового worker нет; сайт продолжает обычную работу.
+
+## API для разработчика сайта
+
+В проекте используется ключ текущего пациента, полученный при входе. Для этих ручек передавать его
+как `Authorization: Bearer <patient_token>`; это существующая авторизация прототипа, не новая система SSO.
+Не брать token другого пациента и не публиковать демонстрационные учётные записи для реального использования.
+
+| Метод и путь | Запрос | Ответ |
+|---|---|---|
+| `GET /api/v1/me/notifications/max` | Authorization | `available`, `connected`, `last_delivery` |
+| `POST /api/v1/me/notifications/max/link` | Authorization; JSON `{"consent": true}` | `url`, `expires_at` |
+| `DELETE /api/v1/me/notifications/max` | Authorization | состояние с `connected: false` |
+| `POST /api/v1/webhooks/max` | MAX JSON + `X-Max-Bot-Api-Secret` | `{"success": true}` после записи события |
+
+Поток подключения: пациент явно соглашается на уведомления → сайт получает `url` → открывает ссылку MAX →
+пользователь запускает бота → webhook подтверждает привязку → повторный GET показывает `connected: true`.
+Ссылка одноразовая; новая ссылка отменяет предыдущую. Изначальный ключ пациента не входит в URL MAX.
+Для привязки и доставки дополнительно нужны действующее согласие и подтверждение совершеннолетия в состоянии пациента.
+Активную привязку нельзя молча переназначить другому аккаунту: сначала отключить её.
+
+Коды ошибок: 401 — неизвестный/отсутствующий ключ пациента; 403 — нет согласия или неверный секрет webhook;
+422 — неверный запрос; 413 — webhook больше 64 КиБ; 503 — MAX выключен или хранилище события недоступно.
+Повтор webhook с тем же идентификатором события не создаёт новых отправок. Групповые чаты игнорируются.
+
+`last_delivery`: `queued`, `sending`, `sent`, `failed`, `cancelled` или `null`.
+`sent` означает принятие сообщения API MAX, а не прочтение человеком.
+
+## Пробное подключение после создания бота
+
+1. Войти на сайте синтетическим пациентом и дать необходимые согласия.
+2. Получить ссылку через POST выше (Swagger `/docs` или будущий интерфейс сайта), перейти в MAX и запустить бота.
+3. Убедиться, что GET показывает `connected: true` и приходит подтверждение.
+4. Завершить тест на сайте; примерно через 30 секунд плюс очередь должно прийти сообщение без результатов.
+5. Дождаться события планировщика и проверить нейтральное напоминание с кнопкой на сайт.
+6. Отправить `/stop`: GET должен показать `connected: false`, ожидающие уведомления отменяются.
+7. Повторить подключение новой ссылкой, проверить DELETE через API и остановку бота через интерфейс MAX.
+
+При недоставке проверить настройки и подписку, доступность HTTPS, состояние очереди и коды ошибок в логах.
+`http_401`/`http_403` требуют проверки токена/прав; `http_429` — ожидания; `transport` — сети/TLS;
+`failed` после шести попыток требует вмешательства администратора. Детали ответов и идентификаторы в логи не выводятся.
+Отключение отменяет очередь; уже принятый MAX запрос отозвать невозможно.
+
+## Гарантии и ограничения
+
+Очередь и подтверждения событий сохраняются в identity БД. Клинические записи остаются в clinical БД.
+Для событий завершения тестов БД повторно просматривается после перезапуска; ключи уведомлений предотвращают
+повторную постановку. Напоминания используют существующий механизм outbox/повторов планировщика.
+При временных ошибках — до 6 попыток с увеличением задержки и учётом `Retry-After`; зависшая отправка получает
+новую аренду через 60 секунд. Потеря процесса между принятием сообщения MAX и записью успеха в БД может
+привести к повторному сообщению: MAX не предоставляет ключ идемпотентности отправки.
+Не удалять строки дедупликации/очереди без согласованной политики хранения. При большом количестве пациентов
+нужны пакетное сканирование завершённых тестов и общий ограничитель скорости; текущая реализация рассчитана на MVP.
+
+Проверки разработчика: `make lint test`; тесты MAX работают с синтетикой и подменённым HTTP-транспортом.
+Реальную доставку подтвердит только пробное подключение после выдачи токена и настройки публичного сервера.
+
+Официальные контракты: [отправка сообщений](https://dev.max.ru/docs-api/methods/POST/messages),
+[подписка webhook](https://dev.max.ru/docs-api/methods/POST/subscriptions),
+[события](https://dev.max.ru/docs-api/objects/Update),
+[ссылки запуска бота](https://dev.max.ru/docs/chatbots/bots-coding/prepare).

app/channels/max_bot.py

@@ -0,0 +1,224 @@
+"""Notifications-only MAX adapter; no patient text enters the dialog engine or an LLM.
+
+Webhook transactions persist receipts and replies together, then return immediately.
+The worker delivers from identity DB with leases and bounded retries. MAX has no send
+idempotency key: a crash after API acceptance and before commit can duplicate a message.
+"""
+
+import asyncio
+import contextlib
+import json
+import logging
+from functools import lru_cache
+
+import yaml
+from pydantic import BaseModel, Field
+from sqlalchemy import select
+from sqlalchemy.exc import IntegrityError
+
+from app.channels.max_client import MaxApiError, MaxClient
+from app.config import get_settings
+from app.core import clock
+from app.db.max_notifications import MaxBinding, MaxReceipt
+from app.db.session import get_identity_session
+from app.dialog.contracts import Reply
+from app.integrations import max_store as store
+from app.integrations.base import Outbox, integrations
+
+log = logging.getLogger(__name__)
+
+
+class Texts(BaseModel):
+    connected: str = Field(max_length=4000)
+    not_connected: str = Field(max_length=4000)
+    invalid: str = Field(max_length=4000)
+    stopped: str = Field(max_length=4000)
+    help: str = Field(max_length=4000)
+    notification: str = Field(max_length=4000)
+    completed: str = Field(max_length=4000)
+    open_site: str = Field(max_length=128)
+
+
+@lru_cache
+def texts() -> Texts:
+    path = get_settings().config_dir / "texts" / "max.yaml"
+    return Texts.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
+
+
+def _event(event: dict) -> tuple[str, int, str, str] | None:
+    """Normalize only documented private-user events; unknown/malformed events are ignored."""
+    kind = event.get("update_type")
+    stamp = event.get("timestamp")
+    if type(stamp) is not int or stamp < 0:
+        return None
+    message_id = ""
+    if kind == "message_created":
+        message = event.get("message")
+        if not isinstance(message, dict):
+            return None
+        recipient, body = message.get("recipient"), message.get("body")
+        if not isinstance(recipient, dict) or recipient.get("chat_type") != "dialog" or not isinstance(body, dict):
+            return None
+        user, text, message_id = message.get("sender"), body.get("text"), body.get("mid")
+        if not isinstance(message_id, str) or not message_id or not isinstance(text, str):
+            return None
+    elif kind in ("bot_started", "bot_stopped", "dialog_removed"):
+        user, text = event.get("user"), event.get("payload") or ""
+    else:
+        return None
+    if not isinstance(user, dict) or user.get("is_bot") is not False:
+        return None
+    uid = user.get("user_id")
+    if type(uid) is not int or not 0 < uid < 2**63 or not isinstance(text, str) or len(text) > 4000:
+        return None
+    # Names, profile details and raw text are neither persisted nor logged.
+    receipt = store.digest(f"{kind}:{uid}:{message_id or stamp}")
+    return kind, uid, text.strip(), receipt
+
+
+async def handle_update(event: dict) -> None:
+    if not get_settings().max_enabled or (parsed := _event(event)) is None:
+        return
+    kind, user_id, text, receipt = parsed
+    now = clock.now()
+    try:
+        async with get_identity_session() as session:
+            if await session.get(MaxReceipt, receipt):
+                return
+            session.add(MaxReceipt(digest=receipt, received_at=now))
+            await session.flush()
+            binding = await session.scalar(select(MaxBinding).where(MaxBinding.user_id == user_id))
+            reply_token = None
+            command, _, payload = text.partition(" ")
+            if kind in ("bot_stopped", "dialog_removed") or command.lower() == "/stop":
+                if binding:
+                    await store.disconnect(session, binding.token)
+                # When MAX itself stops/deletes the bot, do not attempt a reply.
+                if kind != "message_created":
+                    return
+                reply = "stopped"
+            elif kind == "bot_started" or command.lower() == "/start":
+                code = text if kind == "bot_started" else payload.strip()
+                if code:
+                    token = await store.code_token(session, code, now) if len(code) <= 128 else None
+                    linked = (
+                        token and await store.active_patient(token) and await store.bind(session, code, user_id, now)
+                    )
+                    reply = "connected" if linked else "invalid"
+                    reply_token = token if linked else None
+                else:
+                    reply = "connected" if binding and binding.enabled else "not_connected"
+                    reply_token = binding.token if binding and binding.enabled else None
+            else:
+                reply = "help"
+            await store.enqueue(session, key=receipt, user_id=user_id, token=reply_token, kind=reply, now=now)
+    except IntegrityError:
+        # A concurrent delivery of the same webhook can race on its receipt primary key.
+        async with get_identity_session() as session:
+            if await session.get(MaxReceipt, receipt) is None:
+                raise
+
+
+class MaxOutbox:
+    def __init__(self, fallback: Outbox):
+        self.fallback = fallback
+
+    async def push(self, token: str, replies: list[Reply]) -> None:
+        if replies and get_settings().max_enabled and await store.active_patient(token):
+            async with get_identity_session() as session:
+                binding = await session.get(MaxBinding, token)
+                if binding and binding.enabled:
+                    # Hash the event for retry deduplication; never store/transmit its clinical text.
+                    event = json.dumps([r.model_dump() for r in replies], sort_keys=True, ensure_ascii=False)
+                    key = store.digest(f"{token}:{binding.connected_at.isoformat()}:{clock.today()}:{event}")
+                    await store.enqueue(
+                        session, key=key, user_id=binding.user_id, token=token, kind="notification", now=clock.now()
+                    )
+        await self.fallback.push(token, replies)
+
+
+async def deliver_one(client: MaxClient) -> bool:
+    async with get_identity_session() as session:
+        row = await store.claim(session, clock.now())
+    if row is None:
+        return False
+    if row.token is not None:
+        async with get_identity_session() as session:
+            binding = await session.get(MaxBinding, row.token)
+            valid = (
+                binding
+                and binding.enabled
+                and binding.user_id == row.user_id
+                and binding.connected_at <= row.created_at
+            )
+        if not valid or not await store.active_patient(row.token):
+            async with get_identity_session() as session:
+                await store.finish(session, row, state="cancelled", now=clock.now())
+            return True
+    settings, messages = get_settings(), texts()
+    try:
+        await client.send(
+            row.user_id, getattr(messages, row.kind), site_url=settings.max_site_url, button=messages.open_site
+        )
+    except MaxApiError as exc:
+        retry = exc.retryable and row.attempts < store.MAX_ATTEMPTS
+        delay = max(exc.retry_after, min(300, 5 * 2 ** (row.attempts - 1)))
+        async with get_identity_session() as session:
+            await store.finish(
+                session,
+                row,
+                state="queued" if retry else "failed",
+                now=clock.now(),
+                error=exc.code,
+                retry_seconds=delay if retry else 0,
+            )
+        log.warning("MAX delivery deferred=%s code=%s", retry, exc.code)
+    else:
+        async with get_identity_session() as session:
+            await store.finish(session, row, state="sent", now=clock.now())
+    return True
+
+
+async def _run(client: MaxClient) -> None:
+    tick = 0
+    while True:
+        try:
+            if tick % 30 == 0:
+                async with get_identity_session() as session:
+                    await store.collect_completed(session, clock.now())
+            await deliver_one(client)
+        except Exception as exc:
+            # No exception text: SQL/HTTP errors may contain identifiers or parameters.
+            log.error("MAX worker failed type=%s", type(exc).__name__)
+        tick += 1
+        # One send per second per process, below MAX's two-per-second per-dialog limit.
+        await asyncio.sleep(1)
+
+
+_client: MaxClient | None = None
+_task: asyncio.Task | None = None
+_wrapper: MaxOutbox | None = None
+
+
+async def start() -> None:
+    global _client, _task, _wrapper
+    if not get_settings().max_enabled or _task is not None:
+        return
+    texts()  # Validate templates before replacing a working outbox.
+    _client = MaxClient(get_settings())
+    _wrapper = MaxOutbox(integrations.outbox)
+    integrations.outbox = _wrapper
+    _task = asyncio.create_task(_run(_client), name="max-notifications")
+
+
+async def stop() -> None:
+    global _client, _task, _wrapper
+    if _task:
+        _task.cancel()
+        with contextlib.suppress(asyncio.CancelledError):
+            await _task
+    if _wrapper and integrations.outbox is _wrapper:
+        integrations.outbox = _wrapper.fallback
+    if _client:
+        await _client.close()
+    _client = _task = _wrapper = None

app/channels/max_client.py

@@ -0,0 +1,101 @@
+"""Small MAX Bot API client. Secrets stay in headers; failures never expose response bodies."""
+
+import logging
+import ssl
+
+import httpx
+
+from app.config import Settings
+
+API_URL = "https://platform-api2.max.ru"
+UPDATE_TYPES = ["bot_started", "message_created", "bot_stopped", "dialog_removed"]
+
+
+class _HideRecipient(logging.Filter):
+    def filter(self, record: logging.LogRecord) -> bool:
+        # httpx INFO normally logs query strings, which include a MAX user_id.
+        return "platform-api2.max.ru" not in record.getMessage()
+
+
+logging.getLogger("httpx").addFilter(_HideRecipient())
+
+
+class MaxApiError(Exception):
+    def __init__(self, code: str, *, retryable: bool = False, retry_after: float = 0):
+        self.code, self.retryable, self.retry_after = code, retryable, retry_after
+        super().__init__(code)
+
+
+class MaxClient:
+    def __init__(self, settings: Settings, *, transport: httpx.AsyncBaseTransport | None = None):
+        context = ssl.create_default_context()
+        if settings.max_ca_bundle:
+            context.load_verify_locations(cafile=str(settings.max_ca_bundle))
+        self.http = httpx.AsyncClient(
+            base_url=API_URL,
+            headers={"Authorization": settings.max_bot_token.get_secret_value()},
+            timeout=httpx.Timeout(5),
+            verify=context,
+            follow_redirects=False,
+            transport=transport,
+        )
+
+    async def close(self) -> None:
+        await self.http.aclose()
+
+    async def request(self, method: str, path: str, **kwargs) -> dict:
+        try:
+            response = await self.http.request(method, path, **kwargs)
+        except httpx.RequestError:
+            raise MaxApiError("transport", retryable=True) from None
+        if not response.is_success:
+            try:
+                delay = min(3600, max(0, float(response.headers.get("Retry-After", "0"))))
+            except ValueError:
+                delay = 0
+            raise MaxApiError(
+                f"http_{response.status_code}",
+                retryable=response.status_code in (408, 429) or response.status_code >= 500,
+                retry_after=delay,
+            )
+        try:
+            data = response.json()
+        except ValueError:
+            raise MaxApiError("invalid_response", retryable=True) from None
+        if not isinstance(data, dict):
+            raise MaxApiError("invalid_response", retryable=True)
+        if data.get("success") is False:
+            raise MaxApiError("rejected")
+        return data
+
+    async def send(self, user_id: int, text: str, *, site_url: str, button: str) -> None:
+        data = await self.request(
+            "POST",
+            "/messages",
+            params={"user_id": user_id, "disable_link_preview": "true"},
+            json={
+                "text": text,
+                "notify": True,
+                "attachments": [
+                    {
+                        "type": "inline_keyboard",
+                        "payload": {"buttons": [[{"type": "link", "text": button, "url": site_url}]]},
+                    }
+                ],
+            },
+        )
+        if not isinstance(data.get("message"), dict):
+            raise MaxApiError("missing_message", retryable=True)
+
+    async def subscribe(self, settings: Settings) -> None:
+        data = await self.request(
+            "POST",
+            "/subscriptions",
+            json={
+                "url": settings.max_webhook_url,
+                "update_types": UPDATE_TYPES,
+                "secret": settings.max_webhook_secret.get_secret_value(),
+            },
+        )
+        if data.get("success") is not True:
+            raise MaxApiError("subscription_not_confirmed")

app/channels/max_setup.py

@@ -0,0 +1,56 @@
+"""Operator commands for a future bot owner. Never runs as part of application startup."""
+
+import argparse
+import asyncio
+import sys
+
+from pydantic import ValidationError
+
+from app.channels.max_client import MaxApiError, MaxClient
+from app.config import Settings
+
+
+async def run(command: str) -> None:
+    # Validate the same configuration even while the deployed app is still disabled.
+    settings = Settings(max_enabled=True)
+    client = MaxClient(settings)
+    try:
+        bot = await client.request("GET", "/me")
+        if bot.get("is_bot") is not True:
+            raise MaxApiError("not_a_bot")
+        if bot.get("username") != settings.max_bot_username:
+            raise MaxApiError("bot_username_mismatch")
+        if command == "subscribe":
+            await client.subscribe(settings)
+            print("Webhook MAX зарегистрирован. Проверьте командой status, затем выполните пробное подключение.")
+        elif command == "status":
+            result = await client.request("GET", "/subscriptions")
+            subscriptions = result.get("subscriptions", [])
+            configured = any(isinstance(s, dict) and s.get("url") == settings.max_webhook_url for s in subscriptions)
+            print("Нужный webhook зарегистрирован." if configured else "Нужный webhook не найден.")
+            if not configured:
+                raise MaxApiError("webhook_missing")
+        else:
+            print("Токен принят MAX, имя бота совпадает с настройкой. Подписка не изменялась.")
+    finally:
+        await client.close()
+
+
+def main() -> int:
+    parser = argparse.ArgumentParser(description="Подготовка MAX: параметры берутся только из .env/окружения.")
+    parser.add_argument("command", choices=("check", "subscribe", "status"))
+    args = parser.parse_args()
+    try:
+        asyncio.run(run(args.command))
+    except ValidationError:
+        print("Проверьте параметры MAX в .env по app/channels/MAX_SETUP.md.", file=sys.stderr)
+        return 1
+    except (MaxApiError, OSError) as exc:
+        code = exc.code if isinstance(exc, MaxApiError) else "tls_or_file_error"
+        print(f"Не удалось выполнить настройку MAX: {code}. Секреты и ответ сервера скрыты.", file=sys.stderr)
+        return 1
+    return 0
+
+
+if __name__ == "__main__":
+    raise SystemExit(main())

app/config.py

@@ -1,10 +1,12 @@
 """Typed application settings. The only place that reads environment variables."""
 
+import re
 from functools import lru_cache
 from pathlib import Path
 from typing import Literal
+from urllib.parse import urlsplit
 
-from pydantic import Field
+from pydantic import Field, SecretStr, model_validator
 from pydantic_settings import BaseSettings, SettingsConfigDict
 
 ROOT_DIR = Path(__file__).resolve().parent.parent
@@ -12,7 +14,7 @@ ROOT_DIR = Path(__file__).resolve().parent.parent
 
 class Settings(BaseSettings):
     # Empty values in .env (e.g. `TG_BOT_TOKEN=`) fall back to defaults instead of failing validation.
-    model_config = SettingsConfigDict(env_file=".env", extra="ignore", env_ignore_empty=True)
+    model_config = SettingsConfigDict(env_file=".env", extra="ignore", env_ignore_empty=True, hide_input_in_errors=True)
 
     # Two separate databases (ADR-003): identity holds direct identifiers, clinical holds pseudonymised data.
     identity_db_url: str = "postgresql+asyncpg://identity_app:identity_app@localhost:5432/identity"
@@ -28,10 +30,51 @@ class Settings(BaseSettings):
     gigachat_model: str = "GigaChat"
     gigachat_verify_ssl: bool = False
 
+    # Chat agent (tool-using LLM over RAG + patient record). `auto` = OpenRouter if a key is set, else off
+    # (extractive RAG / instruction answers stay). OpenRouter is a TEMPORARY prototype provider on synthetic
+    # data only — prod must use GigaChat (152-FZ, foreign services are forbidden for real PII).
+    chat_agent: Literal["auto", "off", "mock", "openrouter", "gigachat"] = "auto"
+    openrouter_api_key: str = ""
+    openrouter_model: str = "google/gemini-2.5-flash-lite"
+    openrouter_base_url: str = "https://openrouter.ai/api/v1"
+    gigachat_agent_model: str = "GigaChat-2-Pro"  # function calling quality matters more than price here
+    chat_agent_timeout_s: float = 25.0
+    chat_agent_max_steps: int = 5
+
     # Telegram is used only for the prototype on synthetic data; prod channel is MAX / Gosuslugi.
     tg_bot_token: str = ""
     doctor_notify_chat_id: int | None = None
 
+    # MAX is opt-in. Its adapter is delivered in the related backend/channel changes.
+    max_enabled: bool = False
+    max_bot_token: SecretStr = SecretStr("")
+    max_bot_username: str = ""
+    max_webhook_secret: SecretStr = SecretStr("")
+    max_webhook_url: str = ""
+    max_site_url: str = ""
+    max_ca_bundle: Path | None = None
+    max_link_ttl_seconds: int = Field(default=600, ge=60, le=1800)
+
+    @model_validator(mode="after")
+    def validate_max(self) -> "Settings":
+        if not self.max_enabled:
+            return self
+        if not self.max_bot_token.get_secret_value().strip():
+            raise ValueError("MAX_BOT_TOKEN is required when MAX_ENABLED=true")
+        if not re.fullmatch(r"[A-Za-z0-9_]{1,128}", self.max_bot_username):
+            raise ValueError("MAX_BOT_USERNAME must be the bot nickname without @ or a URL")
+        if not re.fullmatch(r"[A-Za-z0-9_-]{32,256}", self.max_webhook_secret.get_secret_value()):
+            raise ValueError("MAX_WEBHOOK_SECRET must contain 32..256 URL-safe characters")
+        for name, value in (("MAX_SITE_URL", self.max_site_url), ("MAX_WEBHOOK_URL", self.max_webhook_url)):
+            url = urlsplit(value)
+            if url.scheme != "https" or not url.hostname or url.username or url.password or url.port not in (None, 443):
+                raise ValueError(f"{name} must use HTTPS on port 443 without credentials")
+            if url.query or (name == "MAX_WEBHOOK_URL" and url.fragment):
+                raise ValueError(f"{name} must not contain a query string (or a fragment for webhook)")
+        if self.max_ca_bundle is not None and not self.max_ca_bundle.is_file():
+            raise ValueError("MAX_CA_BUNDLE must point to an existing trusted CA bundle")
+        return self
+
     # Virtual clock for the demo (ADR-005).
     demo_clock: bool = True
     tz: str = "Europe/Moscow"

app/core/cssrs_content.py

@@ -0,0 +1,59 @@
+"""Russian Recent source transcription, separate from the legacy sequential scale.
+
+This content does not authorize administering or continuing the questionnaire.
+Use questionnaire.score_cssrs_recent for required/missing items and risk, and
+evaluate_intake for the clinical policy gate before presenting another question.
+Never render interviewer guidance as if it were another patient question.
+"""
+
+from pathlib import Path
+from typing import Literal
+
+import yaml
+from pydantic import BaseModel, ConfigDict, Field, model_validator
+
+from app.config import get_settings
+
+ItemId = Literal["q1", "q2", "q3", "q4", "q5", "q6_lifetime", "q6_recent"]
+
+
+class SourceModel(BaseModel):
+    model_config = ConfigDict(extra="forbid", frozen=True)
+
+
+class CssrsOption(SourceModel):
+    value: int = Field(strict=True, ge=0, le=1)
+    label: str
+
+
+class CssrsItem(SourceModel):
+    id: ItemId
+    text: str = Field(min_length=1)
+    interviewer_guidance: str | None
+    recall_period: Literal["past_month", "lifetime", "past_3_months"]
+    yes_risk: Literal["low", "moderate", "high"]
+
+
+class CssrsRussianForm(SourceModel):
+    id: Literal["cssrs_recent_ru"]
+    version: str = Field(min_length=1)
+    title: str
+    subtitle: Literal["Screen Version - Recent"]
+    period_label_original: str
+    initial_instruction: str
+    branch_instruction: str
+    options: tuple[CssrsOption, CssrsOption]
+    items: tuple[CssrsItem, ...]
+
+    @model_validator(mode="after")
+    def _structure(self) -> "CssrsRussianForm":
+        if tuple(item.id for item in self.items) != ("q1", "q2", "q3", "q4", "q5", "q6_lifetime", "q6_recent"):
+            raise ValueError("Recent form requires seven ordered answer fields")
+        if tuple(option.value for option in self.options) != (1, 0):
+            raise ValueError("source answer columns are Yes, No")
+        return self
+
+
+def load_cssrs_russian(path: Path | None = None) -> CssrsRussianForm:
+    path = path or get_settings().config_dir / "instruments" / "cssrs_recent_ru.yaml"
+    return CssrsRussianForm.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))

app/core/instrument_catalog.py

@@ -0,0 +1,142 @@
+"""Read-only catalog of questionnaire items for patient clients (web app).
+
+The dialog engine sends a questionnaire question as plain text plus buttons; the button payload carries the item id
+(`iq:<nonce>:<item>:<i>`, `scale:<scale>:<item>:<v>`). A client looks the item up here to show which form it belongs
+to, its position and recall period. Nothing here changes what is asked or how it is scored — the texts stay those of
+the versioned sources in config/.
+"""
+
+from functools import lru_cache
+from typing import Any, Literal
+
+from pydantic import BaseModel
+
+from app.config import get_settings
+from app.core.cssrs_content import load_cssrs_russian
+from app.core.intake_questions import DIARY_PARTS, content, diary_config, red_flags, texts
+from app.core.scales import load_scale
+
+Section = Literal["safety", "mood", "trauma", "alcohol", "about", "diary", "scale"]
+
+# Forms whose item order depends on earlier answers: a client shows the position without «из N».
+ADAPTIVE = {"cssrs", "rus_audit", "diary", "context"}
+
+
+class FormInfo(BaseModel):
+    id: str
+    title: str
+    section: Section
+    recall_period: str | None = None
+    instruction: str | None = None
+
+
+class ItemInfo(BaseModel):
+    form: str
+    index: int  # 1-based position in the form
+    total: int
+    adaptive: bool
+    optional: bool = False
+    numeric: bool = False
+
+
+class DrinksTable(BaseModel):
+    """RUS-AUDIT item 2 standard-drink table, exactly as in config/texts/intake.yaml (the approved form)."""
+
+    title: str
+    header: list[str]
+    rows: list[tuple[str, list[str]]]
+    note: str
+
+
+class Catalog(BaseModel):
+    forms: dict[str, FormInfo]
+    items: dict[str, ItemInfo]
+    standard_drinks: DrinksTable | None
+
+
+def _drinks() -> DrinksTable | None:
+    raw = texts().get("standard_drinks")
+    if not raw:
+        return None
+    lines = [line.strip() for line in raw.splitlines() if line.strip()]
+    title, header_line, *rest = lines
+    rows = [line for line in rest if ":" in line]
+    note = " ".join(line for line in rest if ":" not in line)
+    return DrinksTable(
+        title=title,
+        header=[h.strip() for h in header_line.split("·")],
+        rows=[
+            (label.strip(), [c.strip() for c in cells.split("·")]) for label, cells in (r.split(":", 1) for r in rows)
+        ],
+        note=note,
+    )
+
+
+@lru_cache(maxsize=1)
+def catalog() -> Catalog:
+    forms: dict[str, FormInfo] = {}
+    items: dict[str, ItemInfo] = {}
+
+    def add(form: FormInfo, ids: list[str], *, optional: set[str] = frozenset(), numeric: set[str] = frozenset()):
+        forms[form.id] = form
+        for i, item in enumerate(ids, 1):
+            items.setdefault(
+                item,
+                ItemInfo(
+                    form=form.id,
+                    index=i,
+                    total=len(ids),
+                    adaptive=form.id in ADAPTIVE,
+                    optional=item in optional,
+                    numeric=item in numeric,
+                ),
+            )
+
+    flags = red_flags()
+    add(FormInfo(id="red_flags", title="Вопросы о безопасности", section="safety"), [i["id"] for i in flags["items"]])
+
+    cssrs = load_cssrs_russian()
+    add(FormInfo(id="cssrs", title=cssrs.title, section="safety"), ["cssrs_" + i.id for i in cssrs.items])
+
+    intake_forms: dict[str, Any] = content()["forms"]
+    for sid, section in (("phq9", "mood"), ("tsq", "trauma"), ("pcl5", "trauma"), ("rus_audit", "alcohol")):
+        raw = intake_forms.get(sid) or {}
+        scale = load_scale(sid)
+        add(
+            FormInfo(
+                id=sid,
+                title=raw.get("title") or scale.title,
+                section=section,
+                recall_period=raw.get("recall_period") or scale.recall_period,
+                instruction=raw.get("instruction") or scale.instruction,
+            ),
+            list(scale.item_ids),
+        )
+    add(FormInfo(id="trauma", title="Травматическое событие", section="trauma"), ["trauma", "recent_trauma"])
+    add(FormInfo(id="context", title="Общие вопросы", section="about"), ["sex", "tbi", "psychotropics"])
+
+    diary = diary_config()
+    core = [item for part in DIARY_PARTS for item in diary[part]]
+    depression = [f"dphq_{i['id'].rsplit('_', 1)[1]}" for i in intake_forms[diary["depression"]["form"]]["items"]]
+    ptsd = [f"dpcl_{i.rsplit('_', 1)[1]}" for i in diary["ptsd"]["items"]]
+    add(
+        FormInfo(id="diary", title="Дневник самочувствия", section="diary"),
+        [i["id"] for i in core] + depression + ptsd,
+        optional={i["id"] for i in core if i.get("optional")},
+        numeric={i["id"] for i in core if i.get("numeric")},
+    )
+
+    # Scales of the onboarding / scheduled sessions (`scale:<id>:...` buttons): the form header only.
+    for path in sorted((get_settings().config_dir / "scales").glob("*.yaml")):
+        scale = load_scale(path.stem)
+        forms.setdefault(
+            scale.id,
+            FormInfo(
+                id=scale.id,
+                title=scale.title,
+                section="scale",
+                recall_period=scale.recall_period,
+                instruction=scale.instruction,
+            ),
+        )
+    return Catalog(forms=forms, items=items, standard_drinks=_drinks())

app/core/intake_questions.py

@@ -0,0 +1,204 @@
+"""Question selection and exact versioned content, with no side effects."""
+
+from dataclasses import dataclass
+
+import yaml
+
+from app.config import get_settings
+from app.core.cssrs_content import load_cssrs_russian
+from app.core.questionnaire import IntakePolicy, alcohol_expansion, score_alcohol, score_cssrs_recent
+from app.core.scales import ScaleDef, load_scale
+
+
+@dataclass(frozen=True)
+class Question:
+    id: str
+    text: str
+    options: tuple[tuple[object, str], ...] = ()
+    period: str = "context"
+    numeric: bool = False
+    optional: bool = False
+    maximum: float = 24
+
+
+def content() -> dict:
+    return yaml.safe_load((get_settings().config_dir / "instruments/intake_forms.yaml").read_text())
+
+
+def texts() -> dict:
+    return yaml.safe_load((get_settings().config_dir / "texts/intake.yaml").read_text())
+
+
+def scale_question(scale_id: str, item_id: str) -> Question:
+    forms = content()["forms"]
+    scale = ScaleDef.model_validate(forms[scale_id]) if scale_id in forms else load_scale(scale_id)
+    item = next(i for i in scale.items if i.id == item_id)
+    instruction = scale.instruction or ""
+    # The beverage table is part of the approved questionnaire source.
+    if item_id == "rus_audit_2":
+        instruction += "\n" + texts()["standard_drinks"]
+    return Question(
+        item_id,
+        instruction + "\n\n" + item.text,
+        tuple((o.value, o.label) for o in item.options),
+        scale.recall_period or "",
+    )
+
+
+def group_answers(answers: dict, prefix: str) -> dict[str, int]:
+    return {k: v for k, v in answers.items() if k.startswith(prefix + "_")}
+
+
+def cssrs_answers(answers: dict) -> dict[str, int]:
+    return {k.removeprefix("cssrs_"): v for k, v in answers.items() if k.startswith("cssrs_")}
+
+
+def red_flags() -> dict:
+    return yaml.safe_load((get_settings().config_dir / "instruments/red_flags.yaml").read_text(encoding="utf-8"))
+
+
+def red_flag_category(item_id: str) -> str | None:
+    return next((i["category"] for i in red_flags()["items"] if i["id"] == item_id), None)
+
+
+def next_intake(answers: dict, policy: IntakePolicy, sex: str | None) -> Question | None:
+    """Stage 1: the red-flag block first (config/instruments/red_flags.yaml), then the fixed order of «Опросники
+    для MVP»: PHQ-2, trauma filter → TSQ, RUS-AUDIT-S, C-SSRS screener, the context questions; stage 2 (rest of
+    PHQ-9, PCL-5, full RUS-AUDIT) only where stage 1 is positive. Items inside a scale keep the order of the source.
+    The risk stop rules run after every answer (flows/intake.py), so a positive answer interrupts the questionnaire
+    wherever it comes."""
+    flags = red_flags()
+    for n, item in enumerate(flags["items"]):
+        if item["id"] not in answers:
+            text = (flags["intro"] + "\n\n" if n == 0 else "") + item["text"]
+            return Question(item["id"], text, tuple((o["value"], o["label"]) for o in flags["options"]), "now")
+    for item in ("phq9_1", "phq9_2"):
+        if item not in answers:
+            return scale_question("phq9", item)
+    if "trauma" not in answers:
+        return Question(
+            "trauma", content()["trauma_introduction"] + "\n\n" + content()["trauma_filter"], ((1, "Да"), (0, "Нет"))
+        )
+    if answers["trauma"]:
+        for item in load_scale("tsq").item_ids:
+            if item not in answers:
+                return scale_question("tsq", item)
+        if "recent_trauma" not in answers:
+            return Question("recent_trauma", texts()["recent_trauma"], ((1, "Да"), (0, "Нет")))
+    for item in load_scale("rus_audit_s").item_ids:
+        if item not in answers:
+            return scale_question("rus_audit_s", item)
+    c = score_cssrs_recent(cssrs_answers(answers))
+    if c.missing:
+        form = load_cssrs_russian()
+        item = next(i for i in form.items if i.id == c.missing[0])
+        period = texts()["periods"][item.recall_period]
+        # Guidance is interviewer-facing; retained in the source and record version.
+        return Question(
+            "cssrs_" + item.id,
+            period + "\n\n" + item.text,
+            tuple((o.value, o.label) for o in form.options),
+            item.recall_period,
+        )
+    if sex is None and "sex" not in answers:
+        return Question("sex", texts()["sex"], (("f", "Женский"), ("m", "Мужской"), ("unknown", "Не указывать")))
+    for key in ("tbi", "psychotropics"):
+        if key not in answers:
+            return Question(key, texts()[key], ((1, "Да"), (0, "Нет")))
+    if answers["phq9_1"] + answers["phq9_2"] >= policy.phq2_expand_at:
+        for item in load_scale("phq9").item_ids:
+            if item not in answers:
+                return scale_question("phq9", item)
+    if answers["trauma"] and sum(group_answers(answers, "tsq").values()) >= policy.tsq_expand_at:
+        for item in load_scale("pcl5").item_ids:
+            if item not in answers:
+                return scale_question("pcl5", item)
+    alcohol = group_answers(answers, "rus_audit")
+    selected_sex = sex or (answers.get("sex") if answers.get("sex") in ("m", "f") else None)
+    short = score_alcohol(
+        {k: v for k, v in alcohol.items() if k in load_scale("rus_audit_s").item_ids}, short=True, sex=selected_sex
+    )
+    if alcohol_expansion(short, policy):
+        for item in load_scale("rus_audit").item_ids:
+            if item == "rus_audit_2" and alcohol.get("rus_audit_1") == 0:
+                continue
+            if item not in answers:
+                return scale_question("rus_audit", item)
+    return None
+
+
+def cssrs_since_contact_question(answers: dict) -> Question | None:
+    """Daily suicide-risk module of stage 2: the C-SSRS screener asked «since the last contact».
+
+    The official Russian Since Last Contact form is not in the repository yet (docs/clinical/README.md, C06), so the
+    items of the Recent form are asked verbatim under the since-last-contact period. Behaviour since the last contact
+    is recent by definition: the answer to q6 also fills q6_recent (derived), so the recent triage applies.
+    """
+    c = score_cssrs_recent(cssrs_answers(answers))
+    missing = [k for k in c.missing if k != "q6_recent"]
+    if not missing:
+        return None
+    form = load_cssrs_russian()
+    item = next(i for i in form.items if i.id == missing[0])
+    return Question(
+        "cssrs_" + item.id,
+        texts()["periods"]["since_last_contact"] + "\n\n" + item.text,
+        tuple((o.value, o.label) for o in form.options),
+        "since_last_contact",
+    )
+
+
+DIARY_PARTS = ("morning", "evening")
+DIARY_KINDS = ("diary_morning", "diary_evening")
+
+
+def diary_config() -> dict:
+    return yaml.safe_load((get_settings().config_dir / "instruments/diary.yaml").read_text(encoding="utf-8"))
+
+
+def diary_questions(part: str, modules: list[str], *, day_index: int = 0) -> tuple[Question, ...]:
+    """Stage 2 diary of one part of the day: the core block plus, in the evening, the modules of the profile.
+
+    PTSD («veteran») and depression run side by side when both are present. The depression module asks three
+    PHQ-9 items a day in rotation by `day_index` (days since the first diary). Ids are prefixed (`dphq_`, `dpcl_`)
+    so diary answers never mix with the full scales.
+    """
+    if part not in DIARY_PARTS:
+        raise ValueError("unknown diary part")
+    config = diary_config()
+    questions = [
+        Question(
+            item["id"],
+            item["text"],
+            tuple((o["value"], o["label"]) for o in item.get("options", [])),
+            "past_day",
+            item.get("numeric", False),
+            item.get("optional", False),
+            item.get("max", 24),
+        )
+        for item in config[part]
+    ]
+    if part == "evening":
+        forms = content()["forms"]
+        if "depression" in modules:
+            module = config["depression"]
+            items = forms[module["form"]]["items"]
+            per_day = module["items_per_day"]
+            start = (day_index % (len(items) // per_day)) * per_day
+            options = tuple((o["value"], o["label"]) for o in module["options"])
+            for item in items[start : start + per_day]:
+                number = item["id"].rsplit("_", 1)[1]
+                questions.append(
+                    Question(f"dphq_{number}", module["question"] + "\n\n" + item["text"], options, "today")
+                )
+        if "veteran" in modules:
+            module = config["ptsd"]
+            form = forms[module["form"]]
+            by_id = {i["id"]: i["text"] for i in form["items"]}
+            options = tuple((o["value"], o["label"]) for o in form["options"])
+            for item_id in module["items"]:
+                number = item_id.rsplit("_", 1)[1]
+                questions.append(
+                    Question(f"dpcl_{number}", module["question"] + "\n\n" + by_id[item_id], options, "today")
+                )
+    return tuple(questions)

app/core/intake_runtime.py

@@ -0,0 +1,205 @@
+"""Versioned release gate and deterministic follow-up planning."""
+
+from calendar import monthrange
+from datetime import date, timedelta
+from pathlib import Path
+from typing import Literal
+from zoneinfo import ZoneInfo
+
+import yaml
+from pydantic import BaseModel, ConfigDict, Field, model_validator
+
+from app.config import get_settings
+from app.core.questionnaire import Approval, demo_mode, load_policy
+
+
+class RuntimePolicy(BaseModel):
+    model_config = ConfigDict(extra="forbid", frozen=True)
+    version: str
+    enabled: bool = False
+    approval: Approval | None = None
+    content_review: Approval | None = None
+    contact_review: Approval | None = None
+    timezone: str
+    morning_hour: int = Field(ge=0, le=23)
+    evening_hour: int = Field(ge=0, le=23)
+    norm_days: int = Field(ge=2)
+    week_days: int = Field(ge=2)
+    min_norm_values: int = Field(ge=1)
+    min_week_values: int = Field(ge=1)
+    mood_drop: float = Field(gt=0, le=10)
+    depression_item_rise: float = Field(gt=0, le=3)
+    ptsd_sum_rise: float = Field(gt=0, le=16)
+    sleep_bad_days: int = Field(ge=1)
+    sleep_hours_below: float = Field(gt=0, le=24)
+    alcohol_heavy_portions: float = Field(gt=0)
+    alcohol_heavy_days: int = Field(ge=1)
+    adherence_below: float = Field(gt=0, le=1)
+    missed_medication_days: int = Field(ge=1)
+    high_risk_silence_days: int = Field(ge=1)
+    medication_days: tuple[int, ...]
+    medication_repeat_days: int = Field(ge=1)
+    route_intervals: dict[str, dict[str, int]]
+    alcohol_repeat_days: int = Field(ge=1)
+    phq9_retriage_delta: int = Field(ge=1)
+    pcl5_retriage_delta: int = Field(ge=1)
+
+    @model_validator(mode="after")
+    def valid(self):
+        ZoneInfo(self.timezone)
+        if set(self.route_intervals) != {"after_crisis", "specialist", "self_help"} or any(
+            set(row) != {"phq9", "pcl5"} for row in self.route_intervals.values()
+        ):
+            raise ValueError("all route and scale intervals must be defined")
+        if self.morning_hour >= self.evening_hour:
+            raise ValueError("the morning diary must come before the evening one")
+        if not self.medication_days or tuple(sorted(set(self.medication_days))) != self.medication_days:
+            raise ValueError("medication days must be nonempty and strictly increasing")
+        if self.medication_days[0] < 1 or any(v < 1 for row in self.route_intervals.values() for v in row.values()):
+            raise ValueError("intervals must be positive")
+        if any(
+            a and a.policy_version != self.version for a in (self.approval, self.content_review, self.contact_review)
+        ):
+            raise ValueError("review must match the runtime version")
+        return self
+
+    @property
+    def released(self) -> bool:
+        return self.enabled and all((self.approval, self.content_review, self.contact_review))
+
+
+def load_runtime(path: Path | None = None) -> RuntimePolicy:
+    path = path or get_settings().config_dir / "intake_runtime.yaml"
+    return RuntimePolicy.model_validate(yaml.safe_load(path.read_text()))
+
+
+def demo_intake() -> bool:
+    """Demo-only switch (INTAKE_DEMO=1 with the virtual clock): shows the questionnaires on synthetic data.
+
+    It never touches the clinical release gate in config/intake_runtime.yaml; production runs keep the forms off
+    until the approvals are recorded there.
+    """
+    return demo_mode()
+
+
+def intake_enabled() -> bool:
+    return (load_runtime().released and load_policy().approval is not None) or demo_intake()
+
+
+def month_before(day: date, months: int = 1) -> date:
+    year, month = divmod(day.year * 12 + day.month - 1 - months, 12)
+    return day.replace(year=year, month=month + 1, day=min(day.day, monthrange(year, month + 1)[1]))
+
+
+def due_scales(
+    *,
+    today: date,
+    enrolled: date,
+    last: dict[str, date],
+    route: Literal["specialist", "self_help"],
+    medication_changed: date | None = None,
+    after_crisis: date | None = None,
+    policy: RuntimePolicy | None = None,
+) -> tuple[str, ...]:
+    """Return each overdue form once. Therapy day zero is the recorded start/change date.
+
+    Due dates stay due until completion. Overlapping schedules choose the earlier
+    date; missed ticks do not create a burst of historical questionnaires.
+    """
+    p = policy or load_runtime()
+    due = set()
+    for scale in ("phq9", "pcl5"):
+        completed = last.get(scale)
+        dates = [(completed or enrolled) + timedelta(days=p.route_intervals[route][scale])]
+        if after_crisis and after_crisis <= today:
+            dates.append(
+                max(completed or after_crisis, after_crisis) + timedelta(days=p.route_intervals["after_crisis"][scale])
+            )
+        if medication_changed and medication_changed <= today:
+            for offset in p.medication_days:
+                milestone = medication_changed + timedelta(days=offset)
+                if completed is None or completed < milestone:
+                    dates.append(milestone)
+                    break
+            else:
+                dates.append(
+                    max(completed or medication_changed, medication_changed + timedelta(days=p.medication_days[-1]))
+                    + timedelta(days=p.medication_repeat_days)
+                )
+        if min(dates) <= today:
+            due.add(scale)
+    if (last.get("rus_audit_s") or enrolled) + timedelta(days=p.alcohol_repeat_days) <= today:
+        due.add("rus_audit_s")
+    return tuple(sorted(due))
+
+
+def _mean(values: list[float]) -> float:
+    return sum(values) / len(values)
+
+
+def diary_flags(
+    history: dict[date, dict],
+    today: date,
+    policy: RuntimePolicy | None = None,
+    *,
+    medication_active: bool = False,
+) -> tuple[str, ...]:
+    """Stage 2 diary flags («Этап 2», p.4): weekly means against the personal norm, never single days.
+
+    `history` holds the merged morning + evening answers per date. The norm is the first `norm_days` of
+    observation; trends are checked only after it. Missing data never become zero or missed doses.
+    """
+    p = policy or load_runtime()
+    flags: list[str] = []
+    current = history.get(today, {})
+    start = min(history) if history else today
+    norm = [history[d] for d in sorted(history) if (d - start).days < p.norm_days]
+    week_start = today - timedelta(days=p.week_days - 1)
+    week = [history[d] for d in sorted(history) if week_start <= d <= today]
+    trend = (week_start - start).days >= p.norm_days
+
+    def values(rows: list[dict], key) -> list[float]:
+        return [v for r in rows if (v := key(r)) is not None]
+
+    def risen(key, by: float, *, min_norm: int, min_week: int, drop: bool = False) -> bool:
+        before, now = values(norm, key), values(week, key)
+        if not trend or len(before) < min_norm or len(now) < min_week:
+            return False
+        change = _mean(before) - _mean(now) if drop else _mean(now) - _mean(before)
+        return change >= by
+
+    if risen(lambda r: r.get("mood"), p.mood_drop, min_norm=p.min_norm_values, min_week=p.min_week_values, drop=True):
+        flags.append("phq9_due_mood")
+    # Depression module: each PHQ-9 item comes every third day, so a weekly mean has ~2 values per item.
+    for item in range(1, 10):
+        if risen(lambda r, i=item: r.get(f"dphq_{i}"), p.depression_item_rise, min_norm=2, min_week=2):
+            flags.append("phq9_due_depression")
+            break
+    # PTSD module: only the sum of the four items is interpreted, never single clusters.
+    ptsd_items = ("dpcl_1", "dpcl_7", "dpcl_10", "dpcl_18")
+
+    def ptsd_sum(r):
+        return sum(r[k] for k in ptsd_items) if all(k in r for k in ptsd_items) else None
+
+    if risen(ptsd_sum, p.ptsd_sum_rise, min_norm=p.min_norm_values, min_week=p.min_week_values):
+        flags.append("pcl5_due_ptsd")
+    nights = [history.get(today - timedelta(days=i), {}) for i in range(p.sleep_bad_days)]
+    if all(
+        (r.get("sleep_hours") is not None and r["sleep_hours"] < p.sleep_hours_below) or r.get("sleep_quality") == 0
+        for r in nights
+    ):
+        flags.append("sleep_review")
+    heavy = [r for r in week if (r.get("alcohol_portions") or 0) >= p.alcohol_heavy_portions]
+    if medication_active and (current.get("alcohol_portions") or 0) >= p.alcohol_heavy_portions:
+        flags.append("alcohol_on_medication")
+    if len(heavy) >= p.alcohol_heavy_days:
+        flags.append("rus_audit_due_alcohol")
+    doses = [history.get(today - timedelta(days=i), {}) for i in range(p.missed_medication_days)]
+    if all(r.get("medication") == "no" for r in doses):
+        flags.append("medication_contact")
+    taken = [r["medication"] for r in week if r.get("medication") in ("yes", "no")]
+    if len(taken) >= p.min_week_values and taken.count("yes") / len(taken) < p.adherence_below:
+        flags.append("adherence_review")
+    if current.get("medication_reason") == "side_effects":
+        flags.append("side_effects_review")
+    return tuple(flags)

app/core/interpretation.py

@@ -0,0 +1,166 @@
+"""Patient-facing interpretation of questionnaire results: deterministic rules, texts from config/texts/results.yaml.
+
+Stage 1 («Опросники для MVP»): screening levels per scale → a preliminary conclusion and the diary modules of stage 2.
+Stage 2 («Этап 2»): full scales on schedule (level + change: response, remission, worsening) and diary flags.
+Nothing here diagnoses: the conclusion is a screening result, the diagnosis is the doctor's (ADR-007, guardrail 3).
+"""
+
+from typing import Any
+
+import yaml
+
+from app.config import get_settings
+from app.core.intake_questions import content
+from app.core.questionnaire import IntakeDecision, IntakePolicy
+from app.core.safety import fill_phones
+
+# Stage 1 finding → diary module of stage 2 (PTSD is the «veteran» module of the profile).
+FINDING_MODULE = {"depression_suspected": "depression", "ptsd_suspected": "veteran"}
+# Remission and improvement cut-offs of the full scales («Этап 2», p.5: Kroenke 2001; Marx et al., 2022).
+PHQ9_REMISSION_BELOW = 5
+PHQ9_IMPROVED_BY = 5
+PCL5_RESPONSE_BY = 10
+PCL5_IMPROVED_BELOW = 28
+
+
+def texts() -> dict[str, Any]:
+    return yaml.safe_load(fill_phones((get_settings().config_dir / "texts/results.yaml").read_text(encoding="utf-8")))
+
+
+def render(interpretation: dict[str, Any]) -> str:
+    """Plain text of an interpretation for the dialog reply (title, lines, then the disclaimer if any)."""
+    parts = [interpretation["title"], *interpretation.get("lines", [])]
+    if interpretation.get("disclaimer"):
+        parts.append(interpretation["disclaimer"])
+    return "\n\n".join(p for p in parts if p)
+
+
+def _alcohol_zone(totals: dict) -> int | None:
+    full, short = totals.get("rus_audit") or {}, totals.get("rus_audit_s") or {}
+    return full.get("zone") if full.get("complete") else short.get("zone")
+
+
+def intake_findings(totals: dict, answers: dict, policy: IntakePolicy) -> list[str]:
+    """Screening findings of stage 1, in the order they are shown."""
+    found = []
+    phq = totals.get("phq9") or {}
+    if phq.get("complete"):
+        if phq["total"] >= policy.phq9_specialist_at:
+            found.append("depression_suspected")
+        elif phq["total"] >= policy.phq9_psychologist_at:
+            found.append("depression_mild")
+    pcl, tsq = totals.get("pcl5") or {}, totals.get("tsq") or {}
+    if pcl.get("complete") and pcl["total"] >= policy.pcl5_specialist_at:
+        found.append("ptsd_suspected")
+    elif answers.get("trauma") == 1 and tsq.get("complete") and tsq["total"] >= policy.tsq_expand_at:
+        found.append("ptsd_signs")
+    zone = _alcohol_zone(totals)
+    if zone == 4:
+        found.append("alcohol_high")
+    elif zone in (2, 3):
+        found.append("alcohol_risky")
+    if (totals.get("cssrs_recent") or {}).get("risk") == "low":
+        found.append("suicide_low")
+    if answers.get("tbi") == 1:
+        found.append("tbi")
+    return found
+
+
+def intake_interpretation(totals: dict, answers: dict, decision: IntakeDecision, policy: IntakePolicy) -> dict:
+    t = texts()
+    found = intake_findings(totals, answers, policy)
+    modules = [FINDING_MODULE[f] for f in found if f in FINDING_MODULE]
+    head = t["intake"]["attention" if found else "ok"]
+    lines = [head["text"]]
+    lines += [f"{t['findings'][f]['title']}. {t['findings'][f]['text']}" for f in found]
+    if decision.primary_route in t["routes"]:
+        lines.append(t["routes"][decision.primary_route])
+    names = ", ".join(t["modules"]["names"][m] for m in modules)
+    lines.append(t["modules"]["diary"].format(modules=t["modules"]["with"].format(names=names) if names else ""))
+    return {
+        "kind": "intake",
+        "title": head["title"],
+        "lines": lines,
+        "codes": found or ["ok"],
+        "findings": [{"code": f, "title": t["findings"][f]["title"]} for f in found],
+        "route": decision.primary_route,
+        "modules": modules,
+        "disclaimer": t["disclaimer"],
+    }
+
+
+def _phq9_level(total: int) -> str:
+    band = next(b for b in content()["forms"]["phq9"]["severity"] if b["min"] <= total <= b["max"])
+    return band["code"]
+
+
+def scale_interpretation(
+    kind: str,
+    totals: dict,
+    *,
+    baseline: int | None,
+    previous: int | None,
+    policy: IntakePolicy,
+    retriage_delta: int,
+) -> dict:
+    """A scheduled full scale: level, then the change against the start of observation and the last measurement."""
+    t = texts()["scales"]
+    if kind == "rus_audit_s":
+        zone = _alcohol_zone(totals)
+        result = totals.get("rus_audit") if (totals.get("rus_audit") or {}).get("complete") else totals["rus_audit_s"]
+        level = t[kind]["levels"][f"zone_{zone}" if zone else "unknown"]
+        line = t["score"].format(title=t[kind]["title"], total=result.get("total"), level=level)
+        return {
+            "kind": kind,
+            "title": t[kind]["title"],
+            "lines": [line],
+            "codes": [f"zone_{zone}" if zone else "unknown"],
+        }
+    total = totals[kind]["total"]
+    pcl5_level = "probable" if total >= policy.pcl5_specialist_at else "below"
+    code = _phq9_level(total) if kind == "phq9" else pcl5_level
+    lines = [t["score"].format(title=t[kind]["title"], total=total, level=t[kind]["levels"][code])]
+    change = None
+    if previous is not None and total - previous >= retriage_delta:
+        change = "worse"
+    elif baseline is not None:
+        if kind == "phq9":
+            if total < PHQ9_REMISSION_BELOW:
+                change = "remission"
+            elif baseline > 0 and total <= baseline / 2:
+                change = "response"
+            elif baseline - total >= PHQ9_IMPROVED_BY:
+                change = "improved"
+            else:
+                change = "stable"
+        else:
+            if baseline - total >= PCL5_RESPONSE_BY:
+                change = "response"
+            elif total < PCL5_IMPROVED_BELOW <= baseline:
+                change = "improved"
+            else:
+                change = "stable"
+    if change:
+        lines.append(t["change"][change])
+    return {"kind": kind, "title": t[kind]["title"], "lines": lines, "codes": [code, *([change] if change else [])]}
+
+
+def diary_interpretation(part: str, flags: tuple[str, ...] | list[str]) -> dict:
+    t = texts()["diary"]
+    shown = [f for f in flags if f in t["flags"]]
+    return {
+        "kind": f"diary_{part}",
+        "title": t["saved"].format(part=t["parts"][part]),
+        "lines": [t["flags"][f] for f in shown],
+        "codes": list(flags),
+    }
+
+
+def cssrs_interpretation(risk: str | None) -> dict:
+    t = texts()["cssrs"]
+    return {
+        "kind": "cssrs_since_contact",
+        "title": t["low" if risk == "low" else "none"],
+        "lines": [],
+        "codes": [risk or "none"],
+    }

app/core/meds_reference.py

@@ -0,0 +1,35 @@
+"""Drug reference of the medication module (data/meds/meds_reference.json, built by scripts/build_meds_reference.py).
+
+Read-only patient information collected from the Minzdrav clinical guidelines: when to expect the effect, how long
+the course lasts, common side effects, red flags. It never suggests a drug or a dose — the app only follows the
+doctor's prescription. Draft until reviewed by a psychiatrist (`status` in the file).
+"""
+
+import json
+from functools import lru_cache
+from typing import Any, Literal
+
+from app.config import get_settings
+
+Indication = Literal["depression", "ptsd"]
+
+
+@lru_cache(maxsize=1)
+def load_reference() -> dict[str, Any]:
+    path = get_settings().data_dir / "meds" / "meds_reference.json"
+    return json.loads(path.read_text(encoding="utf-8"))
+
+
+def find_drug(name: str) -> dict[str, Any] | None:
+    """Reference entry for a prescription's drug (INN in Russian or the latin id), or None if it is not covered."""
+    key = name.strip().split()[0].casefold() if name.strip() else ""
+    for drug in load_reference()["drugs"]:
+        if key in (drug["id"], drug["name_ru"].casefold()):
+            return drug
+    return None
+
+
+def indication_for(modules: list[str], drug: dict[str, Any]) -> Indication | None:
+    """The indication the patient is followed for, among those the drug has in the guidelines."""
+    preferred: list[Indication] = ["ptsd", "depression"] if "veteran" in modules else ["depression", "ptsd"]
+    return next((i for i in preferred if i in drug["indications"]), None)

app/core/questionnaire.py

@@ -0,0 +1,348 @@
+"""Versioned intake rules for clinical review (#52).
+
+No patient wording or LLM calls. This module deliberately does not replace legacy
+cssrs_screen (whose q6 only covers three months) or reinterpret historical data.
+The dialog adapter must pass RAW answers, persist the policy version, and respect
+the returned status. Pending clinical policy never authorizes routine continuation.
+"""
+
+from __future__ import annotations
+
+import os
+from dataclasses import dataclass
+from datetime import datetime
+from pathlib import Path
+from typing import Literal
+
+import yaml
+from pydantic import BaseModel, ConfigDict, Field, model_validator
+
+from app.config import get_settings
+from app.core.scales import Sex, load_scale, score
+
+Risk = Literal["none", "low", "moderate", "high"]
+
+
+class Approval(BaseModel):
+    model_config = ConfigDict(extra="forbid", frozen=True, str_strip_whitespace=True)
+    reviewer: str = Field(min_length=1)
+    decision_reference: str = Field(min_length=1)
+    approved_at: datetime
+    policy_version: str = Field(min_length=1)
+
+    @model_validator(mode="after")
+    def _aware(self) -> Approval:
+        if self.approved_at.tzinfo is None:
+            raise ValueError("approval timestamp must include timezone")
+        return self
+
+
+class IntakePolicy(BaseModel):
+    model_config = ConfigDict(extra="forbid", frozen=True)
+    version: str = Field(min_length=1)
+    approval: Approval | None = None
+    cssrs_positive_policy: Literal["pending", "stop_any", "graded"] = "pending"
+    rus_audit_s_expand_at: int | None = Field(default=None, ge=1, le=12, strict=True)
+    rus_audit_s_expand_from_zone: int | None = Field(default=None, ge=1, le=4, strict=True)
+    phq2_expand_at: int = Field(ge=1, le=6, strict=True)
+    tsq_expand_at: int = Field(ge=1, le=10, strict=True)
+    phq9_psychologist_at: int = Field(ge=0, le=27, strict=True)
+    phq9_specialist_at: int = Field(ge=0, le=27, strict=True)
+    phq9_priority_at: int = Field(ge=0, le=27, strict=True)
+    pcl5_specialist_at: int = Field(ge=0, le=80, strict=True)
+    pcl5_behavior_flag_at: int = Field(ge=0, le=4, strict=True)
+
+    @model_validator(mode="after")
+    def _approval_matches(self) -> IntakePolicy:
+        if self.approval and (
+            self.approval.policy_version != self.version
+            or self.cssrs_positive_policy == "pending"
+            or (self.rus_audit_s_expand_from_zone is None and self.rus_audit_s_expand_at is None)
+        ):
+            raise ValueError("approval requires the matching version and resolved clinical decisions")
+        if self.rus_audit_s_expand_from_zone is not None and self.rus_audit_s_expand_at is not None:
+            raise ValueError("choose a total threshold OR a zone for alcohol expansion")
+        if not self.phq9_psychologist_at < self.phq9_specialist_at < self.phq9_priority_at:
+            raise ValueError("PHQ-9 thresholds must be ordered")
+        return self
+
+
+def demo_mode() -> bool:
+    """Demo-only switch (INTAKE_DEMO=1 with the virtual clock): questionnaires on synthetic data.
+
+    It selects `config/questionnaire_demo.yaml` (marked as NOT a clinical approval) instead of the real policy; the
+    real policy and the release gate in config/intake_runtime.yaml are never touched.
+    """
+    return os.environ.get("INTAKE_DEMO", "").lower() in ("1", "true", "yes") and get_settings().demo_clock
+
+
+def load_policy(path: Path | None = None) -> IntakePolicy:
+    path = path or get_settings().config_dir / ("questionnaire_demo.yaml" if demo_mode() else "questionnaire.yaml")
+    return IntakePolicy.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
+
+
+@dataclass(frozen=True)
+class AlcoholResult:
+    scale: str
+    complete: bool
+    total: int | None
+    zone: int | None
+    missing: tuple[str, ...]
+    derived: tuple[str, ...] = ()
+
+
+def score_alcohol(answers: dict[str, int], *, short: bool, sex: Sex | None) -> AlcoholResult:
+    """RUS-AUDIT-S uses original items 3/9/10; unknown sex never borrows a cut-off."""
+    if sex not in (None, "m", "f"):
+        raise ValueError("sex must be m, f or None")
+    scale_id = "rus_audit_s" if short else "rus_audit"
+    # Validate BEFORE derivation: bools, floats and conflicting answers must not be hidden.
+    score(scale_id, answers, sex=sex)
+    values = dict(answers)
+    derived = []
+    if not short and values.get("rus_audit_1") == 0:
+        for item in ("rus_audit_2", "rus_audit_3"):
+            if values.get(item, 0) != 0:
+                raise ValueError("never drinks conflicts with positive consumption answers")
+            if item == "rus_audit_2" and item not in values:
+                values[item] = 0
+                derived.append(item)
+    result = score(scale_id, values, sex=sex)
+    missing = tuple(i for i in load_scale(scale_id).item_ids if i not in values)
+    zone = int(result.severity_code[-1]) if result.complete and sex is not None else None
+    return AlcoholResult(
+        scale_id, result.complete, result.total if result.complete else None, zone, missing, tuple(derived)
+    )
+
+
+def extend_alcohol(short_answers: dict[str, int], additional: dict[str, int]) -> dict[str, int]:
+    """Reuse original item IDs. Duplicate equal answers count once; conflicting ones fail."""
+    score("rus_audit_s", short_answers)
+    score("rus_audit", additional)
+    for key in short_answers.keys() & additional.keys():
+        if short_answers[key] != additional[key]:
+            raise ValueError(f"conflicting repeated answer: {key}")
+    return {**short_answers, **additional}
+
+
+def alcohol_expansion(result: AlcoholResult, policy: IntakePolicy) -> bool | None:
+    """None means unresolved, never a negative screen or permission to skip the full form."""
+    if result.scale != "rus_audit_s":
+        raise ValueError("expansion requires RUS-AUDIT-S")
+    if not policy.approval or not result.complete or result.zone is None:
+        return None
+    if policy.rus_audit_s_expand_at is not None:
+        return result.total >= policy.rus_audit_s_expand_at
+    assert policy.rus_audit_s_expand_from_zone is not None
+    return result.zone >= policy.rus_audit_s_expand_from_zone
+
+
+_CSSRS_ITEMS = ("q1", "q2", "q3", "q4", "q5", "q6_lifetime", "q6_recent")
+
+
+@dataclass(frozen=True)
+class CssrsResult:
+    complete: bool
+    risk: Risk | None
+    risk_lower_bound: Risk
+    positive: bool
+    required: tuple[str, ...]
+    missing: tuple[str, ...]
+    conflicts: tuple[str, ...]
+
+
+def score_cssrs_recent(answers: dict[str, int]) -> CssrsResult:
+    """Recent screener structure; q1-5 month, q6 lifetime + conditional three-month follow-up.
+
+    These keys describe data, NOT an official Russian translation. Positive signals
+    survive missing/contradictory answers; only complete consistent data yield final risk.
+    """
+    for key, value in answers.items():
+        if key not in _CSSRS_ITEMS or type(value) is not int or value not in (0, 1):
+            raise ValueError("C-SSRS requires known item IDs and integer 0/1 answers")
+    required = ["q1", "q2"]
+    if answers.get("q2") == 1:
+        required.extend(["q3", "q4", "q5"])
+    required.append("q6_lifetime")
+    if answers.get("q6_lifetime") == 1:
+        required.append("q6_recent")
+    conflicts = []
+    if answers.get("q2") == 0 and any(answers.get(k) == 1 for k in ("q3", "q4", "q5")):
+        conflicts.append("ideation_branch_conflict")
+    if answers.get("q6_lifetime") == 0 and answers.get("q6_recent") == 1:
+        conflicts.append("behavior_recency_conflict")
+    missing = tuple(k for k in required if k not in answers)
+    complete = not missing and not conflicts
+    lower: Risk = "none"
+    if any(answers.get(k) == 1 for k in ("q4", "q5", "q6_recent")):
+        lower = "high"
+    elif answers.get("q3") == 1 or answers.get("q6_lifetime") == 1:
+        lower = "moderate"
+    elif any(answers.get(k) == 1 for k in ("q1", "q2")):
+        lower = "low"
+    return CssrsResult(
+        complete, lower if complete else None, lower, 1 in answers.values(), tuple(required), missing, tuple(conflicts)
+    )
+
+
+@dataclass(frozen=True)
+class IntakeDecision:
+    policy_version: str
+    status: Literal["crisis", "clinical_review_required", "incomplete", "ready"]
+    primary_route: str | None
+    parallel_routes: tuple[str, ...]
+    flags: tuple[str, ...]
+    missing: tuple[str, ...]
+
+
+def _additional_flags(pcl5, alcohol, sex, traumatic_brain_injury, psychotropics, policy):
+    """Preserve independently observable flags even when the primary route is crisis.
+
+    Invalid unrelated data is marked for review rather than blocking a known crisis.
+    The routine branch still validates every answer strictly before routing.
+    """
+    flags = []
+    try:
+        score("pcl5", pcl5)
+        if any(pcl5.get(k, 0) >= policy.pcl5_behavior_flag_at for k in ("pcl5_15", "pcl5_16")):
+            flags.append("pcl5_behavior")
+    except ValueError:
+        flags.append("invalid_pcl5_answers")
+    try:
+        full = score_alcohol(alcohol, short=False, sex=sex)
+        short_values = {k: v for k, v in alcohol.items() if k in load_scale("rus_audit_s").item_ids}
+        short = score_alcohol(short_values, short=True, sex=sex)
+        zone = full.zone if full.complete else short.zone
+        if zone is not None and zone >= 2:
+            flags.append("alcohol_zone_ii_or_higher")
+        if psychotropics and (any(v > 0 for v in alcohol.values())):
+            flags.append("alcohol_psychotropics")
+        if full.zone == 4:
+            flags.append("alcohol_zone_iv")
+    except ValueError:
+        flags.append("invalid_alcohol_answers")
+    if traumatic_brain_injury:
+        flags.append("traumatic_brain_injury")
+    return flags
+
+
+def evaluate_intake(
+    *,
+    phq9: dict[str, int],
+    tsq: dict[str, int],
+    pcl5: dict[str, int],
+    alcohol: dict[str, int],
+    cssrs: dict[str, int],
+    sex: Sex | None,
+    trauma_exposure: bool | None,
+    help_now: bool = False,
+    traumatic_brain_injury: bool = False,
+    psychotropics: bool = False,
+    policy: IntakePolicy | None = None,
+) -> IntakeDecision:
+    """Two-stage candidate routing. No side effects, notifications, or claims of approval.
+
+    `alcohol` keeps full-scale IDs across both stages. Existing PHQ/PCL wording and
+    new C-SSRS content still need release review even with a signed routing policy.
+    """
+    policy = policy or load_policy()
+    if type(help_now) is not bool or type(traumatic_brain_injury) is not bool or type(psychotropics) is not bool:
+        raise ValueError("context flags must be bool")
+    if trauma_exposure is not None and type(trauma_exposure) is not bool:
+        raise ValueError("trauma_exposure must be bool or None")
+    # Independent flags survive the higher-priority crisis route.
+    flags = _additional_flags(pcl5, alcohol, sex, traumatic_brain_injury, psychotropics, policy)
+    # A manual emergency request does not depend on the completeness of any scale.
+    if help_now:
+        return IntakeDecision(policy.version, "crisis", "crisis", (), tuple(["help_now", *flags]), ())
+    # Act on explicit safety answers BEFORE processing unrelated, possibly invalid scales.
+    phq_item9 = phq9.get("phq9_9")
+    item9_positive = type(phq_item9) is int and phq_item9 in (1, 2, 3)
+    try:
+        c = score_cssrs_recent(cssrs)
+    except ValueError:
+        known_high = any(type(cssrs.get(k)) is int and cssrs[k] == 1 for k in ("q4", "q5", "q6_recent"))
+        if not item9_positive and not known_high:
+            raise
+        flags.extend(["invalid_cssrs_answers", "phq9_item9_positive" if item9_positive else "cssrs_positive"])
+        return IntakeDecision(policy.version, "crisis", "crisis", (), tuple(flags), ())
+    if item9_positive:
+        flags.append("phq9_item9_positive")
+        if c.complete and c.risk == "none":
+            flags.append("phq9_cssrs_discrepancy")
+    if c.positive:
+        flags.append("cssrs_positive")
+    flags.extend(c.conflicts)
+    # One crisis rule (ADR-013): a high C-SSRS risk. Item 9 alone is a crisis only while the screener is not complete;
+    # with a negative / low screener it is the «discrepancy» flag of the routing table, not the crisis screen.
+    if c.risk_lower_bound == "high" or (item9_positive and not c.complete):
+        return IntakeDecision(policy.version, "crisis", "crisis", (), tuple(flags), c.missing)
+    if c.positive and policy.approval and policy.cssrs_positive_policy == "stop_any":
+        return IntakeDecision(policy.version, "crisis", "crisis", (), tuple(flags), c.missing)
+    if c.positive and not policy.approval:
+        return IntakeDecision(policy.version, "clinical_review_required", None, (), tuple(flags), c.missing)
+
+    phq = score("phq9", phq9)
+    pc = score("tsq", tsq)
+    pcl = score("pcl5", pcl5)
+    full_alcohol = score_alcohol(alcohol, short=False, sex=sex)
+    short_values = {k: v for k, v in alcohol.items() if k in load_scale("rus_audit_s").item_ids}
+    short_alcohol = score_alcohol(short_values, short=True, sex=sex)
+    missing = list(c.missing)
+    phq2_items = ("phq9_1", "phq9_2")
+    missing.extend(k for k in phq2_items if k not in phq9)
+    phq2_complete = all(k in phq9 for k in phq2_items)
+    phq2_positive = phq2_complete and sum(phq9[k] for k in phq2_items) >= policy.phq2_expand_at
+    if phq2_positive:
+        missing.extend(k for k in load_scale("phq9").item_ids if k not in phq9)
+    if trauma_exposure is None:
+        missing.append("trauma_exposure")
+    if trauma_exposure is False and tsq:
+        flags.append("trauma_filter_conflict")
+    pc_positive = trauma_exposure is True and pc.complete and pc.total >= policy.tsq_expand_at
+    if trauma_exposure is True and not pc.complete:
+        missing.extend(k for k in load_scale("tsq").item_ids if k not in tsq)
+    if pc_positive and not pcl.complete:
+        missing.extend(k for k in load_scale("pcl5").item_ids if k not in pcl5)
+    # Partially administered optional scales also cannot be treated as completed negatives.
+    if len(phq9) > 2 and not phq.complete:
+        missing.extend(k for k in load_scale("phq9").item_ids if k not in phq9)
+    if pcl5 and not pcl.complete:
+        missing.extend(k for k in load_scale("pcl5").item_ids if k not in pcl5)
+    missing.extend(short_alcohol.missing)
+    if sex is None:
+        missing.append("alcohol_scoring_sex")
+    expand = alcohol_expansion(short_alcohol, policy)
+    if expand or (len(alcohol) > 3 and not full_alcohol.complete):
+        missing.extend(full_alcohol.missing)
+    if expand is None:
+        flags.append("alcohol_transition_unresolved")
+    if not policy.approval or c.conflicts or "trauma_filter_conflict" in flags:
+        return IntakeDecision(
+            policy.version, "clinical_review_required", None, (), tuple(flags), tuple(dict.fromkeys(missing))
+        )
+    if missing:
+        return IntakeDecision(policy.version, "incomplete", None, (), tuple(flags), tuple(dict.fromkeys(missing)))
+    # PHQ-2-negative does not invent a PHQ-9 total; it simply does not trigger expansion.
+    phq_total = phq.total if phq.complete else 0
+    pcl_total = pcl.total if pcl.complete else 0
+    # Risk and flags first, scales second (clinical review 2026-10-04). A high PCL-5 alone is not a reason for a
+    # priority appointment: it goes to the planned specialist route.
+    if c.risk == "moderate":
+        primary = "urgent_psychiatrist"
+    elif phq_total >= policy.phq9_priority_at:
+        primary = "priority_psychiatrist"
+    elif phq_total >= policy.phq9_specialist_at or pcl_total >= policy.pcl5_specialist_at:
+        primary = "psychiatrist_or_psychotherapist"
+    elif phq_total >= policy.phq9_psychologist_at or pc_positive:
+        primary = "psychologist"
+    else:
+        primary = "self_help"
+    parallel = []
+    if full_alcohol.zone == 4:
+        parallel.append("narcologist")
+    if traumatic_brain_injury:
+        parallel.append("neurologist")
+    if c.risk == "low":
+        flags.append("cssrs_low_safety_plan")
+    return IntakeDecision(policy.version, "ready", primary, tuple(parallel), tuple(flags), ())

app/core/safety.py

@@ -395,6 +395,25 @@ def _crisis_cfg(path: Path = CRISIS_PATH) -> _CrisisCfg:
     return _CrisisCfg.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
 
 
+_PHONE_REF = re.compile(r"\{phone:([a-z_]+)\}")
+
+
+def fill_phones(text: str, path: Path = CRISIS_PATH) -> str:
+    """Replace `{phone:<resource>}` with the number from the single table in config/texts/crisis.yaml.
+
+    Every patient text and prompt refers to the table instead of repeating a number, so a number is changed in one
+    place. An unknown resource fails loudly: a wrong number on the crisis screen must never pass silently.
+    """
+    resources = _crisis_cfg(path).resources
+
+    def number(m: re.Match[str]) -> str:
+        if m.group(1) not in resources:
+            raise ValueError(f"unknown crisis resource {m.group(1)!r}")
+        return resources[m.group(1)].phone
+
+    return _PHONE_REF.sub(number, text)
+
+
 def _render(body: str, resources: list[CrisisResource], doctor_notified: str, grounding: str) -> str:
     lines = [body.strip(), ""]
     for r in resources:

app/db/bootstrap.py

@@ -4,6 +4,9 @@ The only module (besides registration code) that touches both schemas — and on
 """
 
 from app.db import audit as _audit  # noqa: F401  (registers audit_log in clinical metadata)
+from app.db import intake as _intake  # noqa: F401
+from app.db import max_notifications as _max_notifications  # noqa: F401
+from app.db import scheduler as _scheduler  # noqa: F401
 from app.db.clinical import ClinicalBase
 from app.db.identity import IdentityBase
 from app.db.session import clinical_engine, identity_engine

app/db/intake.py

@@ -0,0 +1,55 @@
+"""Versioned questionnaire records, without modifying historical scale results."""
+
+from datetime import date, datetime
+from typing import Any
+
+from sqlalchemy import Date, ForeignKey, Integer, String, UniqueConstraint
+from sqlalchemy.orm import Mapped, mapped_column
+
+from app.db.clinical import BigId, ClinicalBase
+from app.db.types import JSONType, TZDateTime
+
+
+class QuestionnaireRecord(ClinicalBase):
+    __tablename__ = "questionnaire_records"
+    id: Mapped[str] = mapped_column(String(32), primary_key=True)
+    token: Mapped[str] = mapped_column(String(32), index=True)
+    kind: Mapped[str] = mapped_column(String(32))
+    version: Mapped[str] = mapped_column(String(64))
+    policy_version: Mapped[str] = mapped_column(String(64))
+    started_at: Mapped[datetime] = mapped_column(TZDateTime)
+    completed_at: Mapped[datetime | None] = mapped_column(TZDateTime)
+    day: Mapped[date] = mapped_column(Date)
+    status: Mapped[str] = mapped_column(String(32))
+    answers: Mapped[dict[str, Any]] = mapped_column(JSONType, default=dict)
+    # Per-field time, recall period, source and derived values; totals may be null.
+    details: Mapped[dict[str, Any]] = mapped_column(JSONType, default=dict)
+
+
+class QuestionnaireNotice(ClinicalBase):
+    __tablename__ = "questionnaire_notices"
+    __table_args__ = (UniqueConstraint("token", "event_key"),)
+    id: Mapped[int] = mapped_column(BigId, primary_key=True, autoincrement=True)
+    token: Mapped[str] = mapped_column(String(32), index=True)
+    event_key: Mapped[str] = mapped_column(String(128))
+    alert_id: Mapped[int] = mapped_column(ForeignKey("alerts.id"))
+    created_at: Mapped[datetime] = mapped_column(TZDateTime)
+    attempted_at: Mapped[datetime | None] = mapped_column(TZDateTime)
+    accepted_at: Mapped[datetime | None] = mapped_column(TZDateTime)
+    attempts: Mapped[int] = mapped_column(Integer, default=0)
+    status: Mapped[str] = mapped_column(String(32), default="pending")
+    error_code: Mapped[str | None] = mapped_column(String(80))
+
+
+class QuestionnaireTask(ClinicalBase):
+    __tablename__ = "questionnaire_tasks"
+    __table_args__ = (UniqueConstraint("token", "task_key"),)
+    id: Mapped[int] = mapped_column(BigId, primary_key=True, autoincrement=True)
+    token: Mapped[str] = mapped_column(String(32), index=True)
+    task_key: Mapped[str] = mapped_column(String(128))
+    kind: Mapped[str] = mapped_column(String(32))
+    due_at: Mapped[datetime] = mapped_column(TZDateTime)
+    status: Mapped[str] = mapped_column(String(32), default="pending")
+    record_id: Mapped[str | None] = mapped_column(String(32))
+    delivery: Mapped[list] = mapped_column(JSONType, default=list)
+    sent_at: Mapped[datetime | None] = mapped_column(TZDateTime)

app/db/max_notifications.py

@@ -0,0 +1,50 @@
+"""MAX identifiers and delivery metadata live only in the identity DB; no medical message bodies."""
+
+from datetime import datetime
+
+from sqlalchemy import BigInteger, Boolean, Integer, String
+from sqlalchemy.orm import Mapped, mapped_column
+
+from app.db.identity import IdentityBase
+from app.db.types import TZDateTime
+
+
+class MaxBinding(IdentityBase):
+    __tablename__ = "max_bindings"
+
+    # No FK: anonymous web profiles intentionally have no patients row in identity.
+    token: Mapped[str] = mapped_column(String(64), primary_key=True)
+    user_id: Mapped[int] = mapped_column(BigInteger, unique=True)
+    enabled: Mapped[bool] = mapped_column(Boolean, default=True)
+    connected_at: Mapped[datetime] = mapped_column(TZDateTime)
+
+
+class MaxLinkCode(IdentityBase):
+    __tablename__ = "max_link_codes"
+
+    digest: Mapped[str] = mapped_column(String(64), primary_key=True)
+    token: Mapped[str] = mapped_column(String(64), unique=True)
+    expires_at: Mapped[datetime] = mapped_column(TZDateTime, index=True)
+    used_at: Mapped[datetime | None] = mapped_column(TZDateTime)
+
+
+class MaxReceipt(IdentityBase):
+    __tablename__ = "max_webhook_receipts"
+
+    digest: Mapped[str] = mapped_column(String(64), primary_key=True)
+    received_at: Mapped[datetime] = mapped_column(TZDateTime, index=True)
+
+
+class MaxDelivery(IdentityBase):
+    __tablename__ = "max_deliveries"
+
+    id: Mapped[str] = mapped_column(String(64), primary_key=True)
+    token: Mapped[str | None] = mapped_column(String(64), index=True)
+    user_id: Mapped[int] = mapped_column(BigInteger)
+    kind: Mapped[str] = mapped_column(String(24))
+    state: Mapped[str] = mapped_column(String(16), default="queued", index=True)
+    attempts: Mapped[int] = mapped_column(Integer, default=0)
+    created_at: Mapped[datetime] = mapped_column(TZDateTime)
+    next_attempt_at: Mapped[datetime] = mapped_column(TZDateTime, index=True)
+    lease: Mapped[str | None] = mapped_column(String(32))
+    error_code: Mapped[str | None] = mapped_column(String(32))

app/db/scheduler.py

@@ -0,0 +1,24 @@
+"""Delivery log of the demo scheduler (#13): one row per delivered event, the unique key makes runs idempotent.
+
+Clinical DB, keyed by token only (guardrail #5). Created by `init_db` (`app.db.bootstrap`).
+"""
+
+from datetime import datetime
+
+from sqlalchemy import String, UniqueConstraint
+from sqlalchemy.orm import Mapped, mapped_column
+
+from app.db.clinical import TOKEN_LEN, BigId, ClinicalBase
+from app.db.types import TZDateTime
+
+
+class SchedulerEvent(ClinicalBase):
+    __tablename__ = "scheduler_events"
+    __table_args__ = (UniqueConstraint("token", "key", name="uq_scheduler_events_token_key"),)
+
+    id: Mapped[int] = mapped_column(BigId, primary_key=True, autoincrement=True)
+    token: Mapped[str] = mapped_column(String(TOKEN_LEN))
+    key: Mapped[str] = mapped_column(String(96))  # e.g. "dose:3:2026-10-06T08:00", "checkin:2026-10-06"
+    kind: Mapped[str] = mapped_column(String(32))  # med_reminder | missed | daily_checkin | scale_due | evaluation
+    due_at: Mapped[datetime] = mapped_column(TZDateTime)
+    done_at: Mapped[datetime] = mapped_column(TZDateTime)

app/dialog/actions.py

@@ -0,0 +1,85 @@
+"""Execution of *dialog* actions returned by `MonitoringService.after_data_change()` (ADR-007).
+
+The rules (lane B, `config/rules.yaml`) decide WHAT happens; this module only turns an already chosen action
+into replies. `alert` / `enhanced_monitoring` are handled by lane B itself (persisted + doctor notified), so they
+are ignored here. While a crisis is open only crisis-relevant actions (crisis, safety plan, risk screen) reach
+the patient: no medication tips or visit offers in the middle of a crisis.
+"""
+
+from collections.abc import Awaitable, Callable, Iterable
+from typing import Any
+
+from app.core.rules import Action
+from app.db.clinical import SafetyPlan
+from app.dialog.contracts import Button, Reply
+from app.dialog.crisis import crisis_open, open_crisis
+from app.dialog.fsm import Ctx, Step
+from app.dialog.scale_session import active_scale, add_pending
+
+# med_info topic → phrase intent of `config/texts/phrases.yaml` (the LLM only rephrases the template).
+_MED_INFO_INTENTS = {"delayed_effect": "quit_intent", "alcohol_interaction": "alcohol_info", "nausea": "nausea_info"}
+_CRISIS_SAFE = {"crisis", "show_safety_plan", "schedule_scale"}
+
+# Optional `med_info` answerer registered by a flow (`flows/meds.py`, #37): answers from the drug instruction
+# (med_qa). Returning None falls back to the phrase template below.
+MedInfoHandler = Callable[[Ctx, Action], Awaitable[Reply | None]]
+_med_info_handler: MedInfoHandler | None = None
+
+
+def register_med_info_handler(handler: MedInfoHandler | None) -> None:
+    global _med_info_handler
+    _med_info_handler = handler
+
+
+def _plan_line(step: Any) -> str:
+    if isinstance(step, dict):
+        return ": ".join(str(v) for v in step.values() if v)
+    return str(step)
+
+
+async def safety_plan_reply(ctx: Ctx, block: str | None = None) -> Reply:
+    """The plan composed with the doctor (`safety_plans`), or the Stanley–Brown template from config."""
+    row = await ctx.session.get(SafetyPlan, ctx.token)
+    steps = [_plan_line(s) for s in row.steps] if row is not None and row.steps else ctx.texts.safety_plan.template
+    lines = [ctx.texts.safety_plan.title, *(f"{i}. {s}" for i, s in enumerate(steps, 1))]
+    if block == "means_restriction":
+        lines += ["", ctx.texts.safety_plan.means_restriction]
+    return Reply(text="\n".join(lines), kind="safety_plan")
+
+
+async def execute(ctx: Ctx, actions: Iterable[Action]) -> Step:
+    step = Step()
+    shown_plan = False
+    for action in actions:
+        if crisis_open({**ctx.data, **step.data}) and action.type not in _CRISIS_SAFE:
+            continue
+        if action.type == "crisis":
+            if not crisis_open({**ctx.data, **step.data}):
+                step = step.then(open_crisis(ctx, categories=[], source=f"rule:{action.code}"))
+        elif action.type == "show_safety_plan" and not shown_plan:
+            shown_plan = True
+            step = step.then(Step(replies=[await safety_plan_reply(ctx, action.params.get("block"))]))
+        elif action.type == "schedule_scale" and action.params.get("scale"):
+            scale_id = str(action.params["scale"])
+            if active_scale(step.next_state or ctx.state) == scale_id:
+                continue  # already being asked
+            data = {**ctx.data, **step.data}
+            pending = add_pending(data, scale_id, bool(action.params.get("scheduled", False)))
+            step = step.then(Step(data={"pending_scales": pending}))
+        elif action.type == "med_info":
+            reply = await _med_info_handler(ctx, action) if _med_info_handler is not None else None
+            if reply is None:
+                intent = _MED_INFO_INTENTS.get(str(action.params.get("topic")), "default")
+                reply = Reply(text=await ctx.gateway.phrase(intent, {}), kind="info")
+            step = step.then(Step(replies=[reply]))
+        elif action.type == "suggest_visit":
+            text = await ctx.gateway.phrase("book_visit_offer", {})
+            button = Button(label=ctx.texts.visit.button, data="menu:visit")
+            step = step.then(Step(replies=[Reply(text=text, buttons=[[button]], kind="info")]))
+        elif action.type == "reach_out":
+            topic = str(action.params.get("topic", "default"))
+            texts = ctx.texts.reach_out
+            text = {"silence": texts.silence, "missed_doses": texts.missed_doses}.get(topic, texts.default)
+            step = step.then(Step(replies=[Reply(text=text)]))
+        # alert / enhanced_monitoring: lane B persists and notifies; nothing to say to the patient.
+    return step

app/dialog/crisis.py

@@ -0,0 +1,49 @@
+"""Crisis path of the dialog (guardrail #2): fixed texts only, never generated by the LLM.
+
+Decisions:
+  * The crisis script (`app.core.safety.crisis_reply`, `config/texts/crisis.yaml`) is sent verbatim, once per
+    open crisis. "Open" = `data["crisis"]["open"]` — set when the crisis starts, cleared only by the doctor's
+    acknowledgement (`doctor_ack`), so a patient repeating the phrase does not get the same long script again:
+    they get a short fixed support message and emergency resources instead.
+  * Entering the crisis drops unfinished scale sessions (their answered items are already stored item by item):
+    nothing else is asked while the patient is in crisis, except the C-SSRS screen.
+  * Without valid consent (before consent, after refusal/revocation, minors) we still answer a crisis message —
+    protecting life is the one processing ground that does not need consent (152-FZ art. 10 p. 2.3) — but with
+    a variant WITHOUT "your doctor has been notified", because no doctor is notified, and nothing is stored.
+"""
+
+from typing import Any
+
+from app.core.safety import CrisisResource, CrisisScript, crisis_reply
+from app.dialog.contracts import Reply
+from app.dialog.fsm import Ctx, Step
+
+
+def crisis_open(data: dict[str, Any]) -> bool:
+    return bool((data.get("crisis") or {}).get("open"))
+
+
+def _resource_lines(resources: list[CrisisResource]) -> list[str]:
+    return [f"• {r.name}: {r.phone}" + (f" ({r.note})" if r.note else "") for r in resources]
+
+
+def open_crisis(ctx: Ctx, categories: list[str], source: str) -> Step:
+    """Start the crisis (full script) or, if one is already open, send the short repeat text.
+
+    `source` is a code for the dashboard/audit trail: "safety:lexicon", "safety:llm", "scale:phq9", "rule:<id>".
+    """
+    script = crisis_reply(categories)
+    if crisis_open(ctx.data):
+        text = "\n".join([ctx.texts.crisis.repeat, *_resource_lines(script.resources)])
+        return Step(replies=[Reply(text=text, kind="crisis")])
+    crisis = {"open": True, "opened_at": ctx.now.isoformat(), "source": source, "variant": script.variant}
+    return Step(
+        replies=[Reply(text=script.text, kind="crisis")],
+        next_state="crisis",
+        data={"crisis": crisis, "scales": None},
+    )
+
+
+def no_consent_crisis_text(script: CrisisScript) -> str:
+    """Crisis script without the "doctor notified" line — for people we may not (or did not) notify about."""
+    return "\n".join([script.body, "", *_resource_lines(script.resources), "", script.grounding])

app/dialog/engine.py

@@ -0,0 +1,406 @@
+"""Dialog engine (issue #10, ADR-004): `Engine.handle(token, event) -> list[Reply]`, channel-agnostic.
+
+Pipeline for one incoming event (SPEC §3, guardrails #1, #2, #3):
+
+  0. abandoned step     the FSM sits in a question step (check-in, scale) the patient left more than
+                        `settings.abandon_after_hours` ago → back to idle first (stored answers stay; never in
+                        crisis, never in an onboarding chain), then the event is handled as usual.
+
+  text event
+    1. scrub()            raw text → ScrubbedText. Raw text is never stored, logged or sent anywhere.
+    2. consent gate       no valid consent → no LLM, nothing stored; only the local crisis lexicon runs
+                          (protecting life does not need consent) and the core flow shows consent/refusal.
+    3. safety.check()     lexicon FIRST. Lexicon ACUTE → the LLM is not called at all. Otherwise the LLM risk
+                          classifier is an auxiliary signal combined as max(lexicon, llm): it can only raise risk.
+         ACUTE    → fixed crisis script verbatim (once per open crisis), state `crisis`, structured
+                    `safety_events` fact for lane B, MonitoringService.after_data_change() (lane B alerts).
+         POSSIBLE → C-SSRS screen (scale session) and back to the previous state (or crisis if high).
+    4. FSM                the current state's handler (`app/dialog/flows/*`, `app/dialog/scale_session.py`).
+  button / system / start events skip 1–3 (no free text) and go through the same FSM.
+
+  After the FSM step: if clinical data were written → commit → `after_data_change()` → the returned *dialog*
+  actions are executed (`app/dialog/actions.py`). The engine never creates alerts (ADR-007).
+  Then a queued scale starts if the FSM rests (idle; only the C-SSRS while in crisis).
+  Persist: inbound message (scrubbed) + outbound replies + `dialog_state` — only with active consent.
+
+Logs carry only the token, states and event codes (guardrail #8).
+"""
+
+import asyncio
+import logging
+from dataclasses import dataclass, field
+from datetime import datetime, timedelta
+from typing import Any
+from weakref import WeakValueDictionary
+
+from sqlalchemy.exc import InterfaceError, OperationalError
+from sqlalchemy.ext.asyncio import AsyncSession
+
+from app.core import clock, safety
+from app.core.intake_runtime import intake_enabled
+from app.core.privacy import scrub
+from app.core.safety import SafetyResult, crisis_reply
+from app.core.types import RiskLevel, ScrubbedText
+from app.db import repo
+from app.db.session import get_clinical_session
+from app.dialog import scale_session
+from app.dialog.actions import execute
+from app.dialog.contracts import Event, Reply, register_engine
+from app.dialog.crisis import crisis_open, no_consent_crisis_text, open_crisis
+from app.dialog.flows import load_flows
+from app.dialog.flows.core import close_crisis, revoke
+from app.dialog.fsm import (
+    NO_CONSENT_STATES,
+    RESTING_STATES,
+    Ctx,
+    Step,
+    apply_data,
+    enter_hook_for,
+    handler_for,
+    is_abandonable,
+)
+from app.dialog.texts import DialogTexts, load_dialog_texts
+from app.llm.gateway import LLMGateway, get_gateway
+from app.services import questionnaire as intake_service
+from app.services.contracts import MonitoringService, get_monitoring
+
+log = logging.getLogger(__name__)
+
+# Enter hooks may chain (scale done → next onboarding state → next scale); a cycle must not hang a request.
+MAX_ENTER_CHAIN = 8
+_patient_locks = WeakValueDictionary()
+# DB unreachable: answer safely instead of failing the channel (connectivity errors only — bugs must surface).
+_DB_DOWN = (OSError, OperationalError, InterfaceError)
+# dialog_state.data key: when the patient last acted in (or the FSM entered) the current step — abandon timeout.
+STEP_AT = "step_at"
+
+
+@dataclass
+class _Run:
+    replies: list[Reply] = field(default_factory=list)
+    notify: bool = False
+
+
+def _consented(ctx: Ctx) -> bool:
+    return ctx.data.get("consent") is True and ctx.state not in NO_CONSENT_STATES
+
+
+class Engine:
+    """Real `DialogEngine`. `gateway` / `monitoring` are injectable for tests; by default resolved per call so
+    a monitoring implementation registered later (lane B, #38) is picked up."""
+
+    def __init__(self, *, gateway: LLMGateway | None = None, monitoring: MonitoringService | None = None) -> None:
+        self._gateway = gateway
+        self._monitoring = monitoring
+
+    async def handle(self, token: str, event: Event) -> list[Reply]:
+        texts = load_dialog_texts()
+        try:
+            lock = _patient_locks.setdefault(token, asyncio.Lock())
+            async with lock:
+                async with get_clinical_session() as session:
+                    await intake_service.lock_patient(session, token)
+                    replies = await self._handle(token, event, session, texts)
+                await intake_service.dispatch_notices(token)
+                return replies
+        except _DB_DOWN as exc:
+            log.error("dialog db unavailable token=%s event=%s error=%s", token, event.type, type(exc).__name__)
+            return _degraded(event, texts)
+
+    # ------------------------------------------------------------------------------------------ pipeline
+
+    async def _handle(self, token: str, event: Event, session: AsyncSession, texts: DialogTexts) -> list[Reply]:
+        row = await repo.get_dialog_state(session, token)
+        ctx = Ctx(
+            token=token,
+            state=row.state if row is not None else "new",
+            data=dict(row.data or {}) if row is not None else {},
+            now=clock.now(),
+            session=session,
+            gateway=self._gateway or get_gateway(),
+            monitoring=self._monitoring or get_monitoring(),
+            texts=texts,
+        )
+        state_before = ctx.state
+        run = _Run()
+
+        if self._abandoned(ctx):
+            await self._apply(ctx, self._abandon(ctx), run)
+        await self._apply(ctx, await self._route(ctx, event), run)
+
+        if run.notify:
+            # Monitoring (lane B) reads the DB in its own session: commit our writes first.
+            await self._save_state(ctx)
+            await session.commit()
+            actions = await ctx.monitoring.after_data_change(token)
+            await self._apply(ctx, await execute(ctx, actions), run)
+
+        await self._apply(ctx, await self._start_pending(ctx), run)
+
+        if _consented(ctx):
+            for reply in run.replies:
+                # Outgoing texts may quote the safety plan (names of relatives) — scrub before storing too.
+                await repo.add_message(
+                    session, token=token, direction="out", text=scrub(reply.text), ts=ctx.now, fsm_state=ctx.state
+                )
+        if event.type != "system" or ctx.state != state_before:
+            # System events the step ignores (reminders inside a scale) do not count as the patient being there.
+            ctx.data[STEP_AT] = ctx.now.isoformat()
+        await self._save_state(ctx)
+        task_id = event.params.get("questionnaire_task")
+        if event.type == "system" and task_id and run.replies:
+            from app.db.intake import QuestionnaireTask
+
+            task = await session.get(QuestionnaireTask, task_id)
+            if task and task.token == token:
+                task.delivery = [r.model_dump() for r in run.replies]
+        log.info(
+            "dialog token=%s event=%s code=%s state=%s->%s replies=%d",
+            token,
+            event.type,
+            _event_code(event),
+            state_before,
+            ctx.state,
+            len(run.replies),
+        )
+        return run.replies
+
+    def _abandoned(self, ctx: Ctx) -> bool:
+        """The current question step was left unanswered longer than `abandon_after_hours` (app.core.clock)."""
+        if intake_enabled() or not _consented(ctx) or ctx.state in RESTING_STATES or crisis_open(ctx.data):
+            return False
+        hours = ctx.texts.settings.abandon_after_hours
+        last = ctx.data.get(STEP_AT)
+        if not hours or not last or ctx.now - datetime.fromisoformat(last) < timedelta(hours=hours):
+            return False
+        return is_abandonable(ctx)
+
+    def _abandon(self, ctx: Ctx) -> Step:
+        """Drop the unfinished step's progress (answers already stored in item_responses / daily_checkins stay;
+        an unfinished scale gets no scale_results row) and rest in idle so queued scales may start."""
+        log.info("dialog step abandoned token=%s state=%s", ctx.token, ctx.state)
+        scale_id = scale_session.active_scale(ctx.state)
+        scales = {k: v for k, v in (ctx.data.get("scales") or {}).items() if k != scale_id}
+        return Step(next_state="idle", data={"checkin": None, "scales": scales or None})
+
+    async def _route(self, ctx: Ctx, event: Event) -> Step:
+        consented = _consented(ctx)
+        if event.type == "text":
+            # (1) scrub before anything else: from here on only ScrubbedText exists for this message.
+            ctx.text = scrub(event.text or "")
+            if consented and _is_revoke_command(event.text or "", ctx.texts):
+                return await revoke(ctx)
+            if not consented:
+                return await self._no_consent_text(ctx, event)
+            await self._store_in(ctx, ctx.text)
+            return await self._safety(ctx, event)
+
+        if event.type == "button":
+            if consented and event.button == "consent:revoke":
+                return await revoke(ctx)
+            if consented and event.button == "intake:help":
+                from app.db.intake import QuestionnaireRecord
+                from app.dialog.flows.intake import urgent
+
+                row = await ctx.session.get(QuestionnaireRecord, ctx.data.get("questionnaire_record", ""))
+                return await urgent(ctx, row)
+            if consented:
+                await self._store_in(ctx, scrub(f"[button] {event.button}"))  # button data comes from the client
+            return await self._dispatch(ctx, event)
+
+        if event.type == "system":
+            if event.system == "doctor_ack":
+                return close_crisis(ctx)
+            if not consented:
+                return Step()  # nothing is pushed to people without consent
+            if event.system == "scale_due" and event.params.get("scale"):
+                if intake_enabled() and ctx.data.get("adult") is True:
+                    scale = str(event.params["scale"])
+                    kind = "cssrs_since_contact" if scale in ("cssrs_screen", "cssrs") else scale
+                    if kind in ("phq9", "pcl5", "rus_audit_s", "cssrs_since_contact"):
+                        await intake_service.queue_task(
+                            ctx.session, ctx.token, kind, f"external:{kind}:{ctx.now.date()}", ctx.now
+                        )
+                    return Step()
+                scheduled = bool(event.params.get("scheduled", True))
+                pending = scale_session.add_pending(ctx.data, str(event.params["scale"]), scheduled)
+                return Step(data={"pending_scales": pending})  # starts now if resting, else after the current step
+            return await self._dispatch(ctx, event)
+
+        return await self._dispatch(ctx, event)  # start
+
+    async def _no_consent_text(self, ctx: Ctx, event: Event) -> Step:
+        assert ctx.text is not None
+        # Lexicon only: without consent the text must not reach the LLM (third-party processing).
+        result = safety.check(ctx.text)
+        if result.level == RiskLevel.ACUTE:
+            log.warning("safety acute without consent token=%s rules=%s", ctx.token, result.matched_rules)
+            return Step(replies=[Reply(text=no_consent_crisis_text(crisis_reply(result.categories)), kind="crisis")])
+        return await self._dispatch(ctx, event)
+
+    async def _safety(self, ctx: Ctx, event: Event) -> Step:
+        """Guardrail #2: the safety decision is made before any LLM sees the message for anything else."""
+        assert ctx.text is not None
+        lexicon = safety.check(ctx.text)
+        if lexicon.level == RiskLevel.ACUTE:
+            result = lexicon  # an acute message never reaches the LLM — not even the risk classifier
+        else:
+            result = safety.check(ctx.text, llm_signal=await ctx.gateway.risk_classify(ctx.text))
+
+        if result.level == RiskLevel.ACUTE:
+            handled = "crisis_repeat" if crisis_open(ctx.data) else "crisis_script"
+            log.warning("safety acute token=%s rules=%s handled=%s", ctx.token, result.matched_rules, handled)
+            if ctx.data.get("questionnaire_record") or (intake_enabled() and ctx.data.get("adult") is True):
+                from app.db.intake import QuestionnaireRecord
+                from app.dialog.flows.intake import urgent
+
+                row = await ctx.session.get(QuestionnaireRecord, ctx.data.get("questionnaire_record", ""))
+                step = await urgent(ctx, row, code="safety_acute", categories=result.categories)
+            else:
+                step = open_crisis(ctx, result.categories, source=f"safety:{result.source}")
+            step.data["safety_events"] = self._safety_events(ctx, result, handled)
+            step.notify_monitoring = True  # lane B escalates to the doctor on call
+            return step
+
+        if result.level == RiskLevel.POSSIBLE and (
+            ctx.data.get("questionnaire_record") or (intake_enabled() and ctx.data.get("adult") is True)
+        ):
+            from app.db.intake import QuestionnaireRecord
+            from app.dialog.flows.intake import manual_review
+
+            row = await ctx.session.get(QuestionnaireRecord, ctx.data.get("questionnaire_record", ""))
+            if row is None:
+                row = await intake_service.create_record(ctx, "cssrs_since_contact")
+            return await manual_review(ctx, row, "cssrs_since_contact_required")
+
+        if result.level == RiskLevel.POSSIBLE:
+            screen = ctx.texts.settings.risk_screen_scale
+            if self._can_screen(ctx, screen):
+                step = await scale_session.start_scale(
+                    ctx, screen, return_state=ctx.state, scheduled=False, intro=ctx.texts.scale.risk_screen_intro
+                )
+                step.data["risk_screen_at"] = ctx.now.isoformat()
+                handled = "risk_screen"
+            else:
+                step = await self._dispatch(ctx, event)
+                handled = "dispatched"
+            log.info("safety possible token=%s rules=%s handled=%s", ctx.token, result.matched_rules, handled)
+            step.data["safety_events"] = self._safety_events(ctx, result, handled)
+            step.notify_monitoring = True
+            return step
+
+        return await self._dispatch(ctx, event)
+
+    def _can_screen(self, ctx: Ctx, screen: str) -> bool:
+        if crisis_open(ctx.data) or scale_session.active_scale(ctx.state) == screen:
+            return False
+        last = ctx.data.get("risk_screen_at")
+        if last is None:
+            return True
+        hours = (ctx.now - datetime.fromisoformat(last)).total_seconds() / 3600
+        return hours >= ctx.texts.settings.cssrs_cooldown_hours
+
+    def _safety_events(self, ctx: Ctx, result: SafetyResult, handled: str) -> list[dict[str, Any]]:
+        """Structured safety fact for lane B (#38): no text, only codes. Newest last, capped."""
+        event = {
+            "ts": ctx.now.isoformat(),
+            "level": result.level.name.lower(),
+            "categories": result.categories,
+            "rules": result.matched_rules,
+            "source": result.source,
+            "handled": handled,
+            "state": ctx.state,
+        }
+        events = [*(ctx.data.get("safety_events") or []), event]
+        return events[-ctx.texts.settings.max_safety_events :]
+
+    async def _dispatch(self, ctx: Ctx, event: Event) -> Step:
+        handler = handler_for(ctx.state)
+        if handler is None:
+            # A state from a removed/renamed flow: recover instead of getting stuck.
+            log.error("dialog unknown state token=%s state=%s", ctx.token, ctx.state)
+            return Step(next_state="idle" if _consented(ctx) else "new")
+        return await handler(ctx, event)
+
+    async def _apply(self, ctx: Ctx, step: Step, run: _Run, depth: int = 0) -> None:
+        run.replies.extend(step.replies)
+        apply_data(ctx.data, step.data)
+        run.notify = run.notify or step.notify_monitoring
+        if not step.next_state or step.next_state == ctx.state:
+            return
+        ctx.state = step.next_state
+        hook = enter_hook_for(ctx.state)
+        if hook is None:
+            return
+        if depth >= MAX_ENTER_CHAIN:
+            log.error("dialog enter chain too long token=%s state=%s", ctx.token, ctx.state)
+            return
+        await self._apply(ctx, await hook(ctx), run, depth + 1)
+
+    async def _start_pending(self, ctx: Ctx) -> Step:
+        """Start a queued scale when nothing else is being asked. In crisis only the risk screen may run."""
+        if intake_enabled():
+            return Step()
+        pending = list(ctx.data.get("pending_scales") or [])
+        if not pending or ctx.state not in RESTING_STATES:
+            return Step()
+        screen = ctx.texts.settings.risk_screen_scale
+        dropped: dict[str, Any] = {}
+        if any(p["scale"] == screen for p in pending) and await scale_session.recent_risk_screen(ctx, screen):
+            # Item 9 / rule phq9_item9 / scale_due asked for a C-SSRS the patient completed within the cooldown:
+            # do not repeat the same suicide screen (#56). Crisis script and alerts are unaffected.
+            log.info("dialog risk screen skipped (cooldown) token=%s", ctx.token)
+            pending = [p for p in pending if p["scale"] != screen]
+            dropped = {"pending_scales": pending or None}
+            if not pending:
+                return Step(data=dropped)
+        if ctx.state == "crisis":
+            pending_screen = [p for p in pending if p["scale"] == screen]
+            if not pending_screen:
+                return Step(data=dropped)
+            item = pending_screen[0]
+        else:
+            item = pending[0]
+        rest = [p for p in pending if p is not item]
+        step = await scale_session.start_scale(
+            ctx,
+            item["scale"],
+            return_state=ctx.state,
+            scheduled=bool(item.get("scheduled", True)),
+            intro=ctx.texts.scale.risk_screen_intro if item["scale"] == screen else None,
+        )
+        step.data["pending_scales"] = rest or None
+        return step
+
+    async def _store_in(self, ctx: Ctx, text: ScrubbedText) -> None:
+        await repo.add_message(ctx.session, token=ctx.token, direction="in", text=text, ts=ctx.now, fsm_state=ctx.state)
+
+    async def _save_state(self, ctx: Ctx) -> None:
+        await repo.set_dialog_state(ctx.session, token=ctx.token, state=ctx.state, data=ctx.data, now=ctx.now)
+
+
+def _is_revoke_command(raw: str, texts: DialogTexts) -> bool:
+    return raw.strip().lower().rstrip(".!") in texts.commands.revoke
+
+
+def _event_code(event: Event) -> str:
+    if event.type == "button":
+        return event.button or ""
+    if event.type == "system":
+        return event.system or ""
+    return "-"
+
+
+def _degraded(event: Event, texts: DialogTexts) -> list[Reply]:
+    """DB down: still answer a crisis message (lexicon only, no "doctor notified" — nobody could be notified)."""
+    if event.type == "text" and event.text:
+        result = safety.check(scrub(event.text))
+        if result.level == RiskLevel.ACUTE:
+            return [Reply(text=no_consent_crisis_text(crisis_reply(result.categories)), kind="crisis")]
+    if event.type == "system":
+        return []
+    return [Reply(text=texts.unavailable, kind="info")]
+
+
+load_flows()
+register_engine(Engine)

app/dialog/flows/__init__.py

@@ -0,0 +1,16 @@
+"""Dialog flows. Each module here registers its FSM states at import time (`@state`, `@on_enter`, `@trigger`).
+
+A new direction (veteran #36/#37, family, depression) is a new file `app/dialog/flows/<module>.py`; it is picked
+up automatically by `load_flows()` — the engine is not edited.
+"""
+
+import pkgutil
+from importlib import import_module
+
+
+def load_flows() -> None:
+    """Import every flow module of this package (core first, so flows may override core triggers)."""
+    import_module(f"{__name__}.core")
+    for info in sorted(pkgutil.iter_modules(__path__), key=lambda m: m.name):
+        if info.name != "core" and not info.name.startswith("_"):
+            import_module(f"{__name__}.{info.name}")

app/dialog/flows/core.py

@@ -0,0 +1,355 @@
+"""Core flow shared by all modules: connect → consent → age gate → module onboarding → idle; crisis; revocation.
+
+    new ──start(code)──▶ consent ──«Согласен»──▶ age_gate ──adult──▶ <module>.onboarding.start … ──▶ idle
+                            │                       └──< 18──▶ minor (stop, child helpline)
+                            └──«Не согласен»──▶ refused (stop, /start to reconsider)
+    any consented state ──«Отозвать согласие»──▶ consent_revoked (silent; /start → consent again)
+    any ──ACUTE / item 9 / C-SSRS high──▶ crisis ──doctor_ack──▶ idle
+
+Consent and age are the registration step, so this module (and only it) touches the identity DB, through
+`app.db.identity_repo`, and only for consent / revocation / birth year (guardrail #5).
+"""
+
+import re
+
+from app.db import identity_repo, repo
+from app.db.session import get_identity_session
+from app.dialog.actions import safety_plan_reply
+from app.dialog.contracts import Button, Event, Reply
+from app.dialog.fsm import Ctx, Step, get_trigger, is_registered, on_enter, state, trigger
+from app.integrations.base import integrations
+from app.services.contracts import NoopMonitoring
+
+ADULT_AGE = 18
+_YEAR_RE = re.compile(r"\b(19\d{2}|20\d{2})\b")
+_AGE_RE = re.compile(r"^\s*(\d{1,3})\s*(лет|год|года)?\s*$")
+
+
+# ------------------------------------------------------------------------------------------- replies
+
+
+def consent_reply(ctx: Ctx) -> Reply:
+    t = ctx.texts.consent
+    buttons = [[Button(label=t.accept, data="consent:yes")], [Button(label=t.decline, data="consent:no")]]
+    return Reply(text=t.text, buttons=buttons, kind="question")
+
+
+def menu_reply(ctx: Ctx, text: str | None = None) -> Reply:
+    b = ctx.texts.idle.buttons
+    buttons = [
+        [Button(label=b.checkin, data="menu:checkin")],
+        [Button(label=b.med_question, data="menu:med_question")],
+        [Button(label=b.kb_question, data="menu:kb_question")],
+        [Button(label=b.contact_doctor, data="menu:contact_doctor")],
+        [Button(label=b.revoke, data="consent:revoke")],
+    ]
+    from app.core.intake_questions import texts
+    from app.core.intake_runtime import intake_enabled
+
+    if intake_enabled():
+        buttons.insert(0, [Button(label=texts()["help"], data="intake:help")])
+        buttons.insert(
+            0,
+            [
+                Button(
+                    label=texts()["resume"] if ctx.data.get("questionnaire_record") else texts()["start"],
+                    data="intake:resume" if ctx.data.get("questionnaire_record") else "intake:start",
+                )
+            ],
+        )
+    return Reply(text=text or ctx.texts.idle.menu_prompt, buttons=buttons)
+
+
+# ------------------------------------------------------------------------------------------- onboarding API
+
+
+async def onboarding_entry(ctx: Ctx, after: str | None = None) -> str:
+    """Entry state of the next module onboarding: `"{module}.onboarding.start"` for the first module of the
+    profile (after `after`, if given) that has such a state registered; `"idle"` when none is left."""
+    profile = await ctx.profile()
+    modules = list(profile.modules) if profile is not None and profile.modules else []
+    from app.core.intake_runtime import intake_enabled
+
+    # Stage 1 is the same for everyone (ADR-012): it does not depend on modules, which it sets itself — an anonymous
+    # person has no profile at all before it.
+    if after is None and intake_enabled():
+        return "intake.start"
+    if after in modules:
+        modules = modules[modules.index(after) + 1 :]
+    for module in modules:
+        if is_registered(f"{module}.onboarding.start"):
+            return f"{module}.onboarding.start"
+    return "idle"
+
+
+async def finish_onboarding(ctx: Ctx, module: str | None = None) -> Step:
+    """A module flow calls this when its onboarding is done: next module's onboarding, or idle + welcome."""
+    nxt = await onboarding_entry(ctx, after=module)
+    if nxt == "idle":
+        return Step(replies=[menu_reply(ctx, ctx.texts.idle.welcome)], next_state="idle")
+    return Step(next_state=nxt)
+
+
+# ------------------------------------------------------------------------------------------- new / consent
+
+
+@state("new")
+async def _new(ctx: Ctx, event: Event) -> Step:
+    code = event.params.get("code") if event.type == "start" else None
+    if code:
+        # Telegram deep link carries the doctor's one-time connect code; the web console passes the token
+        # directly (no code) — then the token is already known to the system.
+        person = await integrations.identity.verify(str(code))
+        if person is None or person.token != ctx.token:
+            return Step(replies=[Reply(text=ctx.texts.consent.code_invalid)])
+        if await ctx.profile() is None:
+            await repo.upsert_profile(ctx.session, token=ctx.token, doctor_id=person.doctor_id)
+    return Step(replies=[consent_reply(ctx)], next_state="consent")
+
+
+@state("consent")
+async def _consent(ctx: Ctx, event: Event) -> Step:
+    if event.type == "button" and event.button == "consent:yes":
+        version = ctx.texts.consent.version
+        async with get_identity_session() as s:
+            # None when the token has no identity record (web demo console) — the dialog state keeps the fact.
+            await identity_repo.record_consent(s, token=ctx.token, version=version, now=ctx.now)
+        data = {"consent": True, "consent_ver": version, "consent_at": ctx.now.isoformat(), "revoked_at": None}
+        return Step(next_state="age_gate", data=data)
+    if event.type == "button" and event.button == "consent:no":
+        return _refused_step(ctx)
+    # Anything else (incl. free text) is not processed before consent: show the consent text again.
+    return Step(replies=[consent_reply(ctx)])
+
+
+def _refused_step(ctx: Ctx) -> Step:
+    button = Button(label=ctx.texts.consent.reconsider, data="consent:restart")
+    return Step(replies=[Reply(text=ctx.texts.consent.refused, buttons=[[button]])], next_state="refused")
+
+
+@state("refused")
+async def _refused(ctx: Ctx, event: Event) -> Step:
+    if event.type == "start" or (event.type == "button" and event.button == "consent:restart"):
+        return Step(replies=[consent_reply(ctx)], next_state="consent")
+    if event.type == "system":
+        return Step()
+    return _refused_step(ctx)
+
+
+# ------------------------------------------------------------------------------------------- age gate
+
+
+def _age_verdict(birth_year: int, current_year: int) -> str:
+    """Without the birthday the age is `current - birth_year` or one less; ask when the two disagree on 18."""
+    oldest, youngest = current_year - birth_year, current_year - birth_year - 1
+    if youngest >= ADULT_AGE:
+        return "adult"
+    if oldest < ADULT_AGE:
+        return "minor"
+    return "unsure"
+
+
+def _age_question(ctx: Ctx, note: str = "") -> Reply:
+    t = ctx.texts.age_gate
+    buttons = [[Button(label=t.adult, data="age:adult")], [Button(label=t.minor, data="age:minor")]]
+    return Reply(text="\n\n".join(p for p in (note, t.question) if p), buttons=buttons, kind="question")
+
+
+@on_enter("age_gate")
+async def _age_enter(ctx: Ctx) -> Step:
+    profile = await ctx.profile()
+    birth_year = profile.birth_year if profile is not None else None
+    if birth_year is None:
+        async with get_identity_session() as s:
+            patient = await identity_repo.get_patient(s, ctx.token)
+            birth_year = patient.birth_year if patient is not None else None
+    if birth_year is not None:
+        verdict = _age_verdict(birth_year, ctx.now.year)
+        if verdict == "adult":
+            return await _adult(ctx)
+        if verdict == "minor":
+            return await _minor(ctx)
+    return Step(replies=[_age_question(ctx)])
+
+
+@state("age_gate")
+async def _age_gate(ctx: Ctx, event: Event) -> Step:
+    if event.type == "button" and event.button == "age:adult":
+        return await _adult(ctx)
+    if event.type == "button" and event.button == "age:minor":
+        return await _minor(ctx)
+    if event.type == "text" and ctx.text:
+        year = _YEAR_RE.search(ctx.text)
+        age_match = _AGE_RE.match(ctx.text)
+        if year:
+            birth_year = int(year.group(1))
+            verdict = _age_verdict(birth_year, ctx.now.year)
+            if verdict == "adult":
+                return await _adult(ctx, birth_year)
+            if verdict == "minor":
+                return await _minor(ctx)
+        elif age_match:
+            age = int(age_match.group(1))
+            return await (_adult(ctx) if age >= ADULT_AGE else _minor(ctx))
+        return Step(replies=[_age_question(ctx, ctx.texts.age_gate.unclear)])
+    return Step(replies=[_age_question(ctx)])
+
+
+async def _adult(ctx: Ctx, birth_year: int | None = None) -> Step:
+    if birth_year is not None and await ctx.profile() is not None:
+        await repo.upsert_profile(ctx.session, token=ctx.token, birth_year=birth_year)
+    return Step(data={"adult": True}).then(await finish_onboarding(ctx))
+
+
+async def _minor(ctx: Ctx) -> Step:
+    # A minor cannot give this consent on their own: withdraw it and stop processing.
+    async with get_identity_session() as s:
+        await identity_repo.revoke_consent(s, token=ctx.token, now=ctx.now)
+    return Step(
+        replies=[Reply(text=ctx.texts.age_gate.minor_stop, kind="info")],
+        next_state="minor",
+        data={"consent": False, "minor": True},
+    )
+
+
+@state("minor")
+async def _minor_state(ctx: Ctx, event: Event) -> Step:
+    if event.type == "system":
+        return Step()
+    return Step(replies=[Reply(text=ctx.texts.age_gate.minor_stop, kind="info")])
+
+
+# ------------------------------------------------------------------------------------------- idle
+
+
+@state("idle")
+async def _idle(ctx: Ctx, event: Event) -> Step:
+    if event.type == "start":
+        return Step(replies=[menu_reply(ctx)])
+    if event.type == "button" and event.button:
+        handler = get_trigger(f"button:{event.button}")
+        return await handler(ctx, event) if handler else Step(replies=[menu_reply(ctx)])
+    if event.type == "system" and event.system:
+        handler = get_trigger(f"system:{event.system}")
+        return await handler(ctx, event) if handler else Step()
+    if event.type == "text":
+        handler = get_trigger("text:idle")
+        if handler:
+            return await handler(ctx, event)
+        # Neutral empathic reply; the LLM only rephrases the approved template (and is filtered).
+        return Step(replies=[menu_reply(ctx, await ctx.gateway.phrase("support"))])
+    return Step()
+
+
+# Default idle triggers — flows (#15, #36, #37) override them with `@trigger(..., replace=True)`.
+
+
+@trigger("button:menu:checkin")
+async def _menu_checkin(ctx: Ctx, event: Event) -> Step:
+    return Step(replies=[Reply(text=ctx.texts.idle.stub_checkin)])
+
+
+@trigger("button:menu:med_question")
+async def _menu_med_question(ctx: Ctx, event: Event) -> Step:
+    return Step(replies=[Reply(text=ctx.texts.idle.stub_med_question)])
+
+
+@trigger("button:menu:contact_doctor")
+async def _menu_contact_doctor(ctx: Ctx, event: Event) -> Step:
+    # A fact for lane B (#38): the patient asked the doctor to get in touch. No alert is created here (ADR-007).
+    requests = [*(ctx.data.get("contact_requests") or []), {"ts": ctx.now.isoformat()}][-20:]
+    return Step(
+        replies=[Reply(text=ctx.texts.idle.contact_doctor_ack)],
+        data={"contact_requests": requests},
+        notify_monitoring=True,
+    )
+
+
+@trigger("button:menu:visit")
+async def _menu_visit(ctx: Ctx, event: Event) -> Step:
+    return Step(replies=[Reply(text=ctx.texts.idle.visit_stub)])
+
+
+@trigger("button:safety_plan")
+async def _show_plan(ctx: Ctx, event: Event) -> Step:
+    return Step(replies=[await safety_plan_reply(ctx)])
+
+
+@trigger("system:med_reminder")
+async def _med_reminder(ctx: Ctx, event: Event) -> Step:
+    drug = str(event.params.get("drug", ""))
+    return Step(replies=[Reply(text=await ctx.gateway.phrase("med_reminder", {"drug": drug}))])
+
+
+@trigger("system:daily_checkin")
+async def _daily_checkin(ctx: Ctx, event: Event) -> Step:
+    return Step(replies=[menu_reply(ctx, ctx.texts.idle.stub_checkin)])
+
+
+@trigger("system:reach_out")
+async def _reach_out(ctx: Ctx, event: Event) -> Step:
+    return Step(replies=[Reply(text=ctx.texts.reach_out.default)])
+
+
+# ------------------------------------------------------------------------------------------- crisis
+
+
+def close_crisis(ctx: Ctx) -> Step:
+    """Doctor acknowledged the crisis: clear the flag; a C-SSRS still running returns to idle afterwards."""
+    if not (ctx.data.get("crisis") or {}).get("open") and ctx.state != "crisis":
+        return Step()
+    crisis = {**(ctx.data.get("crisis") or {}), "open": False, "closed_at": ctx.now.isoformat()}
+    scales = {
+        sid: {**s, "return_state": "idle"} if s.get("return_state") == "crisis" else s
+        for sid, s in (ctx.data.get("scales") or {}).items()
+    }
+    step = Step(data={"crisis": crisis, "scales": scales})
+    if ctx.state == "crisis":
+        step.next_state = "idle"
+        step.replies.append(Reply(text=ctx.texts.crisis.closed))
+    return step
+
+
+@state("crisis")
+async def _crisis(ctx: Ctx, event: Event) -> Step:
+    # The NoopMonitoring stub knows nothing about crises and always says "not in crisis"; trusting it would
+    # end every crisis on the next message. Until lane B (#38) lands only `doctor_ack` ends a crisis.
+    if not isinstance(ctx.monitoring, NoopMonitoring) and not await ctx.monitoring.is_in_crisis(ctx.token):
+        return close_crisis(ctx)
+    if event.type == "system":
+        return Step()  # reminders and check-ins wait until the crisis is over
+    if event.type == "button" and event.button == "safety_plan":
+        return Step(replies=[await safety_plan_reply(ctx)])
+    plan = Button(label=ctx.texts.safety_plan.title.rstrip(":"), data="safety_plan")
+    return Step(replies=[Reply(text=ctx.texts.crisis.hold, buttons=[[plan]], kind="crisis")])
+
+
+# ------------------------------------------------------------------------------------------- revocation
+
+
+async def revoke(ctx: Ctx) -> Step:
+    """Withdraw consent in one step (152-FZ art. 9 p. 2): identity DB + dialog state; the bot goes silent.
+
+    Clinical data are marked for deletion (`data["delete_requested"]`) — erasure itself is lane B's job.
+    """
+    async with get_identity_session() as s:
+        await identity_repo.revoke_consent(s, token=ctx.token, now=ctx.now)
+    from app.services.questionnaire import cancel_pending
+
+    await cancel_pending(ctx.session, ctx.token)
+    data = {
+        "questionnaire_record": None,
+        "consent": False,
+        "revoked_at": ctx.now.isoformat(),
+        "delete_requested": True,
+        "scales": None,
+        "pending_scales": None,
+    }
+    return Step(replies=[Reply(text=ctx.texts.revoked.confirm)], next_state="consent_revoked", data=data)
+
+
+@state("consent_revoked")
+async def _revoked(ctx: Ctx, event: Event) -> Step:
+    if event.type == "start":
+        return Step(replies=[consent_reply(ctx)], next_state="consent")
+    return Step()  # silent: nothing is processed after revocation

app/dialog/flows/intake.py

@@ -0,0 +1,510 @@
+"""Versioned, resumable questionnaires. Disabled until the clinical release gate opens."""
+
+import math
+from dataclasses import asdict, replace
+from zoneinfo import ZoneInfo
+
+from app.core import interpretation
+from app.core.intake_questions import (
+    DIARY_KINDS,
+    Question,
+    content,
+    cssrs_answers,
+    cssrs_since_contact_question,
+    diary_questions,
+    group_answers,
+    next_intake,
+    red_flag_category,
+    scale_question,
+    texts,
+)
+from app.core.intake_runtime import diary_flags, intake_enabled, load_runtime
+from app.core.questionnaire import alcohol_expansion, load_policy, score_alcohol, score_cssrs_recent
+from app.core.scales import load_scale
+from app.core.types import AlertLevel
+from app.db import repo
+from app.db.intake import QuestionnaireRecord, QuestionnaireTask
+from app.dialog.contracts import Button, Event, Reply
+from app.dialog.crisis import crisis_open, open_crisis
+from app.dialog.fsm import Step, on_enter, state, trigger
+from app.services import questionnaire as service
+from app.services.followup import schedule_post_crisis_call
+
+
+def allowed(ctx):
+    return ctx.data.get("consent") is True and ctx.data.get("adult") is True and intake_enabled()
+
+
+def side_effects_question():
+    """FIBSER-style tolerability question added to the full scales while a medication is active («Этап 2», p.3)."""
+    return Question("side_effects", texts()["side_effects"], ((1, "Да"), (0, "Нет")), "past_week")
+
+
+def next_question(row):
+    a = row.answers
+    if row.kind == "intake":
+        return next_intake(a, load_policy(), row.details.get("sex"))
+    if row.kind == "cssrs_since_contact":
+        return cssrs_since_contact_question(a)
+    if row.kind in DIARY_KINDS:
+        part = row.kind.removeprefix("diary_")
+        for q in diary_questions(part, row.details["modules"], day_index=row.details.get("day_index", 0)):
+            if q.id in a:
+                continue
+            if q.id == "medication_reason" and a.get("medication") != "no":
+                continue
+            return q
+        return None
+    if row.kind in ("phq9", "pcl5", "rus_audit_s"):
+        sid = row.kind
+        if sid == "rus_audit_s":
+            short = score_alcohol(
+                {k: a[k] for k in load_scale(sid).item_ids if k in a}, short=True, sex=row.details.get("sex")
+            )
+            if alcohol_expansion(short, load_policy()):
+                sid = "rus_audit"
+        for item in load_scale(sid).item_ids:
+            if item == "rus_audit_2" and a.get("rus_audit_1") == 0:
+                continue
+            if item not in a:
+                q = scale_question(sid, item)
+                if sid == "pcl5" and row.details["weekly_pcl"]:
+                    q = replace(q, text=q.text.replace("последний месяц", "последнюю неделю"), period="past_week")
+                return q
+        if row.details.get("medication_active") and "side_effects" not in a:
+            return side_effects_question()
+    return None
+
+
+def question_reply(row, q):
+    t = texts()
+    # Nonce + item + option index rejects old/replayed callbacks without exposing raw answers.
+    prefix = f"iq:{row.id[:12]}:{q.id}:"
+    buttons = [[Button(label=label, data=prefix + str(i))] for i, (_, label) in enumerate(q.options)]
+    if q.optional:
+        buttons.append([Button(label=t["comment_skip"], data=prefix + "skip")])
+    buttons.extend([[Button(label=t["help"], data="intake:help")], [Button(label=t["pause"], data="intake:pause")]])
+    return Reply(text=q.text + "\n\n" + t["as_of"].format(day=row.day.isoformat()), buttons=buttons, kind="question")
+
+
+async def urgent(ctx, row=None, *, code="help_now", categories=None):
+    if crisis_open(ctx.data):
+        return open_crisis(ctx, categories or [], source="questionnaire:" + code)
+    profile = await ctx.profile()
+    if profile:
+        profile.enhanced_monitoring = True
+    flags = list(service.decision(row).flags) if row else []
+    if row and (row.answers.get("dphq_9", 0) > 0 or row.answers.get("phq9_9", 0) > 0):
+        flags.append("cssrs_since_contact_required")
+    if row:
+        await service.finish(ctx, row, "interrupted", extra={"stop_reason": code, "flags": flags})
+    await service.alert(
+        ctx.session,
+        ctx.token,
+        f"{row.id if row else ctx.now.isoformat()}:{code}",
+        code,
+        ctx.now,
+        level=AlertLevel.ACUTE,
+        params={"record_id": row.id if row else None, "flags": flags},
+    )
+    await schedule_post_crisis_call(ctx.session, ctx.token, ctx.now, source="questionnaire:" + code)
+    step = open_crisis(ctx, categories or [], source="questionnaire:" + code)
+    step.data["questionnaire_record"] = None
+    step.data["intake_review_required"] = True
+    for reply in step.replies:
+        reply.buttons.append([Button(label=ctx.texts.safety_plan.title.rstrip(":"), data="safety_plan")])
+    return step
+
+
+async def item9_discrepancy(ctx, row):
+    profile = await ctx.profile()
+    if profile:
+        profile.enhanced_monitoring = True
+    await service.alert(
+        ctx.session,
+        ctx.token,
+        row.id + ":phq9_cssrs_discrepancy",
+        "phq9_cssrs_discrepancy",
+        ctx.now,
+        level=AlertLevel.HIGH,
+        params={"record_id": row.id},
+    )
+    row.details = {**row.details, "item9_flagged": True}
+
+
+async def item9_assessment(ctx, row):
+    """Thoughts of death in PHQ-9 item 9 → the C-SSRS screener at once; the screener's level decides (graded)."""
+    await service.alert(
+        ctx.session,
+        ctx.token,
+        row.id + ":item9_assessment",
+        "phq9_item9_cssrs",
+        ctx.now,
+        level=AlertLevel.HIGH,
+        params={"record_id": row.id},
+    )
+    await service.finish(ctx, row, "complete", extra={"stop_reason": "phq9_item9_cssrs"})
+    profile = await ctx.profile()
+    if profile:
+        profile.enhanced_monitoring = True
+    task = await service.queue_task(ctx.session, ctx.token, "cssrs_since_contact", row.id + ":cssrs", ctx.now)
+    return await start(ctx, "cssrs_since_contact", task)
+
+
+async def manual_review(ctx, row, code):
+    await service.finish(ctx, row, "review_required", extra={"stop_reason": code})
+    await service.alert(
+        ctx.session, ctx.token, f"{row.id}:{code}", code, ctx.now, level=AlertLevel.HIGH, params={"record_id": row.id}
+    )
+    return Step(
+        replies=[
+            Reply(
+                text=texts()["missing_followup"] if code == "cssrs_since_contact_required" else texts()["review"],
+                buttons=[[Button(label=texts()["help"], data="intake:help")]],
+                kind="info",
+            )
+        ],
+        next_state="idle",
+        data={"questionnaire_record": None, "intake_review_required": True},
+    )
+
+
+async def advance(ctx, row):
+    a = row.answers
+    c = score_cssrs_recent(cssrs_answers(a))
+    policy = load_policy()
+    # Red flags (asked first): any «Да» stops the questionnaire with the help screen of its category.
+    for item_id, value in a.items():
+        if item_id.startswith("rf_") and value == 1:
+            category = red_flag_category(item_id)
+            return await urgent(ctx, row, code="red_flag_" + item_id[3:], categories=[category] if category else [])
+    # One crisis rule for the whole app (ADR-013): the crisis screen opens at a HIGH C-SSRS risk only. Moderate →
+    # stop + psychiatrist (about 24 h); low → flag, safety plan, continue.
+    if c.risk_lower_bound == "high":
+        return await urgent(ctx, row, code="suicide_signal")
+    if a.get("dphq_9", 0) > 0 and row.kind in DIARY_KINDS:
+        # Diary depression module, item 9 ≥1 → the C-SSRS right away («Этап 2»); its risk level decides.
+        return await item9_assessment(ctx, row)
+    if a.get("phq9_9", 0) > 0 and not c.complete:
+        # Item 9 without a completed screener (only in a scheduled PHQ-9): assess the risk right away.
+        return await item9_assessment(ctx, row)
+    if a.get("phq9_9", 0) > 0 and not row.details.get("item9_flagged"):
+        # Item 9 ≥1 with a negative / low C-SSRS = discrepancy (routing table): flag to the doctor, safety plan.
+        await item9_discrepancy(ctx, row)
+    if c.positive and policy.cssrs_positive_policy == "stop_any":
+        return await urgent(ctx, row, code="cssrs_positive")
+    if c.conflicts:
+        return await manual_review(ctx, row, "cssrs_conflict")
+    # Finish the risk questions before any routine question; a moderate result stops here.
+    if c.complete and c.risk == "moderate":
+        return await manual_review(ctx, row, "urgent_psychiatrist")
+    if c.complete and c.risk == "low":
+        profile = await ctx.profile()
+        if profile:
+            profile.enhanced_monitoring = True
+        await service.alert(
+            ctx.session,
+            ctx.token,
+            row.id + ":cssrs_low",
+            "cssrs_low_safety_plan",
+            ctx.now,
+            params={"record_id": row.id},
+        )
+    try:
+        q = next_question(row)
+        # Validate preserved short answers against a newly answered full-form item 1.
+        score_alcohol(group_answers(a, "rus_audit"), short=False, sex=row.details.get("sex"))
+    except ValueError:
+        return await manual_review(ctx, row, "answer_conflict")
+    if q:
+        replies = [question_reply(row, q)]
+        if ((c.complete and c.risk == "low") or row.details.get("item9_flagged")) and not row.details.get("plan_shown"):
+            from app.dialog.actions import safety_plan_reply
+
+            replies.insert(0, await safety_plan_reply(ctx))
+            row.details = {**row.details, "plan_shown": True}
+        return Step(replies=replies, next_state="intake.collect", data={"questionnaire_record": row.id})
+    extra = {}
+    if a.get("side_effects") == 1:
+        await service.alert(
+            ctx.session,
+            ctx.token,
+            row.id + ":side_effects_review",
+            "side_effects_review",
+            ctx.now,
+            params={"record_id": row.id},
+        )
+    if row.kind == "intake":
+        result = service.decision(row)
+        if result.status != "ready":
+            return await manual_review(ctx, row, "intake_incomplete_review")
+        extra = {"decision": asdict(result), "totals": service.summary(row)}
+        if a.get("recent_trauma") == 1:
+            extra["recent_trauma"] = True
+        extra["interpretation"] = interpretation.intake_interpretation(extra["totals"], a, result, policy)
+        await apply_modules(ctx, extra["interpretation"]["modules"])
+        if result.primary_route != "self_help" or result.flags or result.parallel_routes or a.get("recent_trauma"):
+            await service.alert(
+                ctx.session,
+                ctx.token,
+                row.id + ":route",
+                "intake_route_review",
+                ctx.now,
+                params={"record_id": row.id, **extra},
+            )
+    elif row.kind == "cssrs_since_contact":
+        extra["totals"] = {"cssrs_recent": asdict(c)}
+        extra["interpretation"] = interpretation.cssrs_interpretation(c.risk)
+    elif row.kind in DIARY_KINDS:
+        # Morning and evening answers of one date form one diary day.
+        history: dict = {}
+        for r in await service.records(ctx.session, ctx.token):
+            if r.kind in DIARY_KINDS and r.status == "complete" and r.id != row.id:
+                history.setdefault(r.day, {}).update(r.answers)
+        history.setdefault(row.day, {}).update(a)
+        flags = diary_flags(history, row.day, medication_active=row.details.get("medication_active", False))
+        extra["flags"] = flags
+        for flag in flags:
+            await service.alert(
+                ctx.session, ctx.token, row.id + ":" + flag, flag, ctx.now, params={"record_id": row.id}
+            )
+            if flag in DIARY_SCALE_TASKS:
+                sid = DIARY_SCALE_TASKS[flag]
+                await service.queue_task(ctx.session, ctx.token, sid, row.id + ":" + sid, ctx.now)
+        extra["interpretation"] = interpretation.diary_interpretation(row.kind.removeprefix("diary_"), flags)
+    else:
+        extra["totals"] = service.summary(row)
+        runtime = load_runtime()
+        if row.kind in ("phq9", "pcl5"):
+            sid = row.kind
+            total = extra["totals"][sid]["total"]
+            # Only PHQ-9 has a priority threshold; PCL-5 alone never makes an appointment a priority.
+            priority = getattr(policy, sid + "_priority_at", None)
+            specialist = getattr(policy, sid + "_specialist_at")
+            extra["route"] = (
+                "priority_psychiatrist"
+                if priority is not None and total >= priority
+                else ("psychiatrist_or_psychotherapist" if total >= specialist else "review_with_treating_clinician")
+            )
+            earlier = [
+                r
+                for r in await service.records(ctx.session, ctx.token)
+                if r.id != row.id
+                and r.status == "complete"
+                and r.version == row.version
+                and r.details.get("totals", {}).get(sid, {}).get("complete")
+                and (sid != "pcl5" or r.details.get("weekly_pcl", False) == row.details.get("weekly_pcl", False))
+            ]
+            prior = earlier[-1] if earlier else None
+            if prior:
+                change = total - prior.details["totals"][sid]["total"]
+                extra["delta"] = {
+                    "baseline_record": prior.id,
+                    "value": change,
+                    "retriage": change >= getattr(runtime, sid + "_retriage_delta"),
+                }
+            extra["interpretation"] = interpretation.scale_interpretation(
+                sid,
+                extra["totals"],
+                baseline=earlier[0].details["totals"][sid]["total"] if earlier else None,
+                previous=prior.details["totals"][sid]["total"] if prior else None,
+                policy=policy,
+                retriage_delta=getattr(runtime, sid + "_retriage_delta"),
+            )
+        if row.kind == "rus_audit_s" and not row.details.get("sex"):
+            return await manual_review(ctx, row, "alcohol_sex_unknown")
+        if row.kind == "rus_audit_s":
+            extra["interpretation"] = interpretation.scale_interpretation(
+                "rus_audit_s", extra["totals"], baseline=None, previous=None, policy=policy, retriage_delta=0
+            )
+        if extra["totals"]["rus_audit"].get("zone") == 4:
+            extra["parallel_routes"] = ["narcologist"]
+        retriage = extra.get("delta", {}).get("retriage", False)
+        await service.alert(
+            ctx.session,
+            ctx.token,
+            row.id + ":followup",
+            "followup_retriage_required" if retriage else "followup_review",
+            ctx.now,
+            level=AlertLevel.HIGH if retriage or extra.get("route") == "priority_psychiatrist" else AlertLevel.MODERATE,
+            params={"record_id": row.id, **extra},
+        )
+    await service.finish(ctx, row, "complete", extra=extra)
+    shown = interpretation.render(extra["interpretation"]) if extra.get("interpretation") else texts()["done"]
+    if row.kind == "cssrs_since_contact" and not await done_today(ctx, "diary_evening"):
+        # The risk questions open the evening diary; continue straight into it.
+        step = await start(ctx, "diary_evening")
+        step.replies.insert(0, Reply(text=shown, kind="info"))
+        return step
+    from app.dialog.flows.core import menu_reply
+
+    replies = [menu_reply(ctx, shown)]
+    if ((c.complete and c.risk == "low") or row.details.get("item9_flagged")) and not row.details.get("plan_shown"):
+        # The safety plan is never skipped because the risk signal came with the last question.
+        from app.dialog.actions import safety_plan_reply
+
+        replies.insert(0, await safety_plan_reply(ctx))
+    return Step(replies=replies, next_state="idle", data={"questionnaire_record": None})
+
+
+# Diary flags that bring a full scale forward («Этап 2», p.4).
+DIARY_SCALE_TASKS = {
+    "phq9_due_mood": "phq9",
+    "phq9_due_depression": "phq9",
+    "pcl5_due_ptsd": "pcl5",
+    "rus_audit_due_alcohol": "rus_audit_s",
+}
+
+
+async def apply_modules(ctx, modules):
+    """Stage 1 result → diary modules of stage 2. Without a doctor the screening defines them; a doctor's modules
+    (diagnosis from ЕМИАС) are kept and only extended."""
+    profile = await ctx.profile()
+    if profile is None:
+        await repo.upsert_profile(ctx.session, token=ctx.token, doctor_id="", modules=list(modules))
+        return
+    current = list(profile.modules or [])
+    merged = [*current, *(m for m in modules if m not in current)] if profile.doctor_id else list(modules)
+    await repo.upsert_profile(ctx.session, token=ctx.token, modules=merged)
+
+
+def local_day(ctx):
+    return ctx.now.astimezone(ZoneInfo(load_runtime().timezone)).date()
+
+
+async def done_today(ctx, kind):
+    day = local_day(ctx)
+    return any(
+        r.kind == kind and r.day == day and r.status == "complete"
+        for r in await service.records(ctx.session, ctx.token)
+    )
+
+
+async def start(ctx, kind="intake", task=None):
+    if not allowed(ctx) or crisis_open(ctx.data):
+        if task:
+            return Step()
+        return Step(replies=[Reply(text=texts()["unavailable"], kind="info")])
+    existing = await service.records(ctx.session, ctx.token)
+    active = next((r for r in reversed(existing) if r.status in ("active", "paused")), None)
+    if active:
+        if task and task.record_id != active.id:
+            return Step()
+        if (
+            active.policy_version != load_policy().version
+            or active.version != content()["version"]
+            or active.details.get("runtime_version") != load_runtime().version
+        ):
+            return await manual_review(ctx, active, "questionnaire_version_changed")
+        active.status = "active"
+        return await advance(ctx, active)
+    if ctx.data.get("intake_review_required") and kind != "cssrs_since_contact":
+        if task:
+            return Step()
+        return Step(replies=[Reply(text=texts()["review"], kind="info")])
+    # A manual start takes over the scheduled task of the same form, so the task does not stay outstanding.
+    task = task or await service.outstanding_task(ctx.session, ctx.token, kind)
+    row = await service.create_record(ctx, kind, task=task)
+    return await advance(ctx, row)
+
+
+@on_enter("intake.start")
+async def enter(ctx):
+    return await start(ctx)
+
+
+@trigger("button:intake:start")
+@trigger("button:intake:resume")
+async def start_button(ctx, event):
+    return await start(ctx)
+
+
+@trigger("button:menu:checkin", replace=True)
+@trigger("system:daily_checkin", replace=True)
+async def checkin(ctx, event):
+    if not intake_enabled():
+        return Step(replies=[Reply(text=ctx.texts.idle.stub_checkin)])
+    if event.params.get("questionnaire_task"):
+        task = await ctx.session.get(QuestionnaireTask, event.params["questionnaire_task"])
+        if task is None or task.token != ctx.token or task.status not in ("pending", "active"):
+            return Step()
+        return await start(ctx, task.kind, task)
+    existing = await service.records(ctx.session, ctx.token)
+    if not any(r.kind == "intake" and r.status == "complete" for r in existing):
+        return await start(ctx)
+    return await next_diary(ctx)
+
+
+async def next_diary(ctx):
+    """The part of today's diary that is still open: morning first, then evening. The evening opens with the C-SSRS
+    «since last contact» when the profile is under suicide-risk monitoring («Этап 2», module of suicide risk)."""
+    day = local_day(ctx)
+    done = {r.kind for r in await service.records(ctx.session, ctx.token) if r.day == day and r.status == "complete"}
+    for kind in DIARY_KINDS:
+        if kind in done:
+            continue
+        profile = await ctx.profile()
+        if kind == "diary_evening" and profile and profile.enhanced_monitoring and "cssrs_since_contact" not in done:
+            risk_task = await service.queue_task(ctx.session, ctx.token, "cssrs_since_contact", f"cssrs:{day}", ctx.now)
+            return await start(ctx, "cssrs_since_contact", risk_task)
+        return await start(ctx, kind)
+    return Step(replies=[Reply(text=texts()["diary_done"], kind="info")])
+
+
+@trigger("button:diary:next")
+async def diary_button(ctx, event):
+    return await next_diary(ctx)
+
+
+@state("intake")
+async def collect(ctx, event: Event):
+    if not allowed(ctx):
+        return Step(replies=[Reply(text=texts()["unavailable"], kind="info")], next_state="idle")
+    row = await ctx.session.get(QuestionnaireRecord, ctx.data.get("questionnaire_record", ""))
+    if row is None or row.token != ctx.token or row.status != "active":
+        return Step(next_state="idle")
+    if (
+        row.policy_version != load_policy().version
+        or row.version != content()["version"]
+        or row.details.get("runtime_version") != load_runtime().version
+    ):
+        return await manual_review(ctx, row, "questionnaire_version_changed")
+    if event.type == "system":
+        task_id = event.params.get("questionnaire_task")
+        if task_id and row.details.get("task_id") == task_id:
+            return await advance(ctx, row)
+        return Step()
+    if event.button == "intake:pause":
+        row.status = "paused"
+        return Step(
+            replies=[Reply(text=texts()["paused"], buttons=[[Button(label=texts()["resume"], data="intake:resume")]])],
+            next_state="idle",
+        )
+    q = next_question(row)
+    if q is None:
+        return await advance(ctx, row)
+    prefix = f"iq:{row.id[:12]}:{q.id}:"
+    value = None
+    valid = False
+    if event.type == "button" and (event.button or "").startswith(prefix):
+        index = event.button[len(prefix) :]
+        if index == "skip" and q.optional:
+            valid = True
+        elif index.isdigit() and int(index) < len(q.options):
+            value, valid = q.options[int(index)][0], True
+    elif event.type == "text" and q.numeric:
+        try:
+            value = float(str(ctx.text).replace(",", "."))
+            valid = math.isfinite(value) and 0 <= value <= q.maximum
+        except ValueError:
+            pass
+    elif event.type == "text" and q.optional:
+        value, valid = str(ctx.text)[:2000], True
+    if not valid:
+        hint = "invalid" if not q.numeric else ("numeric_portions" if q.id == "alcohol_portions" else "numeric")
+        return Step(replies=[Reply(text=texts()[hint]), question_reply(row, q)])
+    service.save_answer(row, q, value, ctx.now)
+    if row.kind == "cssrs_since_contact" and q.id == "cssrs_q6_lifetime":
+        # Behaviour since the last contact is recent by definition (see cssrs_since_contact_question).
+        service.save_answer(row, replace(q, id="cssrs_q6_recent"), value, ctx.now, derived=True)
+    return await advance(ctx, row)

app/dialog/flows/knowledge.py

@@ -0,0 +1,107 @@
+"""Questions about the condition and its treatment → knowledge base of clinical guidelines (#64, RAG #60).
+
+    menu «Вопрос о лечении» ──▶ kb.question (free text) ──▶ rag.answer: KR quote + source, or «уточните у врача»
+    free text in idle that looks like a question (veteran_daily `text:idle`, after the check-in signals and the
+        drug question) ──▶ rag.answer, or the usual support phrase when the KB has no answer
+
+The engine has already scrubbed the text, checked consent and run the safety check (ACUTE never gets here).
+Questions about the patient's own drug stay with `med_qa` (instruction only, SPEC §7 п.5); this flow answers
+general questions from the guidelines, extractively and without doses (`app.llm.rag.qa`). Logs carry codes only.
+"""
+
+import logging
+import re
+from functools import lru_cache
+from pathlib import Path
+
+import yaml
+from pydantic import BaseModel, ConfigDict
+
+from app.config import get_settings
+from app.dialog.contracts import Event, Reply
+from app.dialog.flows.core import menu_reply
+from app.dialog.fsm import Ctx, Step, abandonable, handler_for, state, trigger
+from app.llm import agent, rag
+from app.llm.med_qa import DOSE_QUESTION
+
+log = logging.getLogger(__name__)
+
+QUESTION_STATE = "kb.question"
+# `scrub()` placeholders and the punctuation around them: "[NAME], что такое ПТСР?" starts with "что такое".
+_PLACEHOLDERS = re.compile(r"^(?:\s*\[[A-Z_]+\][\s,.:;!-]*)+")
+
+
+class KnowledgeTexts(BaseModel):
+    model_config = ConfigDict(extra="forbid", frozen=True)
+
+    prompt: str
+    dose_redirect: str
+    question_starts: list[str]
+    small_talk: list[str]
+
+
+@lru_cache
+def load_knowledge_texts(path: Path | None = None) -> KnowledgeTexts:
+    path = path or get_settings().config_dir / "texts" / "knowledge.yaml"
+    return KnowledgeTexts.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
+
+
+@lru_cache
+def _question_start() -> re.Pattern[str]:
+    starts = sorted(load_knowledge_texts().question_starts, key=len, reverse=True)
+    return re.compile(r"^\s*(?:" + "|".join(re.escape(s) for s in starts) + r")\b", re.IGNORECASE)
+
+
+@lru_cache
+def _small_talk() -> re.Pattern[str]:
+    return re.compile(r"\b(?:" + "|".join(re.escape(s) for s in load_knowledge_texts().small_talk) + r")\b", re.I)
+
+
+def looks_like_question(text: str) -> bool:
+    """A "?" anywhere or a question word at the start ("что такое флэшбек", "можно ли ..."); small talk
+    ("как дела?") is not a question for the knowledge base."""
+    text = _PLACEHOLDERS.sub("", text)
+    if _small_talk().search(text):
+        return False
+    return "?" in text or bool(_question_start().search(text))
+
+
+async def knowledge_answer(ctx: Ctx, *, explicit: bool) -> str | None:
+    """KB answer for `ctx.text`. No answer → «уточните у врача» if the patient asked via the menu (`explicit`),
+    `None` otherwise (the caller keeps its own reply, e.g. the support phrase)."""
+    if ctx.text is None:
+        return None
+    if DOSE_QUESTION.search(ctx.text.lower()):
+        log.info("kb: dose question redirected to doctor")
+        return load_knowledge_texts().dose_redirect
+    # Tool-using agent first (RAG + ЕМИАС record + drug-safety check); disabled/failed → extractive RAG below.
+    smart = await agent.answer_chat(ctx.token, ctx.text)
+    if smart is not None:
+        log.info("kb: agent answered provider=%s tools=%s", smart.provider, ",".join(smart.tools))
+        return agent.render(smart)
+    reply = await rag.answer(ctx.text, audience="patient")
+    if reply is not None:
+        log.info("kb: answered docs=%s", ",".join(c.doc for c in reply.citations))
+        return reply.text
+    log.info("kb: no answer explicit=%s", explicit)
+    return rag.fallback_text("patient") if explicit else None
+
+
+@trigger("button:menu:kb_question")
+async def _menu_question(ctx: Ctx, event: Event) -> Step:
+    return Step(replies=[Reply(text=load_knowledge_texts().prompt)], next_state=QUESTION_STATE)
+
+
+@state(QUESTION_STATE)
+async def _question(ctx: Ctx, event: Event) -> Step:
+    if event.type != "text" or ctx.text is None:
+        # A menu button or a reminder instead of the question: drop the question and let idle handle it.
+        step = Step(next_state="idle")
+        idle = handler_for("idle")
+        return step.then(await idle(ctx, event)) if idle is not None else step
+    text = await knowledge_answer(ctx, explicit=True)
+    return Step(replies=[menu_reply(ctx, text)], next_state="idle")
+
+
+# A question asked yesterday must not swallow today's message.
+abandonable("kb")

app/dialog/flows/meds.py

@@ -0,0 +1,477 @@
+"""Medication flow (#37, case scenario «управление приёмом лекарств»). Module-agnostic: every patient with a
+prescription gets it, whatever the clinical module.
+
+    system:med_reminder {dose_id, drug, dose}
+        ──▶ «Принял»                → dose taken, check-in med_taken = true
+        ──▶ «Пропущу»               → dose skipped, med_taken = false ──▶ reason:
+                                       забыл / побочки (→ side effects) / решил бросить (quit_intent) / другое
+        ──▶ «Есть побочные эффекты» → code buttons (тошнота, бессонница, …) or «Другое» → free text
+                                       → check-in side_effects (+ dose.side_effects) → «А препарат сегодня приняли?»
+    menu «Вопрос о лекарстве" ──▶ meds.question (free text) ──▶ med_qa (instruction excerpt) or «уточните у врача»
+    rule action med_info (actions.py hook) ──▶ instruction excerpt for the rule topic + fixed notice
+
+Everything the patient answers is written to the clinical DB (`doses`, `daily_checkins`) and the step asks the
+engine to run monitoring (`notify_monitoring`): the rules (lane B, ADR-007) decide alerts and further actions
+(quit intent → delayed-onset explanation, missed doses → caring contact). Nothing here decides risk.
+
+Reminder buttons carry the dose they refer to (#56): "med:taken:<ref>", "med:skip:<ref>",
+"med:side_effects:<ref>" and the follow-up buttons likewise ("med:se:<code>:<ref>", "med:skip_reason:<r>:<ref>",
+"med:dose:yes:<ref>"), matched by prefix triggers. `<ref>` is the `doses.id` of the reminder or, when there is
+no dose row (prescription only known to the МИС), the reminder's ISO date. A button of an earlier day's dose is
+stale (friendly note, nothing recorded); so are the old payload-less buttons ("med:taken") of earlier releases.
+Check-in answers without a button (daily.med step, free text) go to today's planned dose, if any.
+"""
+
+from datetime import date, timedelta
+from functools import lru_cache
+from pathlib import Path
+from typing import Any
+
+import yaml
+from pydantic import BaseModel, ConfigDict
+from sqlalchemy import select
+
+from app.config import get_settings
+from app.core.privacy import scrub
+from app.core.rules import Action
+from app.db import repo
+from app.db.clinical import DailyCheckin, Dose
+from app.db.clinical import Prescription as PrescriptionRow
+from app.dialog.actions import register_med_info_handler
+from app.dialog.contracts import Button, Event, Reply
+from app.dialog.flows.core import menu_reply
+from app.dialog.fsm import Ctx, Step, abandonable, get_trigger, handler_for, state, trigger, trigger_payload
+from app.integrations.base import integrations
+from app.llm import agent
+from app.llm.med_qa import DOSE_QUESTION, fallback_text, med_qa
+
+QUESTION_STATE = "meds.question"
+SIDE_EFFECT_TEXT_STATE = "meds.side_effect_text"
+# A client sends this button when the person submits a free-text step without writing anything.
+NO_COMMENT = "text:skip"
+SIDE_EFFECT_CODES = ("nausea", "insomnia", "headache", "dizziness", "agitation", "other")
+SKIP_REASONS = ("forgot", "side_effects", "quit", "other")
+
+
+# ------------------------------------------------------------------------------------------- texts
+
+
+class _Strict(BaseModel):
+    model_config = ConfigDict(extra="forbid", frozen=True)
+
+
+class ReminderTexts(_Strict):
+    text: str
+    text_no_drug: str
+    taken: str
+    skip: str
+    side_effects: str
+
+
+class SkipTexts(_Strict):
+    question: str
+    reasons: dict[str, str]
+    ack: dict[str, str]
+
+
+class SideEffectTexts(_Strict):
+    question: str
+    options: dict[str, str]
+    questions: dict[str, str]
+    describe: str
+    ack: str
+    repeat: str
+    ask_dose: str
+    dose_yes: str
+    dose_no: str
+
+
+class CheckinMedTexts(_Strict):
+    question: str
+    question_no_drug: str
+    yes: str
+    no: str
+    later: str
+
+
+class QuestionTexts(_Strict):
+    prompt: str
+    no_prescription: str
+
+
+class MedInfoTopic(_Strict):
+    section: str  # med_qa section code (side_effects | onset | alcohol | ...)
+    question: str
+    lead: str = ""
+    fallback: str
+    notice: str = ""
+
+
+class MedsTexts(_Strict):
+    status: str
+    reminder: ReminderTexts
+    taken_ack: str
+    stale: str
+    skip: SkipTexts
+    side_effects: SideEffectTexts
+    checkin: CheckinMedTexts
+    question: QuestionTexts
+    med_info: dict[str, MedInfoTopic]
+
+
+def meds_texts_path() -> Path:
+    return get_settings().config_dir / "texts" / "meds.yaml"
+
+
+@lru_cache
+def load_meds_texts(path: Path | None = None) -> MedsTexts:
+    path = path or meds_texts_path()
+    return MedsTexts.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
+
+
+# ------------------------------------------------------------------------------------------- data helpers
+
+
+class Rx(BaseModel):
+    """Active prescription as the dialog needs it (drug INN + dose exactly as the doctor wrote them)."""
+
+    id: int | None
+    drug: str
+    dose: str
+
+
+async def current_prescription(ctx: Ctx) -> Rx | None:
+    """Latest prescription active today: clinical DB first, then the МИС integration (demo: in-memory)."""
+    today = ctx.now.date()
+    rows = await ctx.session.scalars(
+        select(PrescriptionRow).where(PrescriptionRow.token == ctx.token).order_by(PrescriptionRow.id.desc())
+    )
+    for row in rows:
+        if (row.start_date is None or row.start_date <= today) and (row.end_date is None or row.end_date >= today):
+            return Rx(id=row.id, drug=row.drug, dose=row.dose)
+    for p in await integrations.prescriptions.get_prescriptions(ctx.token):
+        if (p.start_date is None or p.start_date <= today) and (p.end_date is None or p.end_date >= today):
+            return Rx(id=None, drug=p.drug, dose=p.dose)
+    return None
+
+
+async def checkin_of(ctx: Ctx, day: date) -> DailyCheckin | None:
+    return await ctx.session.scalar(
+        select(DailyCheckin).where(DailyCheckin.token == ctx.token, DailyCheckin.day == day)
+    )
+
+
+async def save_checkin(ctx: Ctx, **fields: Any) -> DailyCheckin:
+    return await repo.upsert_checkin(ctx.session, token=ctx.token, day=ctx.now.date(), now=ctx.now, **fields)
+
+
+def dose_ref(dose_id: int | None, day: date) -> str:
+    """Button payload naming a dose: its row id, or the reminder day when there is no row."""
+    return str(dose_id) if dose_id is not None else day.isoformat()
+
+
+async def todays_dose(ctx: Ctx) -> Dose | None:
+    """Latest dose row planned for today (local day of `ctx.now`) — target of answers given without a button."""
+    rows = await ctx.session.scalars(select(Dose).where(Dose.token == ctx.token).order_by(Dose.id.desc()).limit(20))
+    today = ctx.now.date()
+    return next((r for r in rows if r.planned_at.astimezone(ctx.now.tzinfo).date() == today), None)
+
+
+async def resolve_ref(ctx: Ctx, ref: str | None) -> tuple[bool, Dose | None]:
+    """(fresh, dose row) for a button payload. Not fresh: missing/foreign/unknown ref or a dose of another day."""
+    if not ref:
+        return False, None
+    if ref.isdigit():
+        row = await ctx.session.get(Dose, int(ref))
+        if row is None or row.token != ctx.token:
+            return False, None
+        return row.planned_at.astimezone(ctx.now.tzinfo).date() == ctx.now.date(), row
+    try:
+        return date.fromisoformat(ref) == ctx.now.date(), None
+    except ValueError:
+        return False, None
+
+
+async def _dose_row(ctx: Ctx, ref: str | None) -> Dose | None:
+    if ref is None:
+        return await todays_dose(ctx)
+    return (await resolve_ref(ctx, ref))[1]
+
+
+async def record_dose(ctx: Ctx, taken: bool, *, status: str | None = None, ref: str | None = None) -> None:
+    """Dose answer → `doses` row (`ref` from the button, else today's) + `daily_checkins.med_taken` (rules read
+    both)."""
+    row = await _dose_row(ctx, ref)
+    if row is not None:
+        row.status = status or ("taken" if taken else "skipped")
+        row.answered_at = ctx.now
+    await save_checkin(ctx, med_taken=taken)
+
+
+async def record_side_effects(ctx: Ctx, codes: list[str], *, ref: str | None = None) -> None:
+    """Merge side-effect codes into today's check-in (rule `side_effect_3d` counts days with any code)."""
+    today = await checkin_of(ctx, ctx.now.date())
+    merged = list(dict.fromkeys([*(today.side_effects if today and today.side_effects else []), *codes]))
+    await save_checkin(ctx, side_effects=merged)
+    row = await _dose_row(ctx, ref)
+    if row is not None:
+        row.side_effects = ",".join(c for c in dict.fromkeys([*(row.side_effects or "").split(","), *codes]) if c)
+
+
+async def side_effect_reply(ctx: Ctx, codes: list[str]) -> Reply:
+    """Reaction to newly reported side effects.
+
+    Same effect as yesterday → short support (the instruction was already shown; persistence over 3 days is the
+    rules' business). New effect with a known instruction question → the excerpt of the drug instruction
+    (med_qa, section side_effects) — never generated advice. Otherwise a plain acknowledgement.
+    """
+    t = load_meds_texts().side_effects
+    yesterday = await checkin_of(ctx, ctx.now.date() - timedelta(days=1))
+    if yesterday is not None and set(codes) & set(yesterday.side_effects or []):
+        return Reply(text=t.repeat, kind="info")
+    rx = await current_prescription(ctx)
+    for code in codes:
+        if code in t.questions and rx is not None:
+            answer = await med_qa(rx.drug, scrub(t.questions[code]), topic="side_effects")
+            if answer is not None:
+                return Reply(text=answer.text, kind="info")
+    return Reply(text=t.ack, kind="info")
+
+
+async def leave_to_idle(ctx: Ctx, event: Event, data: dict[str, Any] | None = None) -> Step:
+    """Abandon the current sub-flow and let the idle state handle the event (menu button, system event...)."""
+    step = Step(next_state="idle", data=data or {})
+    idle = handler_for("idle")
+    return step.then(await idle(ctx, event)) if idle is not None else step
+
+
+async def run_trigger_inline(ctx: Ctx, key: str, event: Event) -> Step | None:
+    """Run an idle trigger from inside another flow (e.g. a reminder button pressed during the check-in)."""
+    handler = get_trigger(key)
+    return await handler(ctx, event) if handler is not None else None
+
+
+# ------------------------------------------------------------------------------------------- reminder
+
+
+def _reminder_buttons(ref: str) -> list[list[Button]]:
+    t = load_meds_texts().reminder
+    return [
+        [Button(label=t.taken, data=f"med:taken:{ref}")],
+        [Button(label=t.skip, data=f"med:skip:{ref}")],
+        [Button(label=t.side_effects, data=f"med:side_effects:{ref}")],
+    ]
+
+
+@trigger("system:med_reminder", replace=True)
+async def _med_reminder(ctx: Ctx, event: Event) -> Step:
+    t = load_meds_texts().reminder
+    rx = await current_prescription(ctx)
+    drug = str(event.params.get("drug") or (rx.drug if rx else ""))
+    dose = str(event.params.get("dose") or (rx.dose if rx else ""))
+    try:
+        dose_id: int | None = int(event.params["dose_id"])  # type: ignore[call-overload]
+    except (KeyError, TypeError, ValueError):
+        dose_id = None
+    if dose_id is None and rx is not None and rx.id is not None:
+        # No scheduler row (demo console without #13): create the planned dose so the answer has a record.
+        row = Dose(token=ctx.token, prescription_id=rx.id, planned_at=ctx.now, status="pending")
+        ctx.session.add(row)
+        await ctx.session.flush()
+        dose_id = row.id
+    text = t.text.format(drug=drug, dose=dose).replace("  ", " ") if drug else t.text_no_drug
+    reply = Reply(text=text, buttons=_reminder_buttons(dose_ref(dose_id, ctx.now.date())), kind="question")
+    return Step(replies=[reply], data={"med_pending": None})  # key of earlier releases: the button carries it now
+
+
+def _stale_reply() -> Step:
+    return Step(replies=[Reply(text=load_meds_texts().stale)])
+
+
+async def _legacy(ctx: Ctx, event: Event) -> Step:
+    """Payload-less medication button of an earlier release: the dose is unknown → treat as stale."""
+    return _stale_reply()
+
+
+def _with_dose(fn: Any) -> Any:
+    """Prefix-trigger handler wrapper: resolve the dose payload, answer stale buttons without recording."""
+
+    async def handler(ctx: Ctx, event: Event) -> Step:
+        ref = trigger_payload(event)
+        fresh, _row = await resolve_ref(ctx, ref)
+        if not fresh:
+            return _stale_reply()
+        return await fn(ctx, event, ref)
+
+    return handler
+
+
+def med_trigger(name: str) -> Any:
+    """Register `button:med:<name>:*` (with the dose payload) plus the legacy payload-less key as stale."""
+
+    def deco(fn: Any) -> Any:
+        trigger(f"button:med:{name}:*")(_with_dose(fn))
+        trigger(f"button:med:{name}")(_legacy)
+        return fn
+
+    return deco
+
+
+@med_trigger("taken")
+async def _taken(ctx: Ctx, event: Event, ref: str) -> Step:
+    await record_dose(ctx, True, ref=ref)
+    return Step(replies=[Reply(text=load_meds_texts().taken_ack)], notify_monitoring=True)
+
+
+@med_trigger("skip")
+async def _skip(ctx: Ctx, event: Event, ref: str) -> Step:
+    await record_dose(ctx, False, status="skipped", ref=ref)
+    t = load_meds_texts().skip
+    buttons = [[Button(label=t.reasons[r], data=f"med:skip_reason:{r}:{ref}")] for r in SKIP_REASONS]
+    return Step(replies=[Reply(text=t.question, buttons=buttons, kind="question")], notify_monitoring=True)
+
+
+def _side_effect_question(ref: str) -> Reply:
+    t = load_meds_texts().side_effects
+    buttons = [[Button(label=t.options[c], data=f"med:se:{c}:{ref}")] for c in SIDE_EFFECT_CODES]
+    return Reply(text=t.question, buttons=buttons, kind="question")
+
+
+def _skip_reason(reason: str) -> Any:
+    async def handler(ctx: Ctx, event: Event, ref: str) -> Step:
+        if reason == "side_effects":
+            return Step(replies=[_side_effect_question(ref)])
+        if reason == "quit":
+            # «Решил бросить» is the same signal as "брошу" in free text: rule `quit_intent` reacts (alert +
+            # delayed-onset explanation through the med_info action).
+            await save_checkin(ctx, quit_intent=True)
+            return Step(replies=[Reply(text=load_meds_texts().skip.ack["quit"])], notify_monitoring=True)
+        return Step(replies=[Reply(text=load_meds_texts().skip.ack[reason])])
+
+    return handler
+
+
+for _reason in SKIP_REASONS:
+    med_trigger(f"skip_reason:{_reason}")(_skip_reason(_reason))
+
+
+@med_trigger("side_effects")
+async def _side_effects(ctx: Ctx, event: Event, ref: str) -> Step:
+    return Step(replies=[_side_effect_question(ref)])
+
+
+async def _after_side_effects(ctx: Ctx, codes: list[str], ref: str | None) -> Step:
+    if ref is None:
+        row = await todays_dose(ctx)
+        ref = dose_ref(row.id if row is not None else None, ctx.now.date())
+    await record_side_effects(ctx, codes, ref=ref)
+    replies = [await side_effect_reply(ctx, codes)]
+    today = await checkin_of(ctx, ctx.now.date())
+    if (today is None or today.med_taken is None) and await current_prescription(ctx) is not None:
+        t = load_meds_texts().side_effects
+        buttons = [
+            [Button(label=t.dose_yes, data=f"med:dose:yes:{ref}")],
+            [Button(label=t.dose_no, data=f"med:dose:no:{ref}")],
+        ]
+        replies.append(Reply(text=t.ask_dose, buttons=buttons, kind="question"))
+    return Step(replies=replies, next_state="idle", data={"med_se_ref": None}, notify_monitoring=True)
+
+
+def _side_effect_code(code: str) -> Any:
+    async def handler(ctx: Ctx, event: Event, ref: str) -> Step:
+        if code == "other":
+            return Step(
+                # kind="question": the engine waits for free text here (clients show an input, optional).
+                replies=[Reply(text=load_meds_texts().side_effects.describe, kind="question")],
+                next_state=SIDE_EFFECT_TEXT_STATE,
+                data={"med_se_ref": ref},
+            )
+        return await _after_side_effects(ctx, [code], ref)
+
+    return handler
+
+
+for _code in SIDE_EFFECT_CODES:
+    med_trigger(f"se:{_code}")(_side_effect_code(_code))
+
+
+@state(SIDE_EFFECT_TEXT_STATE)
+async def _side_effect_text(ctx: Ctx, event: Event) -> Step:
+    ref = ctx.data.get("med_se_ref")
+    if event.type == "button" and event.button == NO_COMMENT:
+        # The description is optional: «other» side effect without words.
+        return await _after_side_effects(ctx, ["other"], str(ref) if ref else None)
+    if event.type != "text" or ctx.text is None:
+        return await leave_to_idle(ctx, event, {"med_se_ref": None})
+    facts = await ctx.gateway.extract_checkin(ctx.text)
+    # Store only normalised codes, never the description itself (it stays in the scrubbed message log).
+    codes = [str(c) for c in facts.side_effects] if facts is not None and facts.side_effects else ["other"]
+    return await _after_side_effects(ctx, codes, str(ref) if ref else None)
+
+
+def _dose_answer(taken: bool) -> Any:
+    async def handler(ctx: Ctx, event: Event, ref: str) -> Step:
+        await record_dose(ctx, taken, status=None if taken else "missed", ref=ref)
+        return Step(
+            replies=[Reply(text=load_meds_texts().taken_ack if taken else load_meds_texts().skip.ack["other"])],
+            notify_monitoring=True,
+        )
+
+    return handler
+
+
+med_trigger("dose:yes")(_dose_answer(True))
+med_trigger("dose:no")(_dose_answer(False))
+
+# Free-text waiting states of this flow: a long-forgotten question must not swallow tomorrow's message.
+abandonable("meds")
+
+
+# ------------------------------------------------------------------------------------------- question menu
+
+
+@trigger("button:menu:med_question", replace=True)
+async def _menu_question(ctx: Ctx, event: Event) -> Step:
+    t = load_meds_texts().question
+    if await current_prescription(ctx) is None:
+        return Step(replies=[menu_reply(ctx, t.no_prescription)])
+    return Step(replies=[Reply(text=t.prompt, kind="question")], next_state=QUESTION_STATE)
+
+
+async def answer_question(ctx: Ctx, rx: Rx | None) -> str:
+    """Answer from the instruction excerpt only (SPEC §7 п.5); dose questions and gaps → «уточните у врача»."""
+    if rx is None or ctx.text is None:
+        return load_meds_texts().question.no_prescription
+    if DOSE_QUESTION.search(ctx.text.lower()) is None:
+        # Agent: instruction + ЕМИАС record (other drugs, conditions, intolerances) + guidelines; else excerpt only.
+        smart = await agent.answer_chat(ctx.token, ctx.text)
+        if smart is not None:
+            return agent.render(smart)
+    answer = await med_qa(rx.drug, ctx.text)
+    return answer.text if answer is not None else fallback_text()
+
+
+@state(QUESTION_STATE)
+async def _question(ctx: Ctx, event: Event) -> Step:
+    if event.type != "text" or ctx.text is None:
+        return await leave_to_idle(ctx, event)
+    text = await answer_question(ctx, await current_prescription(ctx))
+    return Step(replies=[menu_reply(ctx, text)], next_state="idle")
+
+
+# ------------------------------------------------------------------------------------------- rule actions
+
+
+async def med_info_reply(ctx: Ctx, action: Action) -> Reply | None:
+    """`med_info` action of a rule (quit_intent → onset, alcohol_3d → alcohol): instruction excerpt framed by
+    fixed texts. The rule already decided to say it; this only picks the words. None → engine template."""
+    spec = load_meds_texts().med_info.get(str(action.params.get("topic")))
+    if spec is None:
+        return None
+    rx = await current_prescription(ctx)
+    answer = await med_qa(rx.drug, scrub(spec.question), topic=spec.section) if rx is not None else None
+    body = answer.text if answer is not None else spec.fallback
+    return Reply(text="\n\n".join(p for p in (spec.lead, body, spec.notice) if p), kind="info")
+
+
+register_med_info_handler(med_info_reply)

app/dialog/flows/veteran_daily.py

@@ -0,0 +1,472 @@
+"""Daily check-in and scheduled-scale intros (#37, ADR-002, CLINICAL_MODULES §1–2, case «мониторинг после
+обращения»).
+
+Check-in = core (mood 0–10, dose taken) + the module question (veteran: sleep hours + nightmares; alcohol for
+veterans and for anyone with a positive AUDIT-C) + free text:
+
+    system:daily_checkin / menu «Как я сегодня»
+      ──▶ daily.mood        buttons 0–10 (a bare number is accepted too)
+      ──▶ daily.med         only with a prescription and no dose answer today (the reminder may have got it)
+      ──▶ daily.sleep       <4 / 4–6 / 6–8 / >8 h          ┐ module veteran
+      ──▶ daily.nightmares  yes / no                         ┘
+      ──▶ daily.alcohol     none / 1–2 / more  (veteran or AUDIT-C positive)
+      ──▶ daily.text        «Как вы? Пару слов» (skip button) → extract_checkin on the SCRUBBED text
+      ──▶ [daily.alcohol_amount]  alcohol mentioned in the text but not asked by button → amount buttons
+      ──▶ idle              upsert done, `notify_monitoring` → rules (lane B) → dialog actions
+
+Data algorithm (medical data, jury requirement):
+  * Every button answer is written to `daily_checkins` immediately (`repo.upsert_checkin` merges non-None
+    fields), so an interrupted check-in (crisis, the patient walking away) still leaves today's mood on record —
+    the "mood ≤ 3 three days in a row" rule must not miss a day because the free text was never written.
+  * Button answers are the patient's own and always win over the LLM: from the free text the LLM may only add
+    side effects, the quit intent and fields that were not asked by buttons today.
+  * The LLM never decides anything here: alerts and follow-ups (delayed-onset explanation, unscheduled PHQ-9,
+    alcohol interaction, visit offer) come from the rules through `MonitoringService` (ADR-007).
+  * A free-text message classified POSSIBLE by the safety layer is taken over by the engine (C-SSRS). When the
+    screen returns to `daily.text` the message counts as the answer: the check-in is closed, not asked again.
+  * A check-in left unfinished is dropped on the next event of a later day, or after
+    `settings.abandon_after_hours` of silence (engine abandon timeout, #56) — answers given so far stay stored.
+
+Also here: friendly intros for scheduled scales (pcl5, phq9, dar5, auditc), registered with
+`register_scale_intro` so the engine's `scale_due` / rule-triggered sessions show them.
+"""
+
+import re
+from datetime import datetime
+from functools import lru_cache
+from pathlib import Path
+from typing import Any
+
+import yaml
+from pydantic import BaseModel, ConfigDict
+
+from app.config import get_settings
+from app.core.intake_runtime import intake_enabled
+from app.core.rules import load_rules
+from app.db import repo
+from app.dialog.contracts import Button, Event, Reply
+from app.dialog.flows import intake
+from app.dialog.flows.core import menu_reply
+from app.dialog.flows.knowledge import knowledge_answer, looks_like_question
+from app.dialog.flows.meds import (
+    answer_question,
+    checkin_of,
+    current_prescription,
+    leave_to_idle,
+    load_meds_texts,
+    record_dose,
+    record_side_effects,
+    run_trigger_inline,
+    save_checkin,
+    side_effect_reply,
+)
+from app.dialog.fsm import Ctx, Step, abandonable, on_enter, state, trigger
+from app.dialog.scale_session import register_scale_intro
+
+PREFIX = "daily"
+STEPS = ("mood", "med", "sleep", "nightmares", "alcohol", "text")
+ALCOHOL_AMOUNT = "alcohol_amount"
+SLEEP_BUCKETS = ("<4", "4-6", "6-8", ">8")
+ALCOHOL_BUCKETS = ("none", "1-2", "more")
+_NUMBER = re.compile(r"^\s*(\d{1,2})\s*$")
+
+
+# ------------------------------------------------------------------------------------------- texts
+
+
+class _Strict(BaseModel):
+    model_config = ConfigDict(extra="forbid", frozen=True)
+
+
+class DailySettings(_Strict):
+    sleep_modules: list[str]
+    alcohol_daily_modules: list[str]
+    intro_scales: list[str]
+
+
+class Question(_Strict):
+    question: str
+
+
+class OptionsQuestion(_Strict):
+    question: str
+    options: dict[str, str]
+
+
+class YesNoQuestion(_Strict):
+    question: str
+    yes: str
+    no: str
+
+
+class AlcoholQuestion(_Strict):
+    question: str
+    clarify: str
+    options: dict[str, str]
+
+
+class TextQuestion(_Strict):
+    question: str
+    skip: str
+
+
+class CheckinTexts(_Strict):
+    start: str
+    mood: Question
+    sleep: OptionsQuestion
+    nightmares: YesNoQuestion
+    alcohol: AlcoholQuestion
+    text: TextQuestion
+    buttons_hint: str
+    done: str
+    already_done: str
+
+
+class VisitTexts(_Strict):
+    requested: str
+
+
+class ScaleIntros(_Strict):
+    scheduled: dict[str, str]
+    unscheduled: dict[str, str]
+
+
+class DailyTexts(_Strict):
+    status: str
+    settings: DailySettings
+    checkin: CheckinTexts
+    visit: VisitTexts
+    scale_intros: ScaleIntros
+
+
+def daily_texts_path() -> Path:
+    return get_settings().config_dir / "texts" / "veteran_daily.yaml"
+
+
+@lru_cache
+def load_daily_texts(path: Path | None = None) -> DailyTexts:
+    path = path or daily_texts_path()
+    return DailyTexts.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
+
+
+# ------------------------------------------------------------------------------------------- step logic
+
+
+def _today(ctx: Ctx) -> str:
+    return ctx.now.date().isoformat()
+
+
+def _ck(ctx: Ctx) -> dict[str, Any]:
+    return dict(ctx.data.get("checkin") or {})
+
+
+async def _modules(ctx: Ctx) -> set[str]:
+    profile = await ctx.profile()
+    return set(profile.modules or []) if profile is not None else set()
+
+
+async def _auditc_positive(ctx: Ctx) -> bool:
+    """Latest AUDIT-C at or above the sex-specific cut-off of rule `auditc_positive` (one threshold, one place)."""
+    results = await repo.list_scale_results(ctx.session, ctx.token, "auditc")
+    if not results:
+        return False
+    rule = next((r for r in load_rules().rules if r.id == "auditc_positive"), None)
+    if rule is None:
+        return False
+    profile = await ctx.profile()
+    key = "threshold_f" if profile is not None and profile.sex == "f" else "threshold_m"
+    return results[-1].total >= int(rule.params[key])
+
+
+async def _applicable(ctx: Ctx, step: str) -> bool:
+    settings = load_daily_texts().settings
+    if step in ("mood", "text"):
+        return True
+    if step == "med":
+        today = await checkin_of(ctx, ctx.now.date())
+        return (today is None or today.med_taken is None) and await current_prescription(ctx) is not None
+    modules = await _modules(ctx)
+    if step in ("sleep", "nightmares"):
+        return bool(modules & set(settings.sleep_modules))
+    if step == "alcohol":
+        return bool(modules & set(settings.alcohol_daily_modules)) or await _auditc_positive(ctx)
+    return False
+
+
+async def _next_step(ctx: Ctx, after: str | None) -> str:
+    rest = STEPS if after is None else STEPS[STEPS.index(after) + 1 :]
+    for step in rest:
+        if await _applicable(ctx, step):
+            return step
+    return "text"
+
+
+def _buttons(step: str, options: list[tuple[str, str]]) -> list[list[Button]]:
+    return [[Button(label=label, data=f"{PREFIX}:{step}:{value}")] for value, label in options]
+
+
+async def _question(ctx: Ctx, step: str, note: str = "") -> Reply:
+    t = load_daily_texts().checkin
+    buttons: list[list[Button]]
+    if step == "mood":
+        text = t.mood.question
+        # Two rows (0–5, 6–10): 11 buttons in one column are hard to use on a phone.
+        buttons = [
+            [Button(label=str(v), data=f"{PREFIX}:mood:{v}") for v in range(6)],
+            [Button(label=str(v), data=f"{PREFIX}:mood:{v}") for v in range(6, 11)],
+        ]
+    elif step == "med":
+        m = load_meds_texts().checkin
+        rx = await current_prescription(ctx)
+        text = m.question.format(drug=rx.drug) if rx is not None else m.question_no_drug
+        buttons = _buttons(step, [("yes", m.yes), ("no", m.no), ("later", m.later)])
+    elif step == "sleep":
+        text = t.sleep.question
+        buttons = _buttons(step, [(b, t.sleep.options[b]) for b in SLEEP_BUCKETS])
+    elif step == "nightmares":
+        text = t.nightmares.question
+        buttons = _buttons(step, [("yes", t.nightmares.yes), ("no", t.nightmares.no)])
+    elif step in ("alcohol", ALCOHOL_AMOUNT):
+        text = t.alcohol.question if step == "alcohol" else t.alcohol.clarify
+        buttons = _buttons(step, [(b, t.alcohol.options[b]) for b in ALCOHOL_BUCKETS])
+    else:
+        text = t.text.question
+        buttons = _buttons("text", [("skip", t.text.skip)])
+    return Reply(text="\n\n".join(p for p in (note, text) if p), buttons=buttons, kind="question")
+
+
+async def start_checkin(ctx: Ctx, *, from_menu: bool) -> Step:
+    if ctx.data.get("checkin_done") == _today(ctx):
+        # The scheduler may fire twice; the menu button gets a friendly note instead of a second check-in.
+        return Step(replies=[menu_reply(ctx, load_daily_texts().checkin.already_done)]) if from_menu else Step()
+    first = await _next_step(ctx, None)
+    ck = {"day": _today(ctx), "answered": [], "started_at": ctx.now.isoformat()}
+    return Step(
+        replies=[Reply(text=load_daily_texts().checkin.start)],
+        next_state=f"{PREFIX}.{first}",
+        data={"checkin": ck},
+    )
+
+
+def _finish(ctx: Ctx, replies: list[Reply] | None = None) -> Step:
+    done = Reply(text=load_daily_texts().checkin.done)
+    return Step(
+        replies=[done, *(replies or [])],
+        next_state="idle",
+        data={"checkin": None, "checkin_done": _today(ctx)},
+        notify_monitoring=True,
+    )
+
+
+def _consumed_by_safety(ctx: Ctx, ck: dict[str, Any]) -> bool:
+    """The free-text answer was taken over by the safety layer (C-SSRS screen) after the question was asked."""
+    asked = ck.get("text_asked_at")
+    if not asked:
+        return False
+    for event in reversed(ctx.data.get("safety_events") or []):
+        if event.get("state") == f"{PREFIX}.text" and datetime.fromisoformat(event["ts"]) >= datetime.fromisoformat(
+            asked
+        ):
+            return True
+    return False
+
+
+@on_enter(PREFIX)
+async def _enter(ctx: Ctx) -> Step:
+    step = ctx.state.split(".", 1)[1] if "." in ctx.state else ""
+    ck = _ck(ctx)
+    if not ck or ck.get("day") != _today(ctx):
+        return Step(next_state="idle", data={"checkin": None})
+    if step == "text":
+        if _consumed_by_safety(ctx, ck):
+            return _finish(ctx)
+        return Step(
+            replies=[await _question(ctx, step)], data={"checkin": {**ck, "text_asked_at": ctx.now.isoformat()}}
+        )
+    return Step(replies=[await _question(ctx, step)])
+
+
+async def _advance(ctx: Ctx, step: str, ck: dict[str, Any]) -> Step:
+    ck = {**ck, "answered": [*ck.get("answered", []), step]}
+    if step == ALCOHOL_AMOUNT:
+        return _finish(ctx)
+    nxt = await _next_step(ctx, step)
+    return Step(next_state=f"{PREFIX}.{nxt}", data={"checkin": ck})
+
+
+async def _record_button(ctx: Ctx, step: str, value: str) -> bool:
+    """Store one button answer right away. False = value not valid for this step (stale/forged button)."""
+    if step == "mood" and value.isdigit() and 0 <= int(value) <= 10:
+        await save_checkin(ctx, mood=int(value))
+    elif step == "med" and value in ("yes", "no", "later"):
+        if value != "later":  # «Ещё нет» is not a missed dose: nothing is recorded yet
+            await record_dose(ctx, value == "yes", status=None if value == "yes" else "missed")
+    elif step == "sleep" and value in SLEEP_BUCKETS:
+        await save_checkin(ctx, sleep_bucket=value)
+    elif step == "nightmares" and value in ("yes", "no"):
+        await save_checkin(ctx, nightmares=value == "yes")
+    elif step in ("alcohol", ALCOHOL_AMOUNT) and value in ALCOHOL_BUCKETS:
+        await save_checkin(ctx, alcohol_bucket=value)
+    else:
+        return False
+    return True
+
+
+async def _free_text(ctx: Ctx, ck: dict[str, Any]) -> Step:
+    assert ctx.text is not None
+    facts = await ctx.gateway.extract_checkin(ctx.text)
+    answered = set(ck.get("answered", []))
+    fields: dict[str, Any] = {"free_text_scrubbed": ctx.text}
+    replies: list[Reply] = []
+    clarify_alcohol = False
+    if facts is not None:
+        if facts.quit_intent:
+            fields["quit_intent"] = True
+        # Buttons win: the LLM only fills what was not asked today.
+        if "med" not in answered and facts.med_taken is not None:
+            today = await checkin_of(ctx, ctx.now.date())
+            if today is None or today.med_taken is None:
+                fields["med_taken"] = facts.med_taken
+        if "sleep" not in answered and facts.sleep_hours_bucket is not None:
+            fields["sleep_bucket"] = facts.sleep_hours_bucket
+        if "nightmares" not in answered and facts.nightmares is not None:
+            fields["nightmares"] = facts.nightmares
+        if "alcohol" not in answered and facts.alcohol is not None:
+            fields["alcohol_bucket"] = facts.alcohol  # provisional; the amount buttons below refine it
+            clarify_alcohol = facts.alcohol != "none"
+        if facts.side_effects:
+            await record_side_effects(ctx, [str(c) for c in facts.side_effects])
+            # One topic per message: when the text also carries a quit intent or alcohol, the rules answer
+            # those (delayed onset / interaction); the side-effect excerpt would only bury that message.
+            if not facts.quit_intent and facts.alcohol in (None, "none"):
+                replies.append(await side_effect_reply(ctx, [str(c) for c in facts.side_effects]))
+    await save_checkin(ctx, **fields)
+    if clarify_alcohol:
+        return Step(replies=replies, next_state=f"{PREFIX}.{ALCOHOL_AMOUNT}", data={"checkin": ck})
+    return _finish(ctx, replies)
+
+
+abandonable(PREFIX)
+
+
+@state(PREFIX)
+async def _handle(ctx: Ctx, event: Event) -> Step:
+    step = ctx.state.split(".", 1)[1] if "." in ctx.state else ""
+    ck = _ck(ctx)
+    if not ck or ck.get("day") != _today(ctx):
+        # Unfinished check-in from an earlier day: drop it and handle the event as idle would.
+        return await leave_to_idle(ctx, event, {"checkin": None})
+
+    if event.type == "button" and event.button:
+        parts = event.button.split(":")
+        if len(parts) == 3 and parts[0] == PREFIX and parts[1] == step:
+            if step == "text" and parts[2] == "skip":
+                return _finish(ctx)
+            if await _record_button(ctx, step, parts[2]):
+                return await _advance(ctx, step, ck)
+        if parts[0] == "med":
+            # A reminder button pressed mid check-in: answer it, then repeat the current question.
+            inline = await run_trigger_inline(ctx, f"button:{event.button}", event)
+            if inline is not None:
+                return inline if inline.next_state else inline.then(Step(replies=[await _question(ctx, step)]))
+        if parts[0] in (PREFIX, "scale"):
+            return Step(replies=[await _question(ctx, step)])  # stale button of an earlier question
+        return await leave_to_idle(ctx, event, {"checkin": None})
+
+    if event.type == "system" and event.system:
+        if event.system == "daily_checkin":
+            return Step(replies=[await _question(ctx, step)])
+        inline = await run_trigger_inline(ctx, f"system:{event.system}", event)
+        if inline is None:
+            return Step()
+        return inline if inline.next_state else inline.then(Step(replies=[await _question(ctx, step)]))
+
+    if event.type == "text" and ctx.text is not None:
+        if step == "text":
+            return await _free_text(ctx, ck)
+        number = _NUMBER.match(ctx.text)
+        if step == "mood" and number and await _record_button(ctx, "mood", number.group(1)):
+            return await _advance(ctx, step, ck)
+        return Step(replies=[await _question(ctx, step, note=load_daily_texts().checkin.buttons_hint)])
+
+    return Step(replies=[await _question(ctx, step)])
+
+
+# ------------------------------------------------------------------------------------------- idle triggers
+
+
+@trigger("system:daily_checkin", replace=True)
+async def _daily_checkin(ctx: Ctx, event: Event) -> Step:
+    if intake_enabled():  # the intake diary (#53, feature flag) replaces this check-in when released
+        return await intake.checkin(ctx, event)
+    return await start_checkin(ctx, from_menu=False)
+
+
+@trigger("button:menu:checkin", replace=True)
+async def _menu_checkin(ctx: Ctx, event: Event) -> Step:
+    if intake_enabled():
+        return await intake.checkin(ctx, event)
+    return await start_checkin(ctx, from_menu=True)
+
+
+@trigger("button:menu:visit", replace=True)
+async def _visit(ctx: Ctx, event: Event) -> Step:
+    # «Записаться раньше» (rule action suggest_visit): no online booking yet — the request is a fact for lane B
+    # (#38) and the dashboard, like `contact_requests`. No alert is created here (ADR-007).
+    requests = [*(ctx.data.get("visit_requests") or []), {"ts": ctx.now.isoformat()}][-20:]
+    return Step(
+        replies=[Reply(text=load_daily_texts().visit.requested)],
+        data={"visit_requests": requests},
+        notify_monitoring=True,
+    )
+
+
+@trigger("text:idle", replace=True)
+async def _idle_text(ctx: Ctx, event: Event) -> Step:
+    """Free text outside the check-in: drug question → instruction excerpt; side effects / quit intent / alcohol
+    → today's check-in (the rules react); another question → clinical guidelines (knowledge base); otherwise
+    the neutral support phrase with the menu."""
+    assert ctx.text is not None
+    facts = await ctx.gateway.extract_checkin(ctx.text)
+    if facts is None:
+        text = await knowledge_answer(ctx, explicit=False) if looks_like_question(ctx.text) else None
+        return Step(replies=[menu_reply(ctx, text or await ctx.gateway.phrase("support"))])
+    fields: dict[str, Any] = {}
+    if facts.quit_intent:
+        fields["quit_intent"] = True
+    if facts.alcohol is not None and facts.alcohol != "none":
+        today = await checkin_of(ctx, ctx.now.date())
+        if today is None or today.alcohol_bucket in (None, "none"):
+            fields["alcohol_bucket"] = facts.alcohol
+    text: str | None = None
+    if facts.side_effects:
+        codes = [str(c) for c in facts.side_effects]
+        await record_side_effects(ctx, codes)
+        if not facts.quit_intent:
+            text = (await side_effect_reply(ctx, codes)).text
+    if fields:
+        await save_checkin(ctx, **fields)
+    if text is None and facts.med_question and not facts.quit_intent:
+        text = await answer_question(ctx, await current_prescription(ctx))
+    # A question is answered even if it also mentioned alcohol/side effects (those are recorded above).
+    # Quit intent gets the rule reaction (delayed-onset explanation + doctor notified) — no second answer.
+    if text is None and not facts.quit_intent and looks_like_question(ctx.text):
+        text = await knowledge_answer(ctx, explicit=False)  # general question → clinical guidelines (#64)
+    if text is None:
+        text = await ctx.gateway.phrase("support")
+    return Step(replies=[menu_reply(ctx, text)], notify_monitoring=bool(fields or facts.side_effects))
+
+
+# ------------------------------------------------------------------------------------------- scale intros
+
+
+def _scale_intro(ctx: Ctx, scale_id: str, scheduled: bool, return_state: str) -> str | None:
+    """Friendly intro of a scheduled (or rule-triggered) scale. Onboarding sessions (#36) have their own texts."""
+    if ".onboarding" in return_state:
+        return None
+    intros = load_daily_texts().scale_intros
+    return (intros.scheduled if scheduled else intros.unscheduled).get(scale_id)
+
+
+for _scale_id in load_daily_texts().settings.intro_scales:
+    register_scale_intro(_scale_id, _scale_intro)

app/dialog/flows/veteran_onboarding.py

@@ -0,0 +1,458 @@
+"""Veteran start screening (issue #36, CLINICAL_MODULES §1, ADR-001/002/007/010).
+
+Entered by the core flow after consent + age gate when the profile has module `veteran`:
+
+    veteran.onboarding.start      intro «что нормально после возвращения» + FAQ ──«Начнём»──▶
+    veteran.onboarding.exposure   trauma exposure (yes / no / decline)
+        yes ──▶ scale.pcptsd5 ──▶ ┐
+        no / decline ───────────▶ ┤   (PC-PTSD-5 is not administered; nothing is stored for it)
+    veteran.onboarding.pcl5      ─┘──▶ scale.pcl5
+    veteran.onboarding.phq9        ──▶ scale.phq9   (item 9 buttons only; positive → engine crisis path)
+    veteran.onboarding.auditc      sex from profile, asked if unknown ──▶ scale.auditc
+    veteran.onboarding.weapon      weapon access (4 buttons) → facts; access + risk signal → safe-storage block
+    veteran.onboarding.result      plain-language summary, modules enabled in profile → finish_onboarding()
+
+Clinical decisions encoded here:
+  * PCL-5 is given to every veteran regardless of the exposure answer: the module's start set is PCL-5/PHQ-9/
+    AUDIT-C (CLINICAL_MODULES §1); PC-PTSD-5 is only a short entry screen and, by its own instructions, is asked
+    only after a "yes" to trauma exposure (`config/scales/pcptsd5.yaml: notes`).
+  * Module `depression` is enabled when the PHQ-9 total meets `config/modules.yaml:
+    veteran.enables_depression_if` (≥ 10). Scores and severity labels are never shown to the patient.
+  * Safe-storage block (means restriction, one of the best-evidenced suicide-prevention measures) is shown when
+    the patient reports access to a weapon AND there is a risk signal in this onboarding: a scale flag listed in
+    `settings.weapon_risk_flags` (PHQ-9 item 9 ≥ 1, C-SSRS, AUDIT-C positive), a safety event (POSSIBLE/ACUTE)
+    or a crisis opened since the onboarding began. Deterministic, no LLM (ADR-007).
+
+Facts for lane B (`dialog_state.data["facts"]`, merged with whatever else is there):
+    trauma_exposure        True | False | None (declined)
+    weapon_access          True (self / others_or_safe) | False (none) | None (declined)
+    weapon_access_choice   "none" | "self" | "others_or_safe" | "declined"
+    weapon_access_at       ISO timestamp of the answer
+    weapon_safety_block    True when the safe-storage block was shown
+`PatientSnapshot.weapon_access` should be built from `facts["weapon_access"]`.
+
+Crisis during onboarding: the engine moves to `crisis` and drops the running scale session. Progress is kept in
+`data["veteran_onboarding"]` (`stage`, `since_id`); when the FSM later enters `idle` (doctor acknowledged the
+crisis) the onboarding resumes at the stored stage, and scale stages whose result was already stored since the
+onboarding began are skipped (`since_id` = last scale_results id before the start).
+"""
+
+from __future__ import annotations
+
+from functools import lru_cache
+from pathlib import Path
+from typing import Any
+
+import yaml
+from pydantic import BaseModel, ConfigDict, Field
+
+from app.config import get_settings
+from app.core.modules import load_modules
+from app.db import repo
+from app.db.clinical import ScaleResult
+from app.dialog.contracts import Button, Event, Reply
+from app.dialog.crisis import crisis_open
+from app.dialog.flows.core import finish_onboarding, menu_reply
+from app.dialog.fsm import Ctx, Step, on_enter, state, trigger
+from app.dialog.scale_session import start_scale
+
+MODULE = "veteran"
+PREFIX = "veteran.onboarding"
+START = f"{PREFIX}.start"
+EXPOSURE = f"{PREFIX}.exposure"
+PCL5 = f"{PREFIX}.pcl5"
+PHQ9 = f"{PREFIX}.phq9"
+AUDITC = f"{PREFIX}.auditc"
+WEAPON = f"{PREFIX}.weapon"
+RESULT = f"{PREFIX}.result"
+
+BTN = "vonb"  # button data namespace: "vonb:<question>:<choice>"
+FAQ_KEYS = ("who", "unit", "licences")
+
+# choice code → value of facts["weapon_access"]: storage with others still means the patient owns a weapon.
+WEAPON_ACCESS: dict[str, bool | None] = {"none": False, "self": True, "others_or_safe": True, "declined": None}
+EXPOSURE_VALUE: dict[str, bool | None] = {"yes": True, "no": False, "declined": None}
+SEX_VALUE: dict[str, str | None] = {"m": "m", "f": "f", "declined": None}
+
+
+# ------------------------------------------------------------------------------------------- texts
+
+
+class _Strict(BaseModel):
+    model_config = ConfigDict(extra="forbid", frozen=True)
+
+
+class OnbSettings(_Strict):
+    weapon_risk_flags: list[str] = Field(default_factory=list)
+
+
+class IntroTexts(_Strict):
+    text: str
+    go: str
+    repeat: str
+    resume: str
+
+
+class ExposureTexts(_Strict):
+    question: str
+    answer_yes: str
+    answer_no: str
+    decline: str
+    ack_yes: str
+    ack_other: str
+
+
+class SexTexts(_Strict):
+    question: str
+    male: str
+    female: str
+    decline: str
+
+
+class WeaponTexts(_Strict):
+    question: str
+    no_access: str
+    self: str
+    others_or_safe: str
+    decline: str
+    ack: str
+    safety_block_self: str
+    safety_block_stored: str
+    safety_block_unknown: str
+
+
+class ResultTexts(_Strict):
+    intro: str
+    calm: str
+    load: str
+    ptsd: str
+    mood: str
+    alcohol: str
+    next: str
+
+
+class FaqEntry(_Strict):
+    button: str
+    text: str
+
+
+class FaqTexts(_Strict):
+    who: FaqEntry
+    unit: FaqEntry
+    licences: FaqEntry
+
+
+class VeteranOnboardingTexts(_Strict):
+    status: str
+    settings: OnbSettings
+    intro: IntroTexts
+    buttons_hint: str
+    exposure: ExposureTexts
+    sex: SexTexts
+    weapon: WeaponTexts
+    result: ResultTexts
+    faq: FaqTexts
+
+
+def texts_path() -> Path:
+    return get_settings().config_dir / "texts" / "veteran_onboarding.yaml"
+
+
+@lru_cache
+def load_texts(path: Path | None = None) -> VeteranOnboardingTexts:
+    path = path or texts_path()
+    return VeteranOnboardingTexts.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
+
+
+# ------------------------------------------------------------------------------------------- helpers
+
+
+def _progress(ctx: Ctx) -> dict[str, Any]:
+    return dict(ctx.data.get("veteran_onboarding") or {})
+
+
+def _at_stage(ctx: Ctx, stage: str) -> dict[str, Any]:
+    """Data update remembering the current stage (resume point after a crisis)."""
+    return {"veteran_onboarding": {**_progress(ctx), "stage": stage}}
+
+
+def _facts(ctx: Ctx, **updates: Any) -> dict[str, Any]:
+    return {"facts": {**(ctx.data.get("facts") or {}), **updates}}
+
+
+def _faq_buttons() -> list[list[Button]]:
+    faq = load_texts().faq
+    return [[Button(label=getattr(faq, key).button, data=f"{BTN}:faq:{key}")] for key in FAQ_KEYS]
+
+
+def _choice(event: Event, question: str, allowed: dict[str, Any]) -> str | None:
+    if event.type != "button" or not event.button:
+        return None
+    parts = event.button.split(":")
+    if len(parts) == 3 and parts[0] == BTN and parts[1] == question and parts[2] in allowed:
+        return parts[2]
+    return None
+
+
+def _faq_key(event: Event) -> str | None:
+    if event.type == "button" and event.button and event.button.startswith(f"{BTN}:faq:"):
+        key = event.button.rsplit(":", 1)[1]
+        return key if key in FAQ_KEYS else None
+    return None
+
+
+async def _results_since(ctx: Ctx) -> list[ScaleResult]:
+    since_id = int(_progress(ctx).get("since_id") or 0)
+    return [r for r in await repo.list_scale_results(ctx.session, ctx.token) if r.id > since_id]
+
+
+async def _latest(ctx: Ctx, scale: str) -> ScaleResult | None:
+    rows = [r for r in await _results_since(ctx) if r.scale == scale]
+    return rows[-1] if rows else None
+
+
+async def _risk_signals(ctx: Ctx) -> list[str]:
+    """Deterministic risk signals collected during this onboarding (see module docstring)."""
+    risk_flags = set(load_texts().settings.weapon_risk_flags)
+    signals = sorted({f for r in await _results_since(ctx) for f in (r.flags or {}) if f in risk_flags})
+    started = str(_progress(ctx).get("started_at") or "")
+    events = [
+        e
+        for e in ctx.data.get("safety_events") or []
+        if str(e.get("ts", "")) >= started and e.get("level") in ("possible", "acute")
+    ]
+    if events:
+        signals.append("safety_event")
+    opened_at = str((ctx.data.get("crisis") or {}).get("opened_at") or "")
+    if crisis_open(ctx.data) or (opened_at and opened_at >= started):
+        signals.append("crisis")
+    return signals
+
+
+async def _scale_stage(ctx: Ctx, stage: str, scale: str, next_stage: str) -> Step:
+    """Start `scale` unless its result is already stored in this onboarding (resume after a crisis)."""
+    if await _latest(ctx, scale) is not None:
+        return Step(next_state=next_stage, data=_at_stage(ctx, next_stage))
+    step = await start_scale(ctx, scale, return_state=next_stage, scheduled=True)
+    step.data.update(_at_stage(ctx, stage))
+    return step
+
+
+# ------------------------------------------------------------------------------------------- start
+
+
+def _intro_reply(text: str) -> Reply:
+    go = Button(label=load_texts().intro.go, data=f"{BTN}:go:yes")
+    return Reply(text=text, buttons=[[go], *_faq_buttons()], kind="question")
+
+
+@on_enter(START)
+async def _start_enter(ctx: Ctx) -> Step:
+    rows = await repo.list_scale_results(ctx.session, ctx.token)
+    progress = {
+        "stage": START,
+        "since_id": max((r.id for r in rows), default=0),
+        "started_at": ctx.now.isoformat(),
+    }
+    return Step(replies=[_intro_reply(load_texts().intro.text)], data={"veteran_onboarding": progress})
+
+
+# ------------------------------------------------------------------------------------------- questions
+
+
+def _exposure_reply(note: str = "") -> Reply:
+    t = load_texts().exposure
+    buttons = [
+        [Button(label=t.answer_yes, data=f"{BTN}:exposure:yes")],
+        [Button(label=t.answer_no, data=f"{BTN}:exposure:no")],
+        [Button(label=t.decline, data=f"{BTN}:exposure:declined")],
+    ]
+    return Reply(text="\n\n".join(p for p in (note, t.question) if p), buttons=buttons, kind="question")
+
+
+def _sex_reply(note: str = "") -> Reply:
+    t = load_texts().sex
+    buttons = [
+        [Button(label=t.male, data=f"{BTN}:sex:m")],
+        [Button(label=t.female, data=f"{BTN}:sex:f")],
+        [Button(label=t.decline, data=f"{BTN}:sex:declined")],
+    ]
+    return Reply(text="\n\n".join(p for p in (note, t.question) if p), buttons=buttons, kind="question")
+
+
+def _weapon_reply(note: str = "") -> Reply:
+    t = load_texts().weapon
+    buttons = [
+        [Button(label=t.no_access, data=f"{BTN}:weapon:none")],
+        [Button(label=t.self, data=f"{BTN}:weapon:self")],
+        [Button(label=t.others_or_safe, data=f"{BTN}:weapon:others_or_safe")],
+        [Button(label=t.decline, data=f"{BTN}:weapon:declined")],
+    ]
+    return Reply(text="\n\n".join(p for p in (note, t.question) if p), buttons=buttons, kind="question")
+
+
+def _current_question(ctx: Ctx, note: str = "") -> Reply:
+    if ctx.state == EXPOSURE:
+        return _exposure_reply(note)
+    if ctx.state == AUDITC:
+        return _sex_reply(note)
+    if ctx.state == WEAPON:
+        return _weapon_reply(note)
+    t = load_texts().intro
+    return _intro_reply("\n\n".join(p for p in (note, t.repeat) if p))
+
+
+@on_enter(EXPOSURE)
+async def _exposure_enter(ctx: Ctx) -> Step:
+    return Step(replies=[_exposure_reply()], data=_at_stage(ctx, EXPOSURE))
+
+
+@on_enter(PCL5)
+async def _pcl5_enter(ctx: Ctx) -> Step:
+    return await _scale_stage(ctx, PCL5, "pcl5", PHQ9)
+
+
+@on_enter(PHQ9)
+async def _phq9_enter(ctx: Ctx) -> Step:
+    # Item 9 is buttons-only and a positive answer opens the crisis path inside the scale session (engine).
+    return await _scale_stage(ctx, PHQ9, "phq9", AUDITC)
+
+
+@on_enter(AUDITC)
+async def _auditc_enter(ctx: Ctx) -> Step:
+    if await _latest(ctx, "auditc") is not None:
+        return Step(next_state=WEAPON, data=_at_stage(ctx, WEAPON))
+    profile = await ctx.profile()
+    known = profile is not None and profile.sex in ("m", "f")
+    if known or _progress(ctx).get("sex_asked"):
+        # Unknown sex after "не хочу отвечать": AUDIT-C uses the more sensitive default threshold.
+        return await _scale_stage(ctx, AUDITC, "auditc", WEAPON)
+    return Step(replies=[_sex_reply()], data=_at_stage(ctx, AUDITC))
+
+
+@on_enter(WEAPON)
+async def _weapon_enter(ctx: Ctx) -> Step:
+    return Step(replies=[_weapon_reply()], data=_at_stage(ctx, WEAPON))
+
+
+@state(PREFIX)
+async def _handle(ctx: Ctx, event: Event) -> Step:
+    """Events in the onboarding's own question states (scales are handled by the scale session)."""
+    t = load_texts()
+    faq = _faq_key(event)
+    if faq is not None:
+        return Step(replies=[Reply(text=getattr(t.faq, faq).text), _current_question(ctx)])
+    if event.type == "system":
+        return Step()  # reminders do not interrupt the screening
+
+    if ctx.state == START:
+        if _choice(event, "go", {"yes": True}):
+            return Step(next_state=EXPOSURE)
+        return Step(replies=[_current_question(ctx)])
+
+    if ctx.state == EXPOSURE and (code := _choice(event, "exposure", EXPOSURE_VALUE)):
+        exposed = EXPOSURE_VALUE[code]
+        step = Step(data=_facts(ctx, trauma_exposure=exposed))
+        if exposed:
+            step.replies.append(Reply(text=t.exposure.ack_yes))
+            nxt = await start_scale(ctx, "pcptsd5", return_state=PCL5, scheduled=True)
+            nxt.data.update(_at_stage(ctx, EXPOSURE))
+            return step.then(nxt)
+        step.replies.append(Reply(text=t.exposure.ack_other))
+        return step.then(Step(next_state=PCL5))
+
+    if ctx.state == AUDITC and (code := _choice(event, "sex", SEX_VALUE)):
+        sex = SEX_VALUE[code]
+        if sex is not None:
+            await repo.upsert_profile(ctx.session, token=ctx.token, sex=sex)
+        step = await _scale_stage(ctx, AUDITC, "auditc", WEAPON)
+        step.data["veteran_onboarding"] = {**step.data["veteran_onboarding"], "sex_asked": True}
+        return step
+
+    if ctx.state == WEAPON and (code := _choice(event, "weapon", WEAPON_ACCESS)):
+        return await _weapon_answer(ctx, code)
+
+    return Step(replies=[_current_question(ctx, t.buttons_hint)])
+
+
+async def _weapon_answer(ctx: Ctx, code: str) -> Step:
+    t = load_texts().weapon
+    access = WEAPON_ACCESS[code]
+    replies = [Reply(text=t.ack)]
+    show_block = access is not False and bool(await _risk_signals(ctx))
+    if show_block:
+        block = {"self": t.safety_block_self, "others_or_safe": t.safety_block_stored}.get(code, t.safety_block_unknown)
+        replies = [Reply(text=block, kind="safety_plan")]
+    data = _facts(
+        ctx,
+        weapon_access=access,
+        weapon_access_choice=code,
+        weapon_access_at=ctx.now.isoformat(),
+        weapon_safety_block=show_block,
+    )
+    # notify_monitoring: weapon access is a monitoring fact (lane B rule "доступ к оружию → блок безопасности").
+    return Step(replies=replies, next_state=RESULT, data=data, notify_monitoring=True)
+
+
+# ------------------------------------------------------------------------------------------- result
+
+
+def _meets(total: int, op: str, value: int) -> bool:
+    return total >= value if op == ">=" else total > value
+
+
+@on_enter(RESULT)
+async def _result_enter(ctx: Ctx) -> Step:
+    t = load_texts().result
+    pcl5 = await _latest(ctx, "pcl5")
+    auditc = await _latest(ctx, "auditc")
+
+    # Depression module: PHQ-9 total vs. the threshold from config/modules.yaml (veteran.enables_depression_if).
+    rule = load_modules().modules[MODULE].enables_depression_if
+    trigger_result = await _latest(ctx, rule.scale) if rule is not None else None
+    depression = bool(rule and trigger_result and _meets(trigger_result.total, rule.op, rule.value))
+    profile = await ctx.profile()
+    modules = list(profile.modules or []) if profile is not None else []
+    for module in (MODULE, "depression") if depression else (MODULE,):
+        if module not in modules:
+            modules.append(module)
+    await repo.upsert_profile(ctx.session, token=ctx.token, modules=modules)
+
+    lines = []
+    if pcl5 is not None and "pcl5_probable_ptsd" in (pcl5.flags or {}):
+        lines.append(t.ptsd)
+    if depression:
+        lines.append(t.mood)
+    if auditc is not None and "auditc_positive" in (auditc.flags or {}):
+        lines.append(t.alcohol)
+    body = [t.intro, t.load, *lines] if lines else [t.intro, t.calm]
+    summary = Reply(text="\n".join([*body, "", t.next]), buttons=_faq_buttons())
+    done = Step(
+        replies=[summary],
+        data={"veteran_onboarding": {**_progress(ctx), "stage": None, "done_at": ctx.now.isoformat()}},
+        notify_monitoring=True,
+    )
+    return done.then(await finish_onboarding(ctx, module=MODULE))
+
+
+# ------------------------------------------------------------------------------------------- resume / FAQ
+
+
+@on_enter("idle")
+async def _resume_after_crisis(ctx: Ctx) -> Step:
+    """Back in idle with an unfinished veteran onboarding (it was interrupted by a crisis) → continue it."""
+    stage = _progress(ctx).get("stage")
+    if not stage or not str(stage).startswith(PREFIX) or crisis_open(ctx.data) or ctx.data.get("consent") is not True:
+        return Step()
+    stage = EXPOSURE if stage == START else str(stage)
+    return Step(replies=[Reply(text=load_texts().intro.resume)], next_state=stage)
+
+
+def _faq_trigger(key: str) -> None:
+    @trigger(f"button:{BTN}:faq:{key}")
+    async def _faq(ctx: Ctx, event: Event) -> Step:
+        return Step(replies=[menu_reply(ctx, getattr(load_texts().faq, key).text)])
+
+
+for _key in FAQ_KEYS:
+    _faq_trigger(_key)

app/dialog/fsm.py

@@ -0,0 +1,236 @@
+"""FSM framework of the dialog engine: context, step result and the state / trigger registries.
+
+States are plain strings, namespaced by module ("veteran.onboarding.pcl5"); core states have short names
+("new", "consent", "age_gate", "idle", "crisis", "consent_revoked", ...). A flow module
+(`app/dialog/flows/<module>.py`) registers its states at import time — the engine never has to be edited to
+add a scenario:
+
+    from app.dialog.fsm import Ctx, Step, on_enter, state
+    from app.dialog.scale_session import start_scale
+
+    @on_enter("veteran.onboarding.start")          # runs when the FSM *enters* the state
+    async def _start(ctx: Ctx) -> Step:
+        return await start_scale(ctx, "pcptsd5", return_state="veteran.onboarding.pcl5")
+
+    @state("veteran.onboarding.trauma")            # handles events while the FSM *is in* the state
+    async def _trauma(ctx: Ctx, event: Event) -> Step:
+        ...
+        return Step(replies=[...], next_state="idle", data={"trauma": True})
+
+Name resolution: an exact registration wins, otherwise the longest registered dotted prefix handles the state
+("scale.phq9" → the generic "scale" handler). Triggers (`@trigger("button:menu:checkin")`,
+`@trigger("system:daily_checkin")`, `@trigger("text:idle")`) let flows take over what the core `idle` state does
+with menu buttons, system events and free text; the core registers defaults, a flow overrides with
+`replace=True`.
+
+Prefix triggers carry data in the button (#56): `@trigger("button:med:taken:*")` handles every button whose data
+starts with "med:taken:"; the rest of the data ("med:taken:42" → "42") reaches the handler as
+`trigger_payload(event)`. An exact key always wins over a prefix, a longer prefix over a shorter one.
+
+Abandoned steps (#56): a flow marks its question states with `abandonable("daily")`; if the patient stays silent
+in such a state longer than `settings.abandon_after_hours`, the engine returns the FSM to `idle` before
+handling the next event (answers already stored stay stored).
+"""
+
+from __future__ import annotations
+
+from collections.abc import Awaitable, Callable
+from dataclasses import dataclass, field
+from datetime import datetime
+from typing import Any
+
+from sqlalchemy.ext.asyncio import AsyncSession
+
+from app.core.types import ScrubbedText
+from app.db import repo
+from app.db.clinical import PatientProfile
+from app.dialog.contracts import Event, Reply
+from app.dialog.texts import DialogTexts
+from app.llm.gateway import LLMGateway
+from app.services.contracts import MonitoringService
+
+# States where nothing is being asked: a pending scale may start here (see engine `_start_pending`).
+RESTING_STATES = frozenset({"idle", "crisis"})
+# States without (valid) consent: the engine stores nothing and never calls the LLM here (152-FZ art. 9-10).
+NO_CONSENT_STATES = frozenset({"new", "consent", "refused", "minor", "consent_revoked"})
+
+
+@dataclass
+class Ctx:
+    """Everything a state handler may use. `data` is the persisted `dialog_state.data` (treat as read-only:
+    return changes in `Step.data`, the engine applies them)."""
+
+    token: str
+    state: str
+    data: dict[str, Any]
+    now: datetime  # from app.core.clock, taken once per incoming event (ADR-005)
+    session: AsyncSession  # clinical DB unit of work of this event
+    gateway: LLMGateway
+    monitoring: MonitoringService
+    texts: DialogTexts
+    text: ScrubbedText | None = None  # scrubbed patient text for text events — the only text handlers see
+    _profile: PatientProfile | None = field(default=None, repr=False)
+    _profile_loaded: bool = field(default=False, repr=False)
+
+    async def profile(self) -> PatientProfile | None:
+        if not self._profile_loaded:
+            self._profile = await repo.get_profile(self.session, self.token)
+            self._profile_loaded = True
+        return self._profile
+
+
+@dataclass
+class Step:
+    """Result of a handler.
+
+    replies          — messages to send, in order;
+    next_state       — new FSM state (None = stay); entering a different state runs its `@on_enter` hook;
+    data             — updates merged into `dialog_state.data` (a value of None deletes the key);
+    notify_monitoring — the handler wrote clinical data: the engine commits and calls
+                       `MonitoringService.after_data_change()`, then executes the returned dialog actions.
+    """
+
+    replies: list[Reply] = field(default_factory=list)
+    next_state: str | None = None
+    data: dict[str, Any] = field(default_factory=dict)
+    notify_monitoring: bool = False
+
+    def then(self, other: Step) -> Step:
+        """Sequential composition: replies concatenated, later state/data win."""
+        return Step(
+            replies=[*self.replies, *other.replies],
+            next_state=other.next_state or self.next_state,
+            data={**self.data, **other.data},
+            notify_monitoring=self.notify_monitoring or other.notify_monitoring,
+        )
+
+
+Handler = Callable[[Ctx, Event], Awaitable[Step]]
+EnterHook = Callable[[Ctx], Awaitable[Step]]
+
+_handlers: dict[str, Handler] = {}
+_enter_hooks: dict[str, EnterHook] = {}
+_triggers: dict[str, Handler] = {}
+_prefix_triggers: dict[str, Handler] = {}  # "button:med:taken:" → handler (registered as "button:med:taken:*")
+_abandonable: dict[str, Callable[[Ctx], bool] | None] = {}
+
+PREFIX_WILDCARD = "*"
+PAYLOAD_PARAM = "trigger_payload"
+
+
+def state(name: str) -> Callable[[Handler], Handler]:
+    """Register the event handler of state `name` (or of a dotted prefix, e.g. "scale")."""
+
+    def deco(fn: Handler) -> Handler:
+        if name in _handlers:
+            raise ValueError(f"state '{name}' already registered")
+        _handlers[name] = fn
+        return fn
+
+    return deco
+
+
+def on_enter(name: str) -> Callable[[EnterHook], EnterHook]:
+    """Register a hook that runs when the FSM enters state `name` (asks the first question, chains flows)."""
+
+    def deco(fn: EnterHook) -> EnterHook:
+        if name in _enter_hooks:
+            raise ValueError(f"enter hook of '{name}' already registered")
+        _enter_hooks[name] = fn
+        return fn
+
+    return deco
+
+
+def trigger(key: str, *, replace: bool = False) -> Callable[[Handler], Handler]:
+    """Register a handler for an idle-menu button / system event / idle free text.
+
+    Keys: "button:<Button.data>", "system:<SystemEventKind>", "text:idle". The core registers defaults;
+    flows pass `replace=True` to take one over. A key ending in ":*" is a prefix trigger (see module doc).
+    """
+    table, name = _triggers, key
+    if key.endswith(":" + PREFIX_WILDCARD):
+        table, name = _prefix_triggers, key[: -len(PREFIX_WILDCARD)]
+
+    def deco(fn: Handler) -> Handler:
+        if name in table and not replace:
+            raise ValueError(f"trigger '{key}' already registered (use replace=True to override)")
+        table[name] = fn
+        return fn
+
+    return deco
+
+
+def trigger_payload(event: Event) -> str | None:
+    """Data after the matched prefix of a prefix trigger ("med:taken:42" → "42"); None for exact triggers."""
+    value = event.params.get(PAYLOAD_PARAM)
+    return str(value) if value is not None else None
+
+
+def abandonable(prefix: str, when: Callable[[Ctx], bool] | None = None) -> None:
+    """Mark states `prefix` / `prefix.*` as question steps the engine may abandon after a long silence.
+
+    `when(ctx)` may veto it for a particular situation (e.g. a scale that is part of an onboarding).
+    """
+    if prefix in _abandonable:
+        raise ValueError(f"abandonable '{prefix}' already registered")
+    _abandonable[prefix] = when
+
+
+def is_abandonable(ctx: Ctx) -> bool:
+    key = _resolve(ctx.state, _abandonable)
+    if key is None:
+        return False
+    when = _abandonable[key]
+    return when is None or when(ctx)
+
+
+def _resolve(name: str, table: dict[str, Any]) -> str | None:
+    candidate = name
+    while candidate:
+        if candidate in table:
+            return candidate
+        if "." not in candidate:
+            return None
+        candidate = candidate.rsplit(".", 1)[0]
+    return None
+
+
+def handler_for(name: str) -> Handler | None:
+    key = _resolve(name, _handlers)
+    return _handlers[key] if key else None
+
+
+def enter_hook_for(name: str) -> EnterHook | None:
+    key = _resolve(name, _enter_hooks)
+    return _enter_hooks[key] if key else None
+
+
+def get_trigger(key: str) -> Handler | None:
+    """Exact trigger, else the longest matching prefix trigger (wrapped so it sees the payload)."""
+    exact = _triggers.get(key)
+    if exact is not None:
+        return exact
+    matches = [p for p in _prefix_triggers if key.startswith(p) and len(key) > len(p)]
+    if not matches:
+        return None
+    prefix = max(matches, key=len)
+    fn, payload = _prefix_triggers[prefix], key[len(prefix) :]
+
+    async def with_payload(ctx: Ctx, event: Event) -> Step:
+        return await fn(ctx, event.model_copy(update={"params": {**event.params, PAYLOAD_PARAM: payload}}))
+
+    return with_payload
+
+
+def is_registered(name: str) -> bool:
+    """Exact registration (handler or enter hook) — used to find a module's onboarding entry point."""
+    return name in _handlers or name in _enter_hooks
+
+
+def apply_data(data: dict[str, Any], updates: dict[str, Any]) -> None:
+    for key, value in updates.items():
+        if value is None:
+            data.pop(key, None)
+        else:
+            data[key] = value

app/dialog/scale_session.py

@@ -0,0 +1,288 @@
+"""Reusable scale session: asks a questionnaire item by item inside the dialog (SPEC §6 "Сбор шкалы в диалоге").
+
+Usage from a flow (#36/#37):
+
+    step = await start_scale(ctx, "pcl5", return_state="veteran.onboarding.phq9", scheduled=True)
+    return step  # FSM goes to "scale.pcl5"; its enter hook asks item 1; on completion → return_state
+
+Algorithm per item:
+  1. The item is shown with one button per answer option from `config/scales/<id>.yaml`.
+  2. A button press is taken as is (source="button").
+  3. Free text is accepted only for items without `buttons_only` (PHQ-9 item 9 and the whole C-SSRS are
+     buttons-only: suicidal-ideation answers are never interpreted by the LLM — SPEC §6, ADR-002). The scrubbed
+     text goes to `gateway.extract_item`; `None` (failure / confidence < 0.5 / out-of-range score) → a clarifying
+     question with the same buttons, nothing is stored (source="llm" only for a confident extraction).
+  4. Every answer is stored immediately (`item_responses`), so a session interrupted by a crisis keeps its data.
+  5. After each answer the scale is scored deterministically (`app.core.scales.score`). If a crisis flag from
+     `config/texts/dialog.yaml: settings.crisis_flags` fires (PHQ-9 item 9 ≥ 1, C-SSRS high) the session ends at
+     once: partial result saved, fixed crisis script, C-SSRS queued (unless this *is* the C-SSRS, or a C-SSRS was
+     completed less than `settings.cssrs_cooldown_hours` ago — the patient is not asked the same suicide screen
+     twice in a day; the crisis script and the alert still happen). A positive item 9 is acted upon even in a
+     half-finished questionnaire.
+  6. On completion: `scale_results` row (total, severity, item 9, scheduled flag, flags) → the engine commits
+     and calls `MonitoringService.after_data_change()` (rules decide alerts — ADR-007) → back to `return_state`.
+The patient never sees a score or a severity label: that would read as a diagnosis.
+
+Intros (#56): `start_scale(intro=None)` looks the intro up in a registry filled by flows
+(`register_scale_intro("phq9", fn_or_text)`), so scales started by the engine (`scale_due`, rule actions) get
+the flow's friendly intro without the flow hooking `scale.<id>` itself.
+"""
+
+from collections.abc import Callable
+from dataclasses import replace
+from datetime import timedelta
+from typing import Any
+
+from app.core.privacy import scrub
+from app.core.scales import Item, ScaleDef, ScaleResult, load_scale, score
+from app.db import repo
+from app.dialog.contracts import Button, Event, Reply
+from app.dialog.crisis import crisis_open, open_crisis
+from app.dialog.fsm import RESTING_STATES, Ctx, Step, abandonable, is_abandonable, on_enter, state
+
+PREFIX = "scale"
+
+# (ctx, scale_id, scheduled, return_state) → intro text or None (no intro in this situation).
+IntroFn = Callable[[Ctx, str, bool, str], str | None]
+_intros: dict[str, str | IntroFn] = {}
+
+
+def register_scale_intro(scale_id: str, intro: str | IntroFn, *, replace: bool = False) -> None:
+    """Register the intro shown before `scale_id` when a session is started without an explicit `intro`."""
+    if scale_id in _intros and not replace:
+        raise ValueError(f"intro of scale '{scale_id}' already registered (use replace=True to override)")
+    _intros[scale_id] = intro
+
+
+def scale_intro(ctx: Ctx, scale_id: str, *, scheduled: bool, return_state: str) -> str | None:
+    intro = _intros.get(scale_id)
+    if intro is None or isinstance(intro, str):
+        return intro or None
+    return intro(ctx, scale_id, scheduled, return_state) or None
+
+
+def scale_state(scale_id: str) -> str:
+    return f"{PREFIX}.{scale_id}"
+
+
+def active_scale(state_name: str) -> str | None:
+    return state_name.split(".", 1)[1] if state_name.startswith(PREFIX + ".") else None
+
+
+def add_pending(data: dict[str, Any], scale_id: str, scheduled: bool) -> list[dict[str, Any]]:
+    """Queue a scale to start at the next resting state (idle/crisis); duplicates are ignored."""
+    pending = list(data.get("pending_scales") or [])
+    if scale_id not in {p["scale"] for p in pending}:
+        pending.append({"scale": scale_id, "scheduled": scheduled})
+    return pending
+
+
+async def start_scale(
+    ctx: Ctx, scale_id: str, *, return_state: str, scheduled: bool = True, intro: str | None = None
+) -> Step:
+    """Begin a session of `scale_id`; returns a Step moving the FSM to `scale.<id>`.
+
+    `scheduled=False` marks an unscheduled administration (triggered by a rule or a safety signal).
+    `intro` — optional extra text shown before the scale instruction; None → the registered intro, if any.
+    """
+    scale = load_scale(scale_id)  # fail fast on an unknown id
+    if intro is None:
+        intro = scale_intro(ctx, scale_id, scheduled=scheduled, return_state=return_state)
+    sessions = dict(ctx.data.get("scales") or {})
+    sessions[scale_id] = {
+        "idx": 0,
+        "answers": {},
+        "return_state": return_state,
+        "scheduled": scheduled,
+        "intro": intro,
+        "intro_shown": False,
+    }
+    target = scale_state(scale_id)
+    if ctx.state == target:  # restart in place: the enter hook would not run
+        sessions[scale_id]["intro_shown"] = True
+        return Step(replies=[_question(ctx, scale, sessions[scale_id], intro=True)], data={"scales": sessions})
+    return Step(next_state=target, data={"scales": sessions})
+
+
+def _question(ctx: Ctx, scale: ScaleDef, session: dict[str, Any], *, intro: bool = False, note: str = "") -> Reply:
+    idx = session["idx"]
+    item = scale.items[idx]
+    parts: list[str] = []
+    if note:
+        parts.append(note)
+    if intro:
+        if session.get("intro"):
+            parts.append(session["intro"])
+        parts.append(ctx.texts.scale.intro.format(count=len(scale.items), instruction=scale.instruction or "").strip())
+    parts.append(ctx.texts.scale.question.format(n=idx + 1, total=len(scale.items), text=item.text))
+    buttons = [[Button(label=o.label, data=f"{PREFIX}:{scale.id}:{item.id}:{o.value}")] for o in item.options]
+    return Reply(text="\n\n".join(parts), buttons=buttons, kind="question")
+
+
+def _session(ctx: Ctx) -> tuple[ScaleDef, dict[str, Any]] | None:
+    scale_id = active_scale(ctx.state)
+    session = (ctx.data.get("scales") or {}).get(scale_id) if scale_id else None
+    if scale_id is None or session is None:
+        return None
+    return load_scale(scale_id), session
+
+
+def _abandon_allowed(ctx: Ctx) -> bool:
+    """A silent scale session may be abandoned only if what it returns to may be (idle, a check-in step) —
+    never an onboarding chain, which would otherwise be skipped."""
+    found = _session(ctx)
+    if found is None:
+        return True
+    back = str(found[1].get("return_state") or "idle")
+    if back in RESTING_STATES:
+        return True
+    return back != ctx.state and is_abandonable(replace(ctx, state=back))
+
+
+abandonable(PREFIX, _abandon_allowed)
+
+
+async def recent_risk_screen(ctx: Ctx, screen: str) -> bool:
+    """A complete risk screen (C-SSRS) less than `cssrs_cooldown_hours` ago (scale_results, any trigger)."""
+    since = ctx.now - timedelta(hours=ctx.texts.settings.cssrs_cooldown_hours)
+    results = await repo.list_scale_results(ctx.session, ctx.token, screen)
+    return any(r.complete and r.ts >= since for r in results)
+
+
+@on_enter(PREFIX)
+async def _enter(ctx: Ctx) -> Step:
+    found = _session(ctx)
+    if found is None:
+        return Step(next_state="idle")
+    scale, session = found
+    show_intro = session["idx"] == 0 and not session.get("intro_shown")
+    updated = {**session, "intro_shown": True}
+    sessions = {**(ctx.data.get("scales") or {}), scale.id: updated}
+    return Step(replies=[_question(ctx, scale, updated, intro=show_intro)], data={"scales": sessions})
+
+
+def _parse_button(data: str, scale: ScaleDef, item: Item) -> int | None:
+    parts = data.split(":")
+    if len(parts) != 4 or parts[0] != PREFIX or parts[1] != scale.id or parts[2] != item.id:
+        return None  # stale button from an earlier question
+    try:
+        value = int(parts[3])
+    except ValueError:
+        return None
+    return value if value in {o.value for o in item.options} else None
+
+
+@state(PREFIX)
+async def _handle(ctx: Ctx, event: Event) -> Step:
+    found = _session(ctx)
+    if found is None:
+        return Step(next_state="idle")
+    scale, session = found
+    item = scale.items[session["idx"]]
+
+    if event.type == "button" and event.button:
+        value = _parse_button(event.button, scale, item)
+        if value is not None:
+            return await _record(ctx, scale, session, item, value, source="button")
+        return Step(replies=[_question(ctx, scale, session)])
+
+    if event.type == "text" and ctx.text is not None:
+        if item.buttons_only:
+            # Safety items are never LLM-interpreted: ask again for a button.
+            return Step(replies=[_question(ctx, scale, session, note=ctx.texts.scale.buttons_only)])
+        extracted = await ctx.gateway.extract_item(item.id, item.text, item.max_value, ctx.text)
+        if extracted is None or extracted.score not in {o.value for o in item.options}:
+            return Step(replies=[_question(ctx, scale, session, note=ctx.texts.scale.clarify)])
+        return await _record(
+            ctx,
+            scale,
+            session,
+            item,
+            extracted.score,
+            source="llm",
+            confidence=extracted.confidence,
+            evidence=extracted.evidence,
+        )
+
+    if event.type == "system":
+        return Step()  # reminders etc. do not interrupt a questionnaire
+    return Step(replies=[_question(ctx, scale, session)])
+
+
+async def _record(
+    ctx: Ctx,
+    scale: ScaleDef,
+    session: dict[str, Any],
+    item: Item,
+    value: int,
+    *,
+    source: str,
+    confidence: float | None = None,
+    evidence: str = "",
+) -> Step:
+    await repo.add_item_response(
+        ctx.session,
+        token=ctx.token,
+        scale=scale.id,
+        item_id=item.id,
+        score=value,
+        source=source,
+        ts=ctx.now,
+        confidence=confidence,
+        # Evidence is a quote of already scrubbed text; scrub again so nothing unscrubbed can be stored.
+        evidence=scrub(evidence) if evidence else None,
+    )
+    answers = {**session["answers"], item.id: value}
+    profile = await ctx.profile()
+    sex = profile.sex if profile is not None and profile.sex in ("m", "f") else None
+    result = score(scale.id, answers, sex=sex)  # type: ignore[arg-type]
+    crisis_flags = [f for f in result.flags if f in ctx.texts.settings.crisis_flags]
+    if crisis_flags or session["idx"] + 1 >= len(scale.items):
+        return await _finish(ctx, scale, session, answers, result, crisis_flags)
+    updated = {**session, "answers": answers, "idx": session["idx"] + 1}
+    sessions = {**(ctx.data.get("scales") or {}), scale.id: updated}
+    return Step(replies=[_question(ctx, scale, updated)], data={"scales": sessions})
+
+
+async def _finish(
+    ctx: Ctx,
+    scale: ScaleDef,
+    session: dict[str, Any],
+    answers: dict[str, int],
+    result: ScaleResult,
+    crisis_flags: list[str],
+) -> Step:
+    await repo.add_scale_result(
+        ctx.session,
+        token=ctx.token,
+        scale=scale.id,
+        total=result.total,
+        severity=result.severity_code,
+        complete=result.complete,
+        ts=ctx.now,
+        # PHQ-9 item 9 is stored separately: any value >= 1 escalates regardless of the total.
+        item9=answers.get("phq9_9") if scale.id == "phq9" else None,
+        scheduled=bool(session.get("scheduled", True)),
+        flags={f: True for f in result.flags},
+    )
+    sessions = {k: v for k, v in (ctx.data.get("scales") or {}).items() if k != scale.id}
+    done = Step(
+        replies=[Reply(text=ctx.texts.scale.done)],
+        next_state=session["return_state"],
+        data={"scales": sessions},
+        notify_monitoring=True,
+    )
+    if not crisis_flags:
+        return done
+
+    # Crisis path decided by the scale's own flags (deterministic), not by the LLM.
+    risk_screen = ctx.texts.settings.risk_screen_scale
+    if crisis_open(ctx.data):
+        crisis = Step(next_state="crisis")
+    else:
+        crisis = open_crisis(ctx, categories=[], source=f"scale:{scale.id}")
+    step = done.then(crisis)
+    # Same-day repeat guard: a C-SSRS completed within the cooldown already answered the screening question.
+    if scale.id != risk_screen and not await recent_risk_screen(ctx, risk_screen):
+        step.data["pending_scales"] = add_pending(ctx.data, risk_screen, scheduled=False)
+    return step

app/dialog/texts.py

@@ -0,0 +1,125 @@
+"""Patient-facing dialog texts from `config/texts/dialog.yaml` (ADR-008: texts live in config, not code)."""
+
+from functools import lru_cache
+from pathlib import Path
+
+import yaml
+from pydantic import BaseModel, ConfigDict, Field
+
+from app.config import get_settings
+from app.core.safety import fill_phones
+
+
+class _Strict(BaseModel):
+    # A typo in a YAML key must fail at load time, not silently show an empty message to a patient.
+    model_config = ConfigDict(extra="forbid", frozen=True)
+
+
+class DialogSettings(_Strict):
+    cssrs_cooldown_hours: float = 24
+    max_safety_events: int = 50
+    crisis_flags: list[str] = Field(default_factory=list)
+    risk_screen_scale: str = "cssrs_screen"
+    abandon_after_hours: float = 6
+
+
+class Commands(_Strict):
+    revoke: list[str]
+
+
+class ConsentTexts(_Strict):
+    version: str
+    text: str
+    accept: str
+    decline: str
+    refused: str
+    reconsider: str
+    code_invalid: str
+
+
+class AgeGateTexts(_Strict):
+    question: str
+    adult: str
+    minor: str
+    unclear: str
+    minor_stop: str
+
+
+class IdleButtons(_Strict):
+    checkin: str
+    med_question: str
+    kb_question: str
+    contact_doctor: str
+    revoke: str
+
+
+class IdleTexts(_Strict):
+    welcome: str
+    menu_prompt: str
+    buttons: IdleButtons
+    stub_checkin: str
+    stub_med_question: str
+    contact_doctor_ack: str
+    visit_stub: str
+
+
+class RevokedTexts(_Strict):
+    confirm: str
+
+
+class CrisisTexts(_Strict):
+    repeat: str
+    hold: str
+    closed: str
+
+
+class ScaleTexts(_Strict):
+    intro: str
+    question: str
+    clarify: str
+    buttons_only: str
+    done: str
+    risk_screen_intro: str
+
+
+class SafetyPlanTexts(_Strict):
+    title: str
+    template: list[str]
+    means_restriction: str
+
+
+class ReachOutTexts(_Strict):
+    silence: str
+    missed_doses: str
+    default: str
+    after_crisis: str
+
+
+class VisitTexts(_Strict):
+    button: str
+
+
+class DialogTexts(_Strict):
+    status: str
+    settings: DialogSettings
+    commands: Commands
+    consent: ConsentTexts
+    age_gate: AgeGateTexts
+    idle: IdleTexts
+    revoked: RevokedTexts
+    crisis: CrisisTexts
+    scale: ScaleTexts
+    safety_plan: SafetyPlanTexts
+    reach_out: ReachOutTexts
+    visit: VisitTexts
+    unavailable: str
+
+
+def dialog_texts_path() -> Path:
+    return get_settings().config_dir / "texts" / "dialog.yaml"
+
+
+@lru_cache
+def load_dialog_texts(path: Path | None = None) -> DialogTexts:
+    path = path or dialog_texts_path()
+    return DialogTexts.model_validate(yaml.safe_load(fill_phones(path.read_text(encoding="utf-8"))))

app/integrations/__init__.py

@@ -0,0 +1,51 @@
+"""Demo adapters behind the frozen integration Protocols (SPEC §9, #14).
+
+`setup()` runs when the package is first imported. Every consumer imports `app.integrations.base`, which
+initialises this package first, and `app/main.py` is a frozen contract — so the registry is wired before
+any request or job without a startup hook. Setup only constructs objects: data files and DB sessions are
+opened lazily on the first call, so importing the package never fails on I/O.
+
+Registry after setup:
+- `prescriptions` — `MisMock`: clinical DB `prescriptions`, then `data/meds/mis_prescriptions.json`;
+- `identity` — `ConnectCodeIdentity`: one-time connect code from the doctor (ЕСИА stand-in);
+- `drug_info` — `GrlsExcerpts`: `data/meds/grls/*.yaml`;
+- `notifier` — `CompositeNotifier`: in-memory dashboard feed + optional Telegram doctor chat;
+- `outbox` — unchanged `MemoryOutbox` (the web console drains it; the Telegram channel wraps it at start).
+"""
+
+from app.integrations.base import (
+    EmptyPrescriptions,
+    MemoryNotifier,
+    NoDrugInfo,
+    RejectIdentity,
+    integrations,
+)
+from app.integrations.connect_code import ConnectCodeIdentity
+from app.integrations.grls import GrlsExcerpts
+from app.integrations.mis_mock import MisMock
+from app.integrations.notify import CompositeNotifier, NotificationFeed
+
+__all__ = ["CompositeNotifier", "ConnectCodeIdentity", "GrlsExcerpts", "MisMock", "NotificationFeed", "setup"]
+
+_done = False
+
+
+def setup(*, force: bool = False) -> None:
+    """Register the demo adapters. Idempotent; never replaces an adapter someone already swapped in
+    (a test fake, the Telegram outbox), only the in-memory defaults from `base.py` — unless `force`."""
+    global _done
+    if _done and not force:
+        return
+    if force or isinstance(integrations.prescriptions, EmptyPrescriptions):
+        integrations.prescriptions = MisMock()
+    if force or isinstance(integrations.identity, RejectIdentity):
+        integrations.identity = ConnectCodeIdentity()
+    if force or isinstance(integrations.drug_info, NoDrugInfo):
+        integrations.drug_info = GrlsExcerpts()
+    # Exact type check: MemoryNotifier subclasses used as test sinks must stay in place.
+    if force or type(integrations.notifier) is MemoryNotifier:
+        integrations.notifier = CompositeNotifier()
+    _done = True
+
+
+setup()

app/integrations/connect_code.py

@@ -0,0 +1,58 @@
+"""ЕСИА stand-in: the patient proves identity with the one-time connect code issued by the doctor.
+
+The doctor creates the code in «Подключить пациента» (identity DB `connect_codes`); the patient opens the
+QR deep link / enters the code. In prod this is ЕСИА OAuth; the `IdentityProvider` Protocol stays the same.
+"""
+
+import logging
+from datetime import UTC, timedelta
+
+from sqlalchemy.exc import SQLAlchemyError
+
+from app.core import clock
+from app.integrations.base import VerifiedPerson
+
+log = logging.getLogger(__name__)
+
+# One connect flow verifies the same code twice: the Telegram channel on `/start <code>` (to bind the chat)
+# and then the dialog engine's `new` state (to check the code belongs to this token). A short grace window
+# lets the second check pass; after it a used code is rejected like an unknown one.
+REDEEM_GRACE = timedelta(minutes=15)
+
+
+class ConnectCodeIdentity:
+    """`IdentityProvider` over identity-DB connect codes."""
+
+    def __init__(self, grace: timedelta = REDEEM_GRACE) -> None:
+        self.grace = grace
+
+    async def verify(self, auth_code: str) -> VerifiedPerson | None:
+        code = auth_code.strip()
+        if not code:
+            return None
+        # Imported lazily: the integrations package is imported by clinical-side modules, which must not
+        # pull the identity schema into their import graph (guardrail #5).
+        from app.db import identity_repo
+        from app.db.identity import ConnectCode
+        from app.db.session import get_identity_session
+
+        now = clock.now()
+        try:
+            async with get_identity_session() as s:
+                row = await s.get(ConnectCode, code)
+                if row is None:
+                    log.info("connect code rejected: unknown")
+                    return None
+                person = VerifiedPerson(token=row.token, doctor_id=row.doctor_id)
+                if row.used_at is not None:
+                    used_at = row.used_at if row.used_at.tzinfo else row.used_at.replace(tzinfo=UTC)
+                    if now - used_at <= self.grace:
+                        return person
+                    log.info("connect code rejected: already used")
+                    return None
+                if await identity_repo.redeem_connect_code(s, code=code, now=now) is None:
+                    return None
+                return person
+        except (OSError, SQLAlchemyError) as exc:
+            log.warning("connect code check failed error=%s", type(exc).__name__)
+            return None

app/integrations/emias_mock.py

@@ -0,0 +1,35 @@
+"""ЕМИАС sign-in mock for the patient web app (SPEC §9 `esia_mock`: registration by the doctor's code).
+
+Real ЕМИАС / ЕСИА OAuth needs a registered information system, so the prototype accepts the one-time connect
+code the doctor hands out after the visit (323-FZ art. 36.2): code → patient token + attending doctor. The
+class implements `IdentityProvider`, so the real OAuth client replaces it without touching the web channel.
+
+It is deliberately NOT installed into `integrations.identity`: the Telegram channel verifies a code twice
+(on `/start` and in the core flow), which a one-time redeeming provider would break. Lane B wires the
+production provider for all channels (#14).
+
+This module may use the identity DB: it is the registration boundary (guardrail #5).
+"""
+
+from app.core import clock
+from app.db import identity_repo
+from app.db.identity import ConnectCode
+from app.db.session import get_identity_session
+from app.integrations.base import VerifiedPerson
+
+CODE_MAX_LEN = 32
+
+
+class EmiasMock:
+    async def verify(self, auth_code: str) -> VerifiedPerson | None:
+        code = auth_code.strip().upper()
+        if not code or len(code) > CODE_MAX_LEN:
+            return None
+        async with get_identity_session() as s:
+            row = await s.get(ConnectCode, code)
+            if row is None:
+                return None
+            token = await identity_repo.redeem_connect_code(s, code=code, now=clock.now())
+            if token is None:
+                return None
+            return VerifiedPerson(token=token, doctor_id=row.doctor_id)

app/integrations/emias_record.py

@@ -0,0 +1,94 @@
+"""ЕМИАС medical record mock: diagnoses, comorbidities, allergies and other specialists' prescriptions.
+
+Prod: the regional МИС / ЕГИСЗ adapter replaces `EmiasRecordSource` (same `get(token)` contract). Demo: synthetic
+records from `data/emias/records.yaml` keyed by synthetic SNILS, converted to tokens with `pseudo_id()` at load
+time — so the record handed to the chat agent carries no SNILS, name or phone (guardrail #1). The current
+psychiatric prescription comes from the МИС mock (`integrations.prescriptions`).
+"""
+
+import logging
+from functools import lru_cache
+from pathlib import Path
+
+import yaml
+from pydantic import BaseModel, Field
+
+from app.config import get_settings
+from app.core.privacy import pseudo_id
+from app.integrations.base import integrations
+
+log = logging.getLogger(__name__)
+
+
+class Diagnosis(BaseModel):
+    code: str
+    name: str
+
+
+class Condition(BaseModel):
+    name: str
+    tags: list[str] = Field(default_factory=list)
+
+
+class OtherMedication(BaseModel):
+    drug: str
+    how: str = ""
+    prescribed_by: str = ""
+    classes: list[str] = Field(default_factory=list)
+
+
+class CurrentPrescription(BaseModel):
+    drug: str
+    dose: str
+    instructions: str = ""
+
+
+class PatientRecord(BaseModel):
+    """Clinical-only view of the record (no identifiers): what the chat agent may see."""
+
+    diagnoses: list[Diagnosis] = Field(default_factory=list)
+    conditions: list[Condition] = Field(default_factory=list)
+    allergies: list[Condition] = Field(default_factory=list)
+    other_medications: list[OtherMedication] = Field(default_factory=list)
+    pregnancy: dict[str, str] | None = None
+    current_prescriptions: list[CurrentPrescription] = Field(default_factory=list)
+
+
+def default_records_path() -> Path:
+    return get_settings().data_dir / "emias" / "records.yaml"
+
+
+@lru_cache
+def _load(path: Path) -> dict[str, PatientRecord]:
+    raw = yaml.safe_load(path.read_text(encoding="utf-8")) or {}
+    out: dict[str, PatientRecord] = {}
+    for snils, rec in (raw.get("records") or {}).items():
+        out[pseudo_id(snils)] = PatientRecord.model_validate(rec)
+    return out
+
+
+class EmiasRecordSource:
+    def __init__(self, path: Path | None = None) -> None:
+        self._path = path
+
+    async def get(self, token: str) -> PatientRecord | None:
+        try:
+            base = _load(self._path or default_records_path()).get(token)
+        except (OSError, yaml.YAMLError, ValueError) as exc:
+            log.error("emias records unavailable: %s", type(exc).__name__)
+            base = None
+        record = base.model_copy(deep=True) if base is not None else PatientRecord()
+        try:
+            rx = await integrations.prescriptions.get_prescriptions(token)
+        except Exception as exc:  # noqa: BLE001 — the МИС being down must not break the chat
+            log.error("prescriptions unavailable: %s", type(exc).__name__)
+            rx = []
+        record.current_prescriptions = [
+            CurrentPrescription(drug=p.drug, dose=p.dose, instructions=p.instructions) for p in rx
+        ]
+        if base is None and not rx:
+            return None
+        return record
+
+
+emias_records = EmiasRecordSource()

app/integrations/grls.py

@@ -0,0 +1,80 @@
+"""ГРЛС stand-in: short excerpts of the official drug instruction, per section (SPEC §9, SPEC §7 п.5).
+
+Each `data/meds/grls/<name>.yaml` holds one drug:
+
+    inn: сертралин
+    aliases: [sertraline]
+    sections:
+      side_effects: {text: "...", source: "ГРЛС, инструкция по медицинскому применению, раздел «...»"}
+
+Section codes are the ones `app/llm/med_qa.py` understands (side_effects, onset, alcohol, discontinuation,
+administration, interactions, overdose). The bot answers drug questions ONLY from these texts, so they are
+the single place to verify against the current ГРЛС instruction (see the header of each file).
+"""
+
+import logging
+from pathlib import Path
+
+import yaml
+from pydantic import BaseModel, Field, ValidationError
+
+from app.config import get_settings
+from app.integrations.base import DrugSection
+
+log = logging.getLogger(__name__)
+
+
+class _SectionFile(BaseModel):
+    text: str
+    source: str
+
+
+class _DrugFile(BaseModel):
+    inn: str
+    aliases: list[str] = Field(default_factory=list)
+    sections: dict[str, _SectionFile]
+
+
+def default_grls_dir() -> Path:
+    return get_settings().data_dir / "meds" / "grls"
+
+
+def normalize_inn(name: str) -> str:
+    """Lookup key: «Сертралин 50 мг», «сертралин», «Sertraline» -> first word, lower case, ё -> е."""
+    words = name.strip().lower().replace("ё", "е").split()
+    return words[0] if words else ""
+
+
+class GrlsExcerpts:
+    """`DrugInfo` over local YAML excerpts. Files are read lazily on the first lookup and cached."""
+
+    def __init__(self, directory: Path | None = None) -> None:
+        self._dir = directory
+        self._index: dict[str, list[DrugSection]] | None = None
+
+    def _load(self) -> dict[str, list[DrugSection]]:
+        if self._index is not None:
+            return self._index
+        directory = self._dir or default_grls_dir()
+        index: dict[str, list[DrugSection]] = {}
+        for path in sorted(directory.glob("*.yaml")):
+            try:
+                drug = _DrugFile.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
+            except (OSError, yaml.YAMLError, ValidationError) as exc:
+                log.warning("grls file skipped file=%s error=%s", path.name, type(exc).__name__)
+                continue
+            sections = [
+                DrugSection(inn=drug.inn, section=code, text=" ".join(s.text.split()), source=s.source)
+                for code, s in drug.sections.items()
+            ]
+            for key in (drug.inn, *drug.aliases):
+                index[normalize_inn(key)] = sections
+        self._index = index
+        return index
+
+    def known(self) -> list[str]:
+        """INNs with excerpts (for the dashboard / tests)."""
+        return sorted({s[0].inn for s in self._load().values() if s})
+
+    async def sections(self, inn: str) -> list[DrugSection]:
+        return [s.model_copy() for s in self._load().get(normalize_inn(inn), [])]

app/integrations/max_store.py

@@ -0,0 +1,201 @@
+"""Registration boundary and durable MAX queue. Callers own the identity transaction.
+
+Only this boundary joins a pseudonymous profile to a MAX recipient. Clinical modules never import it.
+Queue rows contain a template name, never replies, scores, prescriptions or patient-auth tokens in URLs.
+"""
+
+import hashlib
+import secrets
+from datetime import datetime, timedelta
+
+from sqlalchemy import delete, select, update
+from sqlalchemy.exc import IntegrityError
+from sqlalchemy.ext.asyncio import AsyncSession
+
+from app.db import repo
+from app.db.clinical import ScaleResult
+from app.db.intake import QuestionnaireRecord
+from app.db.max_notifications import MaxBinding, MaxDelivery, MaxLinkCode
+from app.db.session import get_clinical_session
+
+MAX_ATTEMPTS = 6
+LEASE_SECONDS = 60
+
+
+def digest(value: str) -> str:
+    return hashlib.sha256(value.encode()).hexdigest()
+
+
+async def active_patient(token: str) -> bool:
+    """Same consent/adult gate used by the scheduler, checked again at delivery time."""
+    async with get_clinical_session() as session:
+        state = await repo.get_dialog_state(session, token)
+        return bool(
+            await repo.get_profile(session, token)
+            and state
+            and state.data.get("consent") is True
+            and state.data.get("adult") is True
+        )
+
+
+async def issue_code(session: AsyncSession, token: str, now: datetime, ttl: int) -> tuple[str, datetime]:
+    raw = secrets.token_urlsafe(32)
+    expires = now + timedelta(seconds=ttl)
+    await session.execute(delete(MaxLinkCode).where(MaxLinkCode.token == token))
+    session.add(MaxLinkCode(digest=digest(raw), token=token, expires_at=expires))
+    await session.flush()
+    return raw, expires
+
+
+async def code_token(session: AsyncSession, raw: str, now: datetime) -> str | None:
+    row = await session.get(MaxLinkCode, digest(raw))
+    return row.token if row and row.used_at is None and row.expires_at > now else None
+
+
+async def bind(session: AsyncSession, raw: str, user_id: int, now: datetime) -> str | None:
+    """Atomically consume a code. Existing active identities cannot be silently reassigned."""
+    token = await code_token(session, raw, now)
+    if token is None:
+        return None
+    owner = await session.scalar(select(MaxBinding).where(MaxBinding.user_id == user_id))
+    binding = await session.get(MaxBinding, token)
+    if owner and owner.token != token and owner.enabled:
+        return None
+    if binding and binding.user_id != user_id and binding.enabled:
+        return None
+    used = await session.execute(
+        update(MaxLinkCode)
+        .where(MaxLinkCode.digest == digest(raw), MaxLinkCode.used_at.is_(None), MaxLinkCode.expires_at > now)
+        .values(used_at=now)
+        .returning(MaxLinkCode.token)
+    )
+    if used.scalar_one_or_none() is None:
+        return None
+    if owner and owner.token != token:
+        await session.delete(owner)
+        await session.flush()
+    if binding is None:
+        binding = MaxBinding(token=token, user_id=user_id, connected_at=now)
+        session.add(binding)
+    # Cancel stale deliveries even when the same account reconnects later.
+    await cancel_pending(session, token)
+    binding.user_id, binding.enabled, binding.connected_at = user_id, True, now
+    await session.flush()
+    return token
+
+
+async def cancel_pending(session: AsyncSession, token: str) -> None:
+    await session.execute(
+        update(MaxDelivery)
+        .where(MaxDelivery.token == token, MaxDelivery.state.in_(("queued", "sending")))
+        .values(state="cancelled", lease=None)
+    )
+
+
+async def disconnect(session: AsyncSession, token: str) -> None:
+    binding = await session.get(MaxBinding, token)
+    if binding:
+        binding.enabled = False
+    await session.execute(delete(MaxLinkCode).where(MaxLinkCode.token == token))
+    await cancel_pending(session, token)
+
+
+async def enqueue(
+    session: AsyncSession, *, key: str, user_id: int, kind: str, now: datetime, token: str | None = None
+) -> None:
+    if await session.get(MaxDelivery, key) is not None:
+        return
+    try:
+        async with session.begin_nested():
+            session.add(
+                MaxDelivery(id=key, user_id=user_id, token=token, kind=kind, created_at=now, next_attempt_at=now)
+            )
+            await session.flush()
+    except IntegrityError:
+        # Another worker may enqueue the same event between SELECT and INSERT.
+        if await session.get(MaxDelivery, key) is None:
+            raise
+
+
+async def collect_completed(session: AsyncSession, now: datetime) -> None:
+    """Recover completion events from committed clinical records, including after a restart.
+
+    No clinical hooks depend on identity. Read only IDs/dates, then enqueue a generic template.
+    A binding's activation time bounds history; repeated scans are idempotent.
+    """
+    bindings = (await session.scalars(select(MaxBinding).where(MaxBinding.enabled.is_(True)))).all()
+    for binding in bindings:
+        if not await active_patient(binding.token):
+            continue
+        async with get_clinical_session() as clinical:
+            forms = (
+                await clinical.scalars(
+                    select(QuestionnaireRecord.id).where(
+                        QuestionnaireRecord.token == binding.token,
+                        QuestionnaireRecord.status == "complete",
+                        QuestionnaireRecord.completed_at >= binding.connected_at,
+                    )
+                )
+            ).all()
+            scales = (
+                await clinical.scalars(
+                    select(ScaleResult.id).where(
+                        ScaleResult.token == binding.token,
+                        ScaleResult.complete.is_(True),
+                        ScaleResult.ts >= binding.connected_at,
+                    )
+                )
+            ).all()
+        for source, ids in (("form", forms), ("scale", scales)):
+            for record_id in ids:
+                key = digest(f"completed:{binding.token}:{binding.connected_at.isoformat()}:{source}:{record_id}")
+                await enqueue(session, key=key, token=binding.token, user_id=binding.user_id, kind="completed", now=now)
+
+
+async def claim(session: AsyncSession, now: datetime) -> MaxDelivery | None:
+    """One lease per row; recovery after a worker crash is bounded by the lease deadline."""
+    ready = (MaxDelivery.state.in_(("queued", "sending"))) & (MaxDelivery.next_attempt_at <= now)
+    row = await session.scalar(
+        select(MaxDelivery)
+        .where(ready)
+        .order_by(MaxDelivery.created_at, MaxDelivery.id)
+        .with_for_update(skip_locked=True)
+        .limit(1)
+    )
+    if row is None:
+        return None
+    if row.attempts >= MAX_ATTEMPTS:
+        row.state, row.error_code, row.lease = "failed", "attempt_limit", None
+        return None
+    lease = secrets.token_hex(16)
+    result = await session.execute(
+        update(MaxDelivery)
+        .where(MaxDelivery.id == row.id, ready)
+        .values(
+            state="sending",
+            attempts=MaxDelivery.attempts + 1,
+            lease=lease,
+            next_attempt_at=now + timedelta(seconds=LEASE_SECONDS),
+        )
+        .returning(MaxDelivery.id)
+    )
+    if result.scalar_one_or_none() is None:
+        return None
+    await session.refresh(row)
+    return row
+
+
+async def finish(
+    session: AsyncSession,
+    row: MaxDelivery,
+    *,
+    state: str,
+    now: datetime,
+    error: str | None = None,
+    retry_seconds: float = 0,
+) -> None:
+    await session.execute(
+        update(MaxDelivery)
+        .where(MaxDelivery.id == row.id, MaxDelivery.lease == row.lease, MaxDelivery.state == "sending")
+        .values(state=state, lease=None, error_code=error, next_attempt_at=now + timedelta(seconds=retry_seconds))
+    )

app/integrations/mis_mock.py

@@ -0,0 +1,97 @@
+"""МИС / ЕГИСЗ stand-in: the patient's prescriptions (SPEC §9).
+
+Source order: the clinical DB table `prescriptions` (written when the doctor connects a patient or by the
+demo seed), then the synthetic catalogue `data/meds/mis_prescriptions.json` keyed by token. In prod this is
+a regional МИС query; the Protocol stays the same.
+"""
+
+import json
+import logging
+from datetime import date
+from pathlib import Path
+from typing import Any
+
+from pydantic import BaseModel, Field, ValidationError
+from sqlalchemy import select
+from sqlalchemy.exc import SQLAlchemyError
+
+from app.config import get_settings
+from app.integrations.base import Prescription
+
+log = logging.getLogger(__name__)
+
+
+class _CatalogPatient(BaseModel):
+    persona: str
+    tokens: list[str] = Field(default_factory=list)
+    prescriptions: list[Prescription]
+
+
+class _Catalog(BaseModel):
+    patients: list[_CatalogPatient]
+
+
+def _from_row(drug: str, dose: str, schedule: dict[str, Any], start: date | None, end: date | None) -> Prescription:
+    # The table has no instructions column; the doctor's note («утром после еды») may ride in the schedule JSON.
+    times = {k: [str(x) for x in v] for k, v in schedule.items() if isinstance(v, list)}
+    return Prescription(
+        drug=drug,
+        dose=dose,
+        schedule=times or {"times": ["08:00"]},
+        instructions=str(schedule.get("instructions") or ""),
+        start_date=start,
+        end_date=end,
+    )
+
+
+def default_catalog_path() -> Path:
+    return get_settings().data_dir / "meds" / "mis_prescriptions.json"
+
+
+class MisMock:
+    """`PrescriptionSource`: clinical DB first, synthetic JSON catalogue as the fallback."""
+
+    def __init__(self, catalog_path: Path | None = None, *, use_db: bool = True) -> None:
+        self._path = catalog_path
+        self._use_db = use_db
+        self._by_token: dict[str, list[Prescription]] | None = None
+
+    def _catalog(self) -> dict[str, list[Prescription]]:
+        # Lazy: the package is imported before startup, a missing/broken file must not break the import.
+        if self._by_token is None:
+            path = self._path or default_catalog_path()
+            index: dict[str, list[Prescription]] = {}
+            try:
+                catalog = _Catalog.model_validate(json.loads(path.read_text(encoding="utf-8")))
+            except (OSError, ValueError, ValidationError) as exc:
+                log.warning("mis_mock catalogue not loaded error=%s", type(exc).__name__)
+                catalog = _Catalog(patients=[])
+            for patient in catalog.patients:
+                for token in patient.tokens:
+                    index[token] = patient.prescriptions
+            self._by_token = index
+        return self._by_token
+
+    async def _from_db(self, token: str) -> list[Prescription]:
+        from app.db.clinical import Prescription as PrescriptionRow
+        from app.db.session import get_clinical_session
+
+        async with get_clinical_session() as s:
+            rows = (
+                await s.scalars(
+                    select(PrescriptionRow).where(PrescriptionRow.token == token).order_by(PrescriptionRow.id)
+                )
+            ).all()
+        return [_from_row(r.drug, r.dose, r.schedule or {}, r.start_date, r.end_date) for r in rows]
+
+    async def get_prescriptions(self, token: str) -> list[Prescription]:
+        if self._use_db:
+            try:
+                found = await self._from_db(token)
+            except (OSError, SQLAlchemyError) as exc:
+                # DB down or not migrated: the demo still shows the catalogue prescription.
+                log.warning("mis_mock db lookup failed error=%s", type(exc).__name__)
+                found = []
+            if found:
+                return found
+        return [p.model_copy(deep=True) for p in self._catalog().get(token, [])]

app/integrations/notify.py

@@ -0,0 +1,141 @@
+"""Doctor notifications (SPEC §9): in-memory feed for the dashboard + optional Telegram doctor chat.
+
+The alert itself is already committed to the clinical DB before `send()` is called (the dashboard reads
+alerts from there via the API), so every channel here is best effort: failures are logged, never raised.
+Messages carry only the level, the rule reason/code and a short pseudonymous patient id — no PII
+(guardrail #8); the reason texts come from `config/rules.yaml`, not from patient messages.
+"""
+
+import asyncio
+import itertools
+import logging
+from collections import deque
+from collections.abc import Awaitable, Callable
+from datetime import datetime
+from typing import Any
+
+from pydantic import BaseModel
+
+from app.config import get_settings
+from app.core import clock
+from app.integrations.base import AlertLevelName
+
+log = logging.getLogger(__name__)
+
+FEED_SIZE = 500
+SHORT_ID_LEN = 6
+MAX_REASON_CHARS = 200
+TELEGRAM_TIMEOUT_S = 5.0
+# Doctor-facing labels (not patient texts); acute alerts are visually distinct in the chat.
+LEVEL_LABELS: dict[str, str] = {
+    "acute": "КРИТИЧНО",
+    "high": "Высокий",
+    "moderate": "Умеренный",
+    "info": "Инфо",
+}
+
+ChatSender = Callable[[int, str], Awaitable[Any]]
+
+
+def short_id(token: str | None) -> str:
+    return token[:SHORT_ID_LEN] if token else "—"
+
+
+def format_message(level: str, text: str, token: str | None) -> str:
+    reason = " ".join(text.split())
+    if len(reason) > MAX_REASON_CHARS:
+        reason = reason[: MAX_REASON_CHARS - 1] + "…"
+    return f"[{LEVEL_LABELS.get(level, level)}] {reason}\nПациент #{short_id(token)}"
+
+
+class Notification(BaseModel):
+    id: int
+    ts: datetime
+    doctor_id: str
+    level: str
+    text: str
+    token: str | None = None
+
+
+class NotificationFeed:
+    """Bounded in-memory feed; ids increase monotonically so a poller asks only for `recent(since_id)`."""
+
+    def __init__(self, size: int = FEED_SIZE) -> None:
+        self._items: deque[Notification] = deque(maxlen=size)
+        self._ids = itertools.count(1)
+
+    def add(self, doctor_id: str, level: str, text: str, token: str | None, ts: datetime) -> Notification:
+        item = Notification(id=next(self._ids), ts=ts, doctor_id=doctor_id, level=level, text=text, token=token)
+        self._items.append(item)
+        return item
+
+    def recent(self, since_id: int = 0, doctor_id: str | None = None) -> list[Notification]:
+        return [n for n in self._items if n.id > since_id and (doctor_id is None or n.doctor_id == doctor_id)]
+
+
+class TelegramDoctorChat:
+    """Sends to the doctor chat `DOCTOR_NOTIFY_CHAT_ID` through the bot `TG_BOT_TOKEN`.
+
+    The aiogram `Bot` is created on the first message only; with either setting empty the channel is off.
+    """
+
+    def __init__(self, chat_id: int | None = None, bot_token: str | None = None, sender: ChatSender | None = None):
+        settings = get_settings()
+        self.chat_id = chat_id if chat_id is not None else settings.doctor_notify_chat_id
+        self._bot_token = bot_token if bot_token is not None else settings.tg_bot_token
+        self._sender = sender
+        self._bot: Any = None
+
+    @property
+    def enabled(self) -> bool:
+        return self.chat_id is not None and (self._sender is not None or bool(self._bot_token))
+
+    def _get_sender(self) -> ChatSender:
+        if self._sender is None:
+            from aiogram import Bot
+
+            self._bot = Bot(self._bot_token)
+            self._sender = self._bot.send_message
+        return self._sender
+
+    async def send(self, level: str, text: str, token: str | None) -> None:
+        if not self.enabled or self.chat_id is None:
+            return
+        try:
+            await asyncio.wait_for(
+                self._get_sender()(self.chat_id, format_message(level, text, token)), timeout=TELEGRAM_TIMEOUT_S
+            )
+        except Exception as exc:  # noqa: BLE001 — any channel error; the alert is already in the DB
+            err = type(exc).__name__
+            log.warning("doctor chat notify failed level=%s tok=%s error=%s", level, short_id(token), err)
+
+    async def aclose(self) -> None:
+        if self._bot is not None:
+            await self._bot.session.close()
+            self._bot = None
+            self._sender = None
+
+
+class CompositeNotifier:
+    """`Notifier`: dashboard feed + Telegram doctor chat (when configured)."""
+
+    def __init__(self, feed: NotificationFeed | None = None, chat: TelegramDoctorChat | None = None) -> None:
+        self.feed = feed or NotificationFeed()
+        self._chat = chat
+
+    @property
+    def chat(self) -> TelegramDoctorChat:
+        # Lazy: settings are read on the first notification, not when the package is imported.
+        if self._chat is None:
+            self._chat = TelegramDoctorChat()
+        return self._chat
+
+    def recent(self, since_id: int = 0, doctor_id: str | None = None) -> list[Notification]:
+        return self.feed.recent(since_id, doctor_id)
+
+    async def send(self, doctor_id: str, level: AlertLevelName, text: str, token: str | None = None) -> None:
+        try:
+            self.feed.add(doctor_id, level, text, token, clock.now())
+        except Exception as exc:  # noqa: BLE001 — never break the caller
+            log.warning("notify feed failed error=%s", type(exc).__name__)
+        await self.chat.send(level, text, token)

app/llm/agent/__init__.py

@@ -0,0 +1,166 @@
+"""Chat agent: tool-using LLM over the knowledge base (RAG), the ЕМИАС record and the drug-safety reference.
+
+    from app.llm.agent import answer_chat
+    reply = await answer_chat(token, scrubbed_question)   # None → caller falls back to extractive RAG / med_qa
+
+Guarantees (on top of what the dialog engine already did — scrub, consent, safety check; ACUTE never gets here):
+  * only scrubbed text goes to the provider (`assert_scrubbed`), tool results carry no identifiers;
+  * tools are bound to the current token server-side; read-only;
+  * the final text passes the gateway's forbidden-output filter (diagnoses, dose/drug advice); a violation or any
+    provider error → None, so the patient gets the safe extractive answer instead;
+  * logs carry tool names and counts only.
+"""
+
+import asyncio
+import json
+import logging
+from typing import Any
+
+from pydantic import BaseModel
+
+from app.config import Settings, get_settings
+from app.core.types import ScrubbedText
+from app.llm.agent.prompts import SYSTEM_PROMPT
+from app.llm.agent.providers import (
+    GigaChatToolProvider,
+    MockAgentProvider,
+    OpenRouterProvider,
+    ProviderError,
+    ToolChatProvider,
+)
+from app.llm.agent.tools import TOOL_SPECS, ToolContext, run_tool
+from app.llm.gateway import is_forbidden
+from app.llm.guard import assert_scrubbed
+
+log = logging.getLogger(__name__)
+
+MAX_ANSWER_CHARS = 1200
+NUDGE = "Сформулируй ответ пациенту по результатам инструментов выше (3–6 предложений)."
+_ALLOWED_MSG_KEYS = {"role", "content", "tool_calls", "tool_call_id"}
+
+
+class AgentAnswer(BaseModel):
+    text: str
+    sources: list[str]
+    tools: list[str]
+    provider: str
+
+
+def build_provider(settings: Settings | None = None) -> ToolChatProvider | None:
+    s = settings or get_settings()
+    mode = s.chat_agent
+    if mode == "auto":
+        mode = "gigachat" if s.gigachat_credentials else "openrouter" if s.openrouter_api_key else "off"
+    if mode == "openrouter":
+        if not s.openrouter_api_key:
+            log.warning("chat agent: openrouter selected without OPENROUTER_API_KEY — disabled")
+            return None
+        return OpenRouterProvider(s)
+    if mode == "mock":
+        return MockAgentProvider()
+    if mode == "gigachat":
+        if not s.gigachat_credentials:
+            log.warning("chat agent: gigachat selected without GIGACHAT_CREDENTIALS — disabled")
+            return None
+        return GigaChatToolProvider(s)
+    return None
+
+
+async def _chat_with_retry(provider: ToolChatProvider, messages: list[dict[str, Any]]):
+    """One retry: OpenRouter occasionally fails a single call (seen live as intermittent ProviderError)."""
+    wire = _wire(messages) if provider.name == "openrouter" else messages  # gigachat needs the tool `name`
+    try:
+        return await provider.chat(wire, TOOL_SPECS)
+    except ProviderError as exc:
+        log.warning("chat agent provider=%s retry after %s", provider.name, exc)
+        return await provider.chat(wire, TOOL_SPECS)
+
+
+async def _patient_brief(ctx: ToolContext) -> str:
+    """One line of context so the model knows what «мои таблетки» means (drug names only, no identifiers)."""
+    rec = await ctx.record()
+    if rec is None or not rec.current_prescriptions:
+        return "\n\nТекущее назначение психиатра: нет данных."
+    drugs = ", ".join(p.drug for p in rec.current_prescriptions)
+    return f"\n\nТекущее назначение психиатра: {drugs}. «Мои таблетки» = это назначение."
+
+
+def _wire(messages: list[dict[str, Any]]) -> list[dict[str, Any]]:
+    """Strip internal keys (tool `name`) before sending."""
+    return [{k: v for k, v in m.items() if k in _ALLOWED_MSG_KEYS} for m in messages]
+
+
+async def answer_chat(
+    token: str, question: ScrubbedText, *, provider: ToolChatProvider | None = None, settings: Settings | None = None
+) -> AgentAnswer | None:
+    s = settings or get_settings()
+    provider = provider or build_provider(s)
+    if provider is None:
+        return None
+    try:
+        assert_scrubbed(question)
+    except ValueError:
+        log.warning("chat agent: unscrubbed input rejected")
+        return None
+    ctx = ToolContext(token=token)
+    messages: list[dict[str, Any]] = [
+        {"role": "system", "content": SYSTEM_PROMPT + await _patient_brief(ctx)},
+        {"role": "user", "content": str(question)},
+    ]
+    nudged = False
+    try:
+        async with asyncio.timeout(s.chat_agent_timeout_s * 2):
+            for _ in range(s.chat_agent_max_steps):
+                turn = await _chat_with_retry(provider, messages)
+                if not turn.tool_calls:
+                    if not (turn.content or "").strip() and not nudged:
+                        # Some models (Gemini Flash) occasionally end with an empty message after tool results.
+                        nudged = True
+                        messages.append({"role": "user", "content": NUDGE})
+                        continue
+                    return _finish(turn.content or "", ctx, provider.name)
+                messages.append(
+                    {
+                        "role": "assistant",
+                        "content": turn.content,
+                        "tool_calls": [
+                            {
+                                "id": c.id,
+                                "type": "function",
+                                "function": {"name": c.name, "arguments": json.dumps(c.arguments, ensure_ascii=False)},
+                            }
+                            for c in turn.tool_calls
+                        ],
+                    }
+                )
+                for c in turn.tool_calls:
+                    result = await run_tool(ctx, c.name, c.arguments)
+                    messages.append({"role": "tool", "tool_call_id": c.id, "name": c.name, "content": result})
+            log.warning("chat agent: step limit reached tools=%s", ",".join(ctx.used))
+            return None
+    except (ProviderError, TimeoutError) as exc:
+        log.error("chat agent provider=%s failed: %s %s", provider.name, type(exc).__name__, exc)
+        return None
+    except Exception:  # noqa: BLE001 — the agent is optional: any bug must degrade to the extractive answer, not a 500
+        log.exception("chat agent provider=%s crashed", provider.name)
+        return None
+
+
+def _finish(text: str, ctx: ToolContext, provider: str) -> AgentAnswer | None:
+    text = text.strip()
+    if not text:
+        return None
+    if is_forbidden(text):
+        log.warning("chat agent: forbidden output filtered provider=%s", provider)
+        return None
+    if len(text) > MAX_ANSWER_CHARS:
+        text = text[:MAX_ANSWER_CHARS].rsplit(" ", 1)[0] + "…"
+    log.info("chat agent ok provider=%s tools=%s sources=%d", provider, ",".join(ctx.used), len(ctx.sources))
+    return AgentAnswer(text=text, sources=ctx.sources[:4], tools=ctx.used, provider=provider)
+
+
+def render(answer: AgentAnswer) -> str:
+    """Patient-facing text: answer + short sources footer."""
+    if not answer.sources:
+        return answer.text
+    return f"{answer.text}\n\nИсточники: " + "; ".join(answer.sources)

app/llm/agent/__main__.py

@@ -0,0 +1,59 @@
+"""Try the chat agent from the shell (synthetic personas only):
+
+    uv run python -m app.llm.agent "Можно мне ибупрофен вместе с моими таблетками?" --persona andrey
+    CHAT_AGENT=mock uv run python -m app.llm.agent "Есть ли лактоза в сертралине?"
+
+Prescriptions come from the МИС mock (DB if reachable, else data/meds/mis_prescriptions.json); the question is
+scrubbed before it reaches any provider.
+"""
+
+import argparse
+import asyncio
+import logging
+
+from app.config import get_settings
+from app.core.privacy import pseudo_id, scrub
+from app.integrations.base import Prescription, integrations
+from app.llm.agent import answer_chat, build_provider, render
+
+PERSONAS = {  # synthetic SNILS from scripts/seed_demo.py → current psychiatric prescription
+    "andrey": ("900-000-013 34", "сертралин"),
+    "dmitry": ("900-000-041 01", "сертралин"),
+    "sergey": ("900-000-037 02", "пароксетин"),
+    "nikolay": ("900-000-052 03", "сертралин"),
+    "anna": ("900-000-023 04", "флуоксетин"),
+    "pavel": ("900-000-045 07", "эсциталопрам"),
+}
+
+
+class _FixedRx:
+    def __init__(self, drug: str) -> None:
+        self.drug = drug
+
+    async def get_prescriptions(self, token: str) -> list[Prescription]:
+        return [Prescription(drug=self.drug, dose="по назначению врача")]
+
+
+async def main() -> None:
+    p = argparse.ArgumentParser()
+    p.add_argument("question")
+    p.add_argument("--persona", default="andrey", choices=sorted(PERSONAS))
+    p.add_argument("-v", "--verbose", action="store_true")
+    a = p.parse_args()
+    logging.basicConfig(level=logging.INFO if a.verbose else logging.WARNING)
+    snils, drug = PERSONAS[a.persona]
+    integrations.prescriptions = _FixedRx(drug)  # CLI runs without the DB
+    provider = build_provider()
+    if provider is None:
+        raise SystemExit(
+            f"agent disabled (CHAT_AGENT={get_settings().chat_agent}); set OPENROUTER_API_KEY or CHAT_AGENT=mock"
+        )
+    ans = await answer_chat(pseudo_id(snils), scrub(a.question), provider=provider)
+    if ans is None:
+        raise SystemExit("no answer (provider error, filtered output or nothing found) — chat falls back to RAG")
+    print(render(ans))
+    print(f"\n[provider={ans.provider} tools={', '.join(ans.tools)}]")
+
+
+if __name__ == "__main__":
+    asyncio.run(main())

app/llm/agent/drug_safety.py

@@ -0,0 +1,147 @@
+"""Deterministic drug-safety lookup: composition, contraindications, interactions, patient-specific findings.
+
+The LLM never decides whether a drug is safe for the patient (ADR-007 spirit): it calls `check_patient` and
+retells the findings. Matching is by tags shared with the ЕМИАС record (`data/emias/records.yaml`):
+condition tags → `cautions[].when_condition`, allergy tags → `composition.excipient_tags`, other medication
+classes → `interactions[].with_class`. Source data: `data/meds/drug_safety.yaml` (prototype retelling of ГРЛС).
+"""
+
+from functools import lru_cache
+from pathlib import Path
+from typing import Literal
+
+import yaml
+from pydantic import BaseModel, Field
+
+from app.config import get_settings
+from app.integrations.emias_record import PatientRecord
+
+Severity = Literal["high", "medium", "low"]
+
+
+class Caution(BaseModel):
+    when_condition: str
+    severity: Severity
+    text: str
+
+
+class Interaction(BaseModel):
+    with_class: str
+    severity: Severity
+    text: str
+
+
+class Composition(BaseModel):
+    form: str
+    active: str
+    excipients: list[str] = Field(default_factory=list)
+    excipient_tags: list[str] = Field(default_factory=list)
+    note: str = ""
+
+
+class DrugEntry(BaseModel):
+    inn: str
+    aliases: list[str] = Field(default_factory=list)
+    drug_class: str = ""
+    classes: list[str] = Field(default_factory=list)  # classes this drug belongs to (e.g. nsaid, ssri)
+    contraindications: list[str] = Field(default_factory=list)
+    cautions: list[Caution] = Field(default_factory=list)
+    interactions: list[Interaction] = Field(default_factory=list)
+    composition: Composition | None = None
+    pregnancy: str = ""
+    source: str = ""
+
+
+class Finding(BaseModel):
+    severity: Severity
+    kind: Literal["condition", "allergy", "interaction", "pregnancy", "contraindication"]
+    text: str
+
+
+class SafetyDb(BaseModel):
+    drugs: dict[str, DrugEntry]
+    allergy_labels: dict[str, str] = Field(default_factory=dict)
+
+
+def _path() -> Path:
+    return get_settings().data_dir / "meds" / "drug_safety.yaml"
+
+
+@lru_cache
+def load_db(path: Path | None = None) -> SafetyDb:
+    raw = yaml.safe_load((path or _path()).read_text(encoding="utf-8"))
+    classes_of: dict[str, list[str]] = {}
+    for cls, members in (raw.get("drug_classes") or {}).items():
+        for m in members:
+            classes_of.setdefault(m, []).append(cls)
+    drugs: dict[str, DrugEntry] = {}
+    for inn, d in (raw.get("drugs") or {}).items():
+        entry = DrugEntry(
+            inn=inn,
+            aliases=d.get("aliases", []),
+            drug_class=d.get("class", ""),
+            classes=sorted(set(d.get("classes", [])) | set(classes_of.get(inn, []))),
+            contraindications=d.get("contraindications", []),
+            cautions=d.get("cautions", []),
+            interactions=d.get("interactions", []),
+            composition=d.get("composition"),
+            pregnancy=d.get("pregnancy", ""),
+            source=d.get("source", ""),
+        )
+        drugs[inn] = entry
+    return SafetyDb(drugs=drugs, allergy_labels=raw.get("allergy_labels") or {})
+
+
+def find_drug(name: str, db: SafetyDb | None = None) -> DrugEntry | None:
+    """By INN or alias, case-insensitive; "сертралин 50 мг" → сертралин."""
+    db = db or load_db()
+    words = [w.strip(".,!?;:«»()") for w in name.lower().replace("ё", "е").split()]
+    for entry in db.drugs.values():
+        names = {entry.inn, *(a.lower() for a in entry.aliases)}
+        # Russian case endings: "сертралине", "ибупрофена" — match on the stem (name minus the last letter).
+        if any(w in names or any(len(n) > 4 and w.startswith(n[:-1]) for n in names) for w in words):
+            return entry
+    return None
+
+
+def check_patient(drug: DrugEntry, record: PatientRecord, db: SafetyDb | None = None) -> list[Finding]:
+    """Patient-specific findings for `drug`, most severe first. Empty list = nothing found in the reference —
+    which is NOT a statement that the drug is safe (the answer must say so)."""
+    db = db or load_db()
+    out: list[Finding] = []
+    cond_tags = {t for c in record.conditions for t in c.tags}
+    for c in drug.cautions:
+        if c.when_condition in cond_tags:
+            out.append(Finding(severity=c.severity, kind="condition", text=c.text))
+    # Excipients vs allergies / intolerances.
+    allergy_tags = {t for a in record.allergies for t in a.tags}
+    if drug.composition is not None:
+        for tag in sorted(allergy_tags & set(drug.composition.excipient_tags)):
+            label = db.allergy_labels.get(tag, tag)
+            out.append(
+                Finding(
+                    severity="high", kind="allergy", text=f"В составе есть {label}, а в карте отмечена непереносимость."
+                )
+            )
+    # Interactions with the patient's other medicines and with the current psychiatric prescription.
+    other_classes: dict[str, str] = {}
+    for m in record.other_medications:
+        for cls in m.classes:
+            other_classes[cls] = m.drug
+    for rx in record.current_prescriptions:
+        entry = find_drug(rx.drug, db)
+        if entry is not None and entry.inn != drug.inn:
+            for cls in entry.classes:
+                other_classes.setdefault(cls, rx.drug)
+    for i in drug.interactions:
+        if i.with_class in other_classes:
+            out.append(
+                Finding(
+                    severity=i.severity, kind="interaction", text=f"{i.text} (в карте: {other_classes[i.with_class]})."
+                )
+            )
+    if record.pregnancy and drug.pregnancy:
+        out.append(Finding(severity="medium", kind="pregnancy", text=drug.pregnancy))
+    order = {"high": 0, "medium": 1, "low": 2}
+    out.sort(key=lambda f: order[f.severity])
+    return out

app/llm/agent/prompts.py

@@ -0,0 +1,40 @@
+"""System prompt of the chat agent (Russian). Prohibitions follow SPEC §7; grounding: answer only from tools."""
+
+from app.core.safety import fill_phones
+
+_SYSTEM_PROMPT = """Ты — помощник пациента в сервисе сопровождения лечения между визитами к врачу. Пациент лечится у
+психиатра; ты отвечаешь на его вопросы о состоянии, лечении и лекарствах.
+
+Как работать:
+1. Сначала собери данные инструментами. Для вопросов о лекарствах, сочетаниях, составе, аллергиях всегда
+   вызывай get_patient_record и check_drug_for_patient (для каждого упомянутого препарата и, если вопрос
+   о «моих таблетках», для текущего назначения). Вопросы об алкоголе, еде, вождении, сочетании с другими
+   средствами, составе и непереносимостях — тоже вопросы о лекарстве: проверь текущее назначение через
+   check_drug_for_patient (там есть состав, сравнение с непереносимостями и все взаимодействия).
+   Вопросы «когда подействует», «что будет, если бросить», «как принимать», побочные эффекты — смотри поле
+   instruction в check_drug_for_patient (инструкция ГРЛС) и дополняй search_guidelines.
+   Для общих вопросов о лечении вызывай search_guidelines.
+2. Отвечай ТОЛЬКО на основе результатов инструментов. Если в них нет ответа — честно скажи, что в
+   рекомендациях и инструкции этого нет, и предложи уточнить у лечащего врача. Ничего не додумывай.
+3. Если check_drug_for_patient вернул findings — назови КАЖДУЮ находку (сначала severity=high) простыми
+   словами и посоветуй обсудить с врачом до приёма. Пустой список не значит «безопасно».
+   Находки (findings) упоминай, когда вопрос о приёме, сочетании или безопасности препарата; на вопросы о
+   сроках действия, отмене, побочных эффектах отвечай по существу, без посторонних находок.
+   Про состав и непереносимости (intolerance_check) говори, только если о них спросили.
+   Про алкоголь бери текст из general_interactions.
+4. Ссылайся на источник в тексте коротко: «по клиническим рекомендациям», «по инструкции к препарату»,
+   «в вашей карте указано».
+
+Запрещено:
+- ставить или называть диагнозы («у вас депрессия»), даже если они есть в карте;
+- назначать, отменять препараты, менять дозы, советовать «примите/не принимайте» — решение всегда за врачом;
+- называть дозировки в миллиграммах;
+- проводить психотерапию; обещать конфиденциальность сверх реальной;
+- выдумывать факты, которых нет в результатах инструментов.
+
+Стиль: по-русски, на «вы», спокойно и по-человечески, 3–6 коротких предложений, без markdown-заголовков.
+Если в вопросе есть признаки угрозы жизни — коротко скажи, что важно сразу позвонить 112 или на телефон
+доверия {phone:helpline}, и что врач будет уведомлён."""
+
+# Numbers come from the single table config/texts/crisis.yaml.
+SYSTEM_PROMPT = fill_phones(_SYSTEM_PROMPT)

app/llm/agent/providers.py

@@ -0,0 +1,268 @@
+"""Tool-calling chat providers for the agent.
+
+* `OpenRouterProvider` — OpenAI-compatible `/chat/completions` with `tools`. TEMPORARY for the prototype on
+  synthetic data: OpenRouter is a foreign service, forbidden for real PII (152-FZ art. 18 p. 5). Replace with
+  GigaChat (function calling) before any real patient — same `ToolChatProvider` contract.
+* `MockAgentProvider` — offline, deterministic: plans tool calls from keywords and composes an answer from the
+  tool results. Keeps the demo working without network (ADR-004).
+"""
+
+import json
+import logging
+import re
+from typing import Any, Protocol
+
+import httpx
+from pydantic import BaseModel, Field
+
+from app.config import Settings
+
+log = logging.getLogger(__name__)
+
+
+class ToolCall(BaseModel):
+    id: str
+    name: str
+    arguments: dict[str, Any] = Field(default_factory=dict)
+
+
+class AssistantTurn(BaseModel):
+    content: str | None = None
+    tool_calls: list[ToolCall] = Field(default_factory=list)
+
+
+class ToolChatProvider(Protocol):
+    name: str
+
+    async def chat(self, messages: list[dict[str, Any]], tools: list[dict[str, Any]]) -> AssistantTurn: ...
+
+
+class ProviderError(RuntimeError):
+    pass
+
+
+class OpenRouterProvider:
+    name = "openrouter"
+
+    def __init__(self, settings: Settings, client: httpx.AsyncClient | None = None) -> None:
+        self._key = settings.openrouter_api_key
+        self._model = settings.openrouter_model
+        self._url = settings.openrouter_base_url.rstrip("/") + "/chat/completions"
+        self._timeout = settings.chat_agent_timeout_s
+        self._client = client
+
+    async def chat(self, messages: list[dict[str, Any]], tools: list[dict[str, Any]]) -> AssistantTurn:
+        body: dict[str, Any] = {"model": self._model, "messages": messages, "tools": tools, "temperature": 0.1}
+        body["max_tokens"] = 900
+        if not any(m["role"] == "tool" for m in messages):
+            body["tool_choice"] = "required"  # never answer from the model's own memory: ground first
+        headers = {"Authorization": f"Bearer {self._key}", "X-Title": "PTSRaiAgent prototype (synthetic data)"}
+        try:
+            if self._client is not None:
+                resp = await self._client.post(self._url, json=body, headers=headers, timeout=self._timeout)
+            else:
+                async with httpx.AsyncClient(timeout=self._timeout) as client:
+                    resp = await client.post(self._url, json=body, headers=headers)
+        except httpx.HTTPError as exc:
+            raise ProviderError(type(exc).__name__) from exc
+        if resp.status_code != 200:
+            # Provider error bodies are generic (no patient text) — log the message to make failures diagnosable.
+            try:
+                err = resp.json().get("error", "")
+                detail = str(err.get("message", "") if isinstance(err, dict) else err)[:200]
+            except (ValueError, AttributeError):
+                detail = resp.text[:200]
+            log.error("openrouter http %s: %s", resp.status_code, detail)
+            raise ProviderError(f"http {resp.status_code}")
+        try:
+            msg = resp.json()["choices"][0]["message"]
+        except (ValueError, KeyError, IndexError) as exc:
+            raise ProviderError("bad response") from exc
+        calls = []
+        for c in msg.get("tool_calls") or []:
+            fn = c.get("function") or {}
+            try:
+                args = json.loads(fn.get("arguments") or "{}")
+            except json.JSONDecodeError:
+                args = {}
+            calls.append(ToolCall(id=c.get("id") or fn.get("name", "call"), name=fn.get("name", ""), arguments=args))
+        usage = resp.json().get("usage") or {}
+        log.info("openrouter ok calls=%d tokens=%s", len(calls), usage.get("total_tokens"))
+        return AssistantTurn(content=msg.get("content"), tool_calls=calls)
+
+
+class GigaChatToolProvider:
+    """GigaChat function calling (RF provider, 152-FZ compliant). Converts the OpenAI-style history the agent keeps:
+    assistant `tool_calls` → `function_call`, `tool` results → role `function` with the function name.
+    GigaChat returns at most one function call per turn — the agent loop handles that naturally."""
+
+    name = "gigachat"
+
+    def __init__(self, settings: Settings, client: Any | None = None) -> None:
+        self._settings = settings
+        self._client = client
+
+    def _get_client(self) -> Any:
+        if self._client is None:
+            from gigachat import GigaChat
+
+            s = self._settings
+            self._client = GigaChat(
+                credentials=s.gigachat_credentials,
+                scope=s.gigachat_scope,
+                model=s.gigachat_agent_model,
+                verify_ssl_certs=s.gigachat_verify_ssl,
+                timeout=s.chat_agent_timeout_s,
+            )
+        return self._client
+
+    @staticmethod
+    def to_messages(messages: list[dict[str, Any]]) -> list[Any]:
+        from gigachat.models import FunctionCall, Messages, MessagesRole
+
+        out = []
+        for m in messages:
+            role = m["role"]
+            if role == "system":
+                out.append(Messages(role=MessagesRole.SYSTEM, content=m["content"]))
+            elif role == "user":
+                out.append(Messages(role=MessagesRole.USER, content=m["content"]))
+            elif role == "assistant":
+                calls = m.get("tool_calls") or []
+                for c in calls or [None]:
+                    fc = None
+                    if c is not None:
+                        fc = FunctionCall(name=c["function"]["name"], arguments=json.loads(c["function"]["arguments"]))
+                    out.append(Messages(role=MessagesRole.ASSISTANT, content=m.get("content") or "", function_call=fc))
+            elif role == "tool":
+                out.append(Messages(role=MessagesRole.FUNCTION, name=m.get("name"), content=m["content"]))
+        return out
+
+    @staticmethod
+    def to_functions(tools: list[dict[str, Any]]) -> list[Any]:
+        from gigachat.models import Function
+
+        return [Function.model_validate(t["function"]) for t in tools]
+
+    async def chat(self, messages: list[dict[str, Any]], tools: list[dict[str, Any]]) -> AssistantTurn:
+        from gigachat.models import Chat
+
+        chat = Chat(
+            messages=self.to_messages(messages),
+            functions=self.to_functions(tools),
+            function_call="auto",
+            temperature=0.1,
+            max_tokens=900,
+        )
+        try:
+            resp = await self._get_client().achat(chat)
+        except Exception as exc:  # noqa: BLE001 — network/auth/HTTP errors of the SDK
+            raise ProviderError(type(exc).__name__) from exc
+        msg = resp.choices[0].message
+        calls = []
+        if msg.function_call is not None:
+            args = msg.function_call.arguments or {}
+            if isinstance(args, str):
+                try:
+                    args = json.loads(args)
+                except json.JSONDecodeError:
+                    args = {}
+            calls.append(ToolCall(id=msg.function_call.name, name=msg.function_call.name, arguments=args))
+        usage = getattr(resp, "usage", None)
+        log.info("gigachat agent ok calls=%d tokens=%s", len(calls), getattr(usage, "total_tokens", None))
+        return AssistantTurn(content=msg.content or None, tool_calls=calls)
+
+
+# ------------------------------------------------------------------------------------------------ offline mock
+
+_DRUG_WORDS = re.compile(
+    r"\b(сертралин\w*|пароксетин\w*|эсциталопрам\w*|флуоксетин\w*|ибупрофен\w*|нурофен\w*|золофт\w*)", re.I
+)
+_MED_HINT = re.compile(r"(таблет|лекарств|препарат|состав|можно ли|совмест|вместе|противопоказ|аллерг|лактоз)", re.I)
+
+
+class MockAgentProvider:
+    """Plans: record → (drug check for each mentioned drug, or the current prescription for medicine questions)
+    → guidelines search; then writes a short answer strictly from the tool results."""
+
+    name = "mock"
+
+    async def chat(self, messages: list[dict[str, Any]], tools: list[dict[str, Any]]) -> AssistantTurn:
+        question = next(m["content"] for m in reversed(messages) if m["role"] == "user")
+        done = [m for m in messages if m["role"] == "tool"]
+        if not done:
+            drugs = [m.group(1).lower() for m in _DRUG_WORDS.finditer(question)]
+            calls = [ToolCall(id="c0", name="get_patient_record")]
+            calls += [
+                ToolCall(id=f"d{i}", name="check_drug_for_patient", arguments={"drug": d}) for i, d in enumerate(drugs)
+            ]
+            if drugs and re.search(r"состав|лактоз|желатин|аллерг|непереносим", question, re.I):
+                calls += [
+                    ToolCall(id=f"i{i}", name="get_drug_info", arguments={"drug": d}) for i, d in enumerate(drugs)
+                ]
+            calls.append(ToolCall(id="s0", name="search_guidelines", arguments={"query": question}))
+            return AssistantTurn(tool_calls=calls)
+        mine = re.search(r"мо(и|ими|их|ей|я|ё) (таблет|лекарств|препарат)", question, re.I)
+        checked = [m for m in done if m.get("name") == "check_drug_for_patient"]
+        if (not checked or mine) and len(checked) < 3 and _MED_HINT.search(question):
+            record = _tool_json(done, "get_patient_record")
+            rx = (record or {}).get("current_prescriptions") or []
+            checked_args = {str(json.loads(m["content"]).get("inn", "")) for m in checked}
+            rx = [r for r in rx if not any(r["drug"].lower().startswith(c[:-1]) for c in checked_args if c)]
+            if rx:
+                return AssistantTurn(
+                    tool_calls=[ToolCall(id="d9", name="check_drug_for_patient", arguments={"drug": rx[0]["drug"]})]
+                )
+        return AssistantTurn(content=_compose(done))
+
+
+def _tool_json(done: list[dict[str, Any]], name: str) -> dict[str, Any] | None:
+    for m in done:
+        if m.get("name") == name:
+            try:
+                return json.loads(m["content"])
+            except json.JSONDecodeError:
+                return None
+    return None
+
+
+def _compose(done: list[dict[str, Any]]) -> str:
+    parts: list[str] = []
+    seen: set[str] = set()
+    for m in done:
+        if m.get("name") != "check_drug_for_patient":
+            continue
+        data = json.loads(m["content"])
+        if not data.get("found") or data["inn"] in seen:
+            continue
+        seen.add(data["inn"])
+        findings = data.get("findings") or []
+        if findings:
+            parts.append(f"По вашей карте и инструкции к препарату «{data['inn']}» есть важное:")
+            parts += [f"• {f['text']}" for f in findings[:3]]
+        else:
+            parts.append(f"В справочнике не нашлось особых ограничений по «{data['inn']}» с учётом вашей карты.")
+    for m in done:
+        if m.get("name") != "get_drug_info":
+            continue
+        data = json.loads(m["content"])
+        comp = data.get("composition") if data.get("found") else None
+        if comp:
+            record = _tool_json(done, "get_patient_record") or {}
+            allergies = record.get("allergies") or []
+            if allergies:
+                names = ", ".join(a["name"] for a in allergies)
+                hit = {t for a in allergies for t in a.get("tags", [])} & set(comp.get("excipient_tags", []))
+                verdict = "это вещество есть" if hit else "этого вещества нет, но состав зависит от производителя"
+                parts.append(f"В вашей карте: {names}. В примере состава «{data['inn']}» {verdict}.")
+            excipients = ", ".join(comp["excipients"])
+            parts.append(f"Состав ({comp['form']}): {comp['active']}; вспомогательные: {excipients}. {comp['note']}")
+    search = _tool_json(done, "search_guidelines") or {}
+    results = search.get("results") or []
+    if results and not parts:  # medicine findings already answer the question; a KR quote would dilute it
+        text = results[0]["text"].strip()
+        parts.append(f"В клинических рекомендациях: «{text[:400]}{'…' if len(text) > 400 else ''}»")
+    if not parts:
+        return ""
+    parts.append("Любые изменения в лечении обсуждайте с вашим врачом.")
+    return "\n".join(parts)

app/llm/agent/tools.py

@@ -0,0 +1,219 @@
+"""Read-only tools of the chat agent. Every tool is bound to the current patient's token on the server side:
+the model never passes a token, so it cannot read another patient's data (medical secrecy, 323-FZ art. 13).
+
+Tool results contain clinical data only (no name, SNILS, phone) — they are sent to the LLM provider.
+"""
+
+import json
+import logging
+import re
+from dataclasses import dataclass, field
+from typing import Any
+
+from app.integrations.base import integrations
+from app.integrations.emias_record import PatientRecord, emias_records
+from app.llm.agent.drug_safety import check_patient, find_drug, load_db
+from app.llm.rag import retrieve
+from app.llm.rag.index import sentences
+
+log = logging.getLogger(__name__)
+
+RAG_TOP_K = 4
+PASSAGE_CHARS = 700
+# Patients never get dosages (SPEC §7): sentences with doses are dropped before the text reaches the LLM.
+_DOSE = re.compile(r"\d\s*(?:-|–)?\s*\d*\s*(?:мг|mg|мкг|г/сут|таблетк)|\bдоз(?:а|у|ы|е|ой|ировк)", re.I)
+
+TOOL_SPECS: list[dict[str, Any]] = [
+    {
+        "type": "function",
+        "function": {
+            "name": "search_guidelines",
+            "description": (
+                "Поиск по базе знаний: клинические рекомендации Минздрава РФ (депрессия 2024, ПТСР 2023). "
+                "Возвращает фрагменты с источником и страницей. Используй для любых общих вопросов о состоянии, "
+                "лечении, сроках действия терапии, побочных эффектах, отмене, образе жизни."
+            ),
+            "parameters": {
+                "type": "object",
+                "properties": {"query": {"type": "string", "description": "Поисковый запрос на русском"}},
+                "required": ["query"],
+            },
+        },
+    },
+    {
+        "type": "function",
+        "function": {
+            "name": "get_patient_record",
+            "description": (
+                "Медицинская карта текущего пациента из ЕМИАС: диагнозы (МКБ-10), сопутствующие заболевания, "
+                "аллергии и непереносимости, назначения других врачей и текущее назначение психиатра. "
+                "Вызывай, когда ответ зависит от особенностей пациента или его лекарств."
+            ),
+            "parameters": {"type": "object", "properties": {}},
+        },
+    },
+    {
+        "type": "function",
+        "function": {
+            "name": "get_drug_info",
+            "description": (
+                "Справка о препарате по инструкции ГРЛС: состав (действующее и вспомогательные вещества), "
+                "противопоказания, взаимодействия, беременность. Аргумент — название препарата (МНН или торговое)."
+            ),
+            "parameters": {
+                "type": "object",
+                "properties": {"drug": {"type": "string"}},
+                "required": ["drug"],
+            },
+        },
+    },
+    {
+        "type": "function",
+        "function": {
+            "name": "check_drug_for_patient",
+            "description": (
+                "Детерминированная проверка препарата для текущего пациента: сопутствующие заболевания, "
+                "непереносимости по составу, взаимодействия с другими его лекарствами. Используй перед любым "
+                "ответом о том, подходит ли пациенту препарат или сочетание препаратов."
+            ),
+            "parameters": {
+                "type": "object",
+                "properties": {
+                    "drug": {"type": "string", "description": "Название препарата; пусто — текущее назначение пациента"}
+                },
+            },
+        },
+    },
+]
+
+
+@dataclass
+class ToolContext:
+    token: str
+    sources: list[str] = field(default_factory=list)  # citations collected for the answer footer
+    used: list[str] = field(default_factory=list)
+    _record: PatientRecord | None = None
+    _record_loaded: bool = False
+
+    async def record(self) -> PatientRecord | None:
+        if not self._record_loaded:
+            self._record = await emias_records.get(self.token)
+            self._record_loaded = True
+        return self._record
+
+    def cite(self, label: str) -> None:
+        if label and label not in self.sources:
+            self.sources.append(label)
+
+
+async def run_tool(ctx: ToolContext, name: str, args: dict[str, Any]) -> str:
+    """Execute a tool; always returns a JSON string (errors included) so the model can recover."""
+    ctx.used.append(name)
+    log.info("agent tool=%s", name)  # no arguments: they may echo patient text
+    try:
+        if name == "search_guidelines":
+            return _json(_search(ctx, str(args.get("query", ""))))
+        if name == "get_patient_record":
+            rec = await ctx.record()
+            if rec is None:
+                return _json({"found": False})
+            ctx.cite("ЕМИАС: медицинская карта")
+            return _json({"found": True, **rec.model_dump()})
+        if name == "get_drug_info":
+            return _json(_drug_info(ctx, str(args.get("drug", ""))))
+        if name == "check_drug_for_patient":
+            return _json(await _check(ctx, str(args.get("drug", ""))))
+        return _json({"error": f"unknown tool {name}"})
+    except Exception as exc:  # noqa: BLE001 — a tool failure must not crash the chat
+        log.error("agent tool=%s failed: %s", name, type(exc).__name__)
+        return _json({"error": "tool failed"})
+
+
+def _search(ctx: ToolContext, query: str) -> dict[str, Any]:
+    hits = retrieve(query, audience="patient", top_k=RAG_TOP_K) if query.strip() else []
+    out = []
+    for h in hits:
+        label = h.chunk.citation.strip("[]")
+        ctx.cite(label)
+        text = " ".join(x for x in sentences(h.passage) if not _DOSE.search(x))[:PASSAGE_CHARS]
+        if text:
+            out.append({"source": label, "section": h.chunk.section, "text": text})
+    return {"results": out, "found": bool(out)}
+
+
+def _drug_info(ctx: ToolContext, name: str) -> dict[str, Any]:
+    entry = find_drug(name)
+    if entry is None:
+        return {"found": False, "drug": name}
+    ctx.cite(entry.source)
+    return {
+        "found": True,
+        "inn": entry.inn,
+        "class": entry.drug_class,
+        "composition": entry.composition.model_dump() if entry.composition else None,
+        "contraindications": entry.contraindications,
+        "interactions": [i.text for i in entry.interactions],
+        "pregnancy": entry.pregnancy,
+        "source": entry.source,
+    }
+
+
+async def _check(ctx: ToolContext, name: str) -> dict[str, Any]:
+    entry = find_drug(name) if name.strip() else None
+    if entry is None:
+        # "мои таблетки" / no name → the current psychiatric prescription from the record.
+        rec = await ctx.record()
+        current = [find_drug(p.drug) for p in (rec.current_prescriptions if rec else [])]
+        entry = next((e for e in current if e is not None), None) if not find_drug(name) else None
+    if entry is None:
+        return {"found": False, "drug": name, "note": "Препарата нет в справочнике — отвечать «уточните у врача»."}
+    rec = await ctx.record()
+    if rec is None:
+        return {"found": True, "inn": entry.inn, "record": False, "findings": []}
+    ctx.cite(entry.source)
+    ctx.cite("ЕМИАС: медицинская карта")
+    db = load_db()
+    findings = check_patient(entry, rec, db)
+    comp = entry.composition
+    intolerances = [a.name for a in rec.allergies]
+    intolerance_check = None
+    if comp is not None and intolerances:
+        hit = {t for a in rec.allergies for t in a.tags} & set(comp.excipient_tags)
+        intolerance_check = f"Непереносимость из карты ({', '.join(intolerances)}): " + (
+            "вещество ЕСТЬ в составе."
+            if hit
+            else "в примере состава этого вещества нет; состав зависит от производителя."
+        )
+    instruction = await _instruction(ctx, entry.inn)
+    return {
+        "found": True,
+        "inn": entry.inn,
+        "record": True,
+        "instruction": instruction,  # ГРЛС excerpts: onset, side effects, discontinuation, administration
+        "findings": [f.model_dump() for f in findings],
+        "intolerance_check": intolerance_check,
+        "composition": comp.model_dump(exclude={"excipient_tags"}) if comp else None,
+        "general_interactions": [i.text for i in entry.interactions],  # incl. alcohol — for questions about it
+        "contraindications": entry.contraindications,
+        "note": "Пустой findings не означает, что препарат безопасен: решение о приёме принимает врач.",
+    }
+
+
+INSTRUCTION_SECTIONS = ("onset", "side_effects", "discontinuation", "administration", "alcohol")
+
+
+async def _instruction(ctx: ToolContext, inn: str) -> dict[str, str]:
+    """ГРЛС excerpts for the drug (no doses in mg — see data/meds/grls)."""
+    try:
+        sections = await integrations.drug_info.sections(inn)
+    except Exception as exc:  # noqa: BLE001
+        log.error("drug_info unavailable: %s", type(exc).__name__)
+        return {}
+    out = {s.section: s.text for s in sections if s.section in INSTRUCTION_SECTIONS}
+    if out:
+        ctx.cite(sections[0].source.split(",")[0] + ": инструкция к препарату")
+    return out
+
+
+def _json(data: Any) -> str:
+    return json.dumps(data, ensure_ascii=False)

app/llm/rag/__init__.py

@@ -0,0 +1,24 @@
+"""Knowledge base (RAG, #60): clinical guidelines -> citable chunks -> BM25 retrieval -> grounded answers.
+
+    from app.llm.rag import answer, retrieve
+    hits = retrieve("синдром отмены антидепрессантов", audience="doctor")
+    reply = await answer(scrub(text), audience="patient")   # None -> rag.fallback_text()
+
+Corpus and parameters: `config/rag/sources.yaml`; PDF sources and the converter: `docs/source/rag/`.
+"""
+
+from app.llm.rag.corpus import Chunk, load_chunks
+from app.llm.rag.index import Hit, get_index, retrieve
+from app.llm.rag.qa import Citation, RagAnswer, answer, fallback_text
+
+__all__ = [
+    "Chunk",
+    "Citation",
+    "Hit",
+    "RagAnswer",
+    "answer",
+    "fallback_text",
+    "get_index",
+    "load_chunks",
+    "retrieve",
+]

app/llm/rag/__main__.py

@@ -0,0 +1,52 @@
+"""Manual check of the knowledge base on synthetic questions.
+
+    python -m app.llm.rag "через сколько начинают действовать антидепрессанты"
+    python -m app.llm.rag --audience doctor "синдром отмены антидепрессантов"
+    python -m app.llm.rag --search "ДПДГ при ПТСР"          # raw retrieval: chunks, scores, passages
+    python -m app.llm.rag --stats                           # corpus summary
+
+The question always goes through `privacy.scrub()` first; the CLI never bypasses it.
+"""
+
+import argparse
+import asyncio
+from collections import Counter
+
+from app.core import privacy
+from app.llm.gateway import get_gateway
+from app.llm.rag.index import get_index
+from app.llm.rag.qa import answer, fallback_text
+
+
+def main(argv: list[str] | None = None) -> int:
+    parser = argparse.ArgumentParser(prog="python -m app.llm.rag")
+    parser.add_argument("question", nargs="?")
+    parser.add_argument("--audience", choices=["patient", "doctor", "team"], default="patient")
+    parser.add_argument("--search", action="store_true", help="show retrieved chunks instead of an answer")
+    parser.add_argument("--top", type=int, default=5)
+    parser.add_argument("--stats", action="store_true")
+    args = parser.parse_args(argv)
+
+    index = get_index()
+    if args.stats:
+        by_doc = Counter(c.doc.short for c in index.chunks)
+        print(f"chunks={len(index.chunks)}", ", ".join(f"{d}: {n}" for d, n in by_doc.items()))
+        return 0
+    if not args.question:
+        parser.error("question is required")
+    question = privacy.scrub(args.question)
+
+    if args.search:
+        for hit in index.search(question, audience=args.audience, top_k=args.top, min_score=0):
+            print(f"{hit.score:6.1f} (bm25 {hit.bm25:5.1f}) {hit.chunk.citation} {hit.chunk.section}")
+            print(f"       > {hit.passage[:300]}")
+        return 0
+
+    print(f"provider={get_gateway().provider_name} audience={args.audience}\n")
+    reply = asyncio.run(answer(question, audience=args.audience, index=index))
+    print(reply.text if reply else fallback_text(args.audience))
+    return 0
+
+
+if __name__ == "__main__":
+    raise SystemExit(main())

app/llm/rag/corpus.py

@@ -0,0 +1,350 @@
+"""Knowledge-base corpus: `config/rag/sources.yaml` + txt files -> citable chunks.
+
+The txt files come from `docs/source/rag/pdf_to_txt.py`: paragraphs are separated by blank lines, pages by
+`--- стр. N ---` markers, tables are markdown, text transcribed from figures follows an
+`[Изображение: ...]` line. Chunking rules:
+
+* a chunk never crosses a section boundary (numbered headings "2.1 ...", "Приложение Г5", ...), so its
+  section title is reliable context; the title is stored separately and indexed with extra weight;
+* "Комментарии: ..." after a recommendation stays with the recommendation (the comment explains it);
+* a line starting in lowercase continues the previous paragraph (cut by a page break the converter missed);
+* tables are split by rows, every table piece repeats the table header, so a chunk is readable alone;
+* each chunk keeps the page range it came from, for the citation "[КР ПТСР 2023, стр. 45]"; inline
+  "⟦стр. N⟧" markers (paragraph glued across a page break) are removed from the text but move the range.
+"""
+
+import re
+from dataclasses import dataclass, field
+from functools import lru_cache
+from pathlib import Path
+
+import yaml
+from pydantic import BaseModel, Field
+
+from app.config import get_settings
+
+Audience = str  # "doctor" | "patient" | "team"
+
+PAGE_MARKER = re.compile(r"^--- стр\. (\d+) ---$")
+# A paragraph that flows onto the next page is glued by the converter; "⟦стр. N⟧" marks where page N begins.
+INLINE_PAGE = re.compile(r"\s*⟦стр\. (\d+)⟧\s*")
+TABLE_DIVIDER = re.compile(r"^\|(-+\|)+$")
+# "2.1 Жалобы и анамнез", "3.1.2. Купирующая терапия ..." — a numbered subsection title.
+SUBSECTION = re.compile(r"^(\d{1,2}(?:\.\d{1,2})+)\.?\s+([А-ЯЁA-Z].*)$")  # not dates "28.07.2022 N ..."
+# Top-level KR sections: "1. Краткая информация ...", "3. Лечение, включая ...". Plain "1. ..." lines are
+# list items, so a top-level heading must start with one of the standard KR section names.
+TOPLEVEL = re.compile(
+    r"^([1-9])\.\s+(Краткая информация|Диагностика|Лечение|Медицинская реабилитация|Профилактика"
+    r"|Организация оказания|Дополнительная информация)"
+)
+NAMED = re.compile(
+    r"^(Приложение [А-ЯЁ]\d*(?:-[А-ЯЁ]+\d*)?\b.*|Критерии оценки качества медицинской помощи|Список литературы"
+    r"|Список сокращений|Термины и определения)$"
+)
+# Unnumbered short title lines (team specs): capitalised, short, no final punctuation, not a list item.
+SHORT_TITLE = re.compile(r"^[А-ЯЁ][^.:;!?|]{2,60}$")
+COMMENT = re.compile(r"^Комментари[йи]\s*:")
+SENTENCE_SPLIT = re.compile(r"(?<=[.!?…])\s+(?=[А-ЯЁA-Z0-9«\"(])")
+# Abbreviations after which a capital letter does not start a new sentence: "(см. Приложение Б5)".
+ABBREVIATION_END = re.compile(
+    r"(?:\b(?:см|т\.\s?е|т\.\s?д|т\.\s?п|др|напр|рис|табл|стр|г|гг|им|ср|англ|лат|греч)|\b[А-ЯЁA-Z])\.$"
+)
+MAX_TITLE_CHARS = 300
+
+
+class DocumentMeta(BaseModel):
+    id: str
+    file: str
+    title: str
+    short: str
+    issuer: str
+    year: int
+    icd: list[str] = Field(default_factory=list)
+    audiences: list[Audience]
+
+
+class ChunkingConfig(BaseModel):
+    max_chars: int = 1200
+    min_chars: int = 200
+    skip_sections: list[str] = Field(default_factory=list)
+
+
+class RetrievalConfig(BaseModel):
+    top_k: int = 5
+    bm25_k1: float = 1.5
+    bm25_b: float = 0.75
+    title_weight: int = 2
+    min_score: float = 3.0
+    rerank_candidates: int = 30
+    window_sentences: int = 2
+    window_weight: float = 0.5
+    # section title prefix -> score multiplier, per audience ({"patient": {"Приложение В": 1.5}})
+    section_boost: dict[str, dict[str, float]] = Field(default_factory=dict)
+    # doc id -> regexes naming its disease; a question naming one disease favours that document
+    doc_cues: dict[str, list[str]] = Field(default_factory=dict)
+    doc_cue_boost: float = 1.0
+
+
+class AnswerConfig(BaseModel):
+    max_chunks: int = 3
+    max_passages: int = 2
+    max_sentences: int = 3
+    max_chars: int = 600
+    min_coverage: float = 0.5
+    second_passage_ratio: float = 0.8
+    neighbor_ratio: float = 0.5
+
+
+class RagConfig(BaseModel):
+    documents: list[DocumentMeta]
+    chunking: ChunkingConfig = ChunkingConfig()
+    retrieval: RetrievalConfig = RetrievalConfig()
+    answer: AnswerConfig = AnswerConfig()
+    synonyms: list[list[str]] = Field(default_factory=list)
+
+
+@dataclass(frozen=True)
+class Chunk:
+    id: str  # "<doc>#<n>"
+    doc: DocumentMeta
+    section: str  # nearest heading ("" before the first one)
+    page_start: int
+    page_end: int
+    text: str  # display text: paragraphs and markdown table rows
+
+    @property
+    def pages(self) -> str:
+        return str(self.page_start) if self.page_start == self.page_end else f"{self.page_start}–{self.page_end}"
+
+    @property
+    def citation(self) -> str:
+        return f"[{self.doc.short}, стр. {self.pages}]"
+
+
+@dataclass
+class _Unit:
+    """Indivisible piece of a chunk: a paragraph (with its comment) or one table row."""
+
+    text: str
+    page: int  # page where the unit starts
+    table_header: str | None = None  # "| a | b |\n|---|---|" for table rows
+    breaks: list[tuple[int, int]] = field(default_factory=list)  # (offset in text, page starting there)
+
+    @property
+    def page_end(self) -> int:
+        return self.breaks[-1][1] if self.breaks else self.page
+
+    def page_at(self, offset: int) -> int:
+        page = self.page
+        for start, p in self.breaks:
+            if start <= offset:
+                page = p
+        return page
+
+    def append(self, line: str, page: int, sep: str) -> None:
+        """Glue a continuation line; record a page break if it comes from a later page."""
+        base = len(self.text) + len(sep)
+        text, breaks = _strip_inline_pages(line)
+        if page > self.page_end:
+            self.breaks.append((base, page))
+        self.breaks.extend((base + off, p) for off, p in breaks)
+        self.text += sep + text
+
+
+def _strip_inline_pages(line: str) -> tuple[str, list[tuple[int, int]]]:
+    """Text without "⟦стр. N⟧" markers + (offset, page) of each marker in the cleaned text."""
+    out, breaks, pos = [], [], 0
+    for m in INLINE_PAGE.finditer(line):
+        out.append(line[pos : m.start()])
+        breaks.append((sum(len(x) for x in out) + 1, int(m.group(1))))
+        out.append(" ")
+        pos = m.end()
+    out.append(line[pos:])
+    return "".join(out), breaks
+
+
+def _new_unit(line: str, page: int) -> _Unit:
+    text, breaks = _strip_inline_pages(line)
+    return _Unit(text, page, breaks=breaks)
+
+
+@dataclass
+class _Section:
+    title: str
+    units: list[_Unit] = field(default_factory=list)
+
+
+def rag_dir() -> Path:
+    return get_settings().config_dir / "rag"
+
+
+@lru_cache
+def load_config(path: Path | None = None) -> RagConfig:
+    path = path or rag_dir() / "sources.yaml"
+    return RagConfig.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
+
+
+def heading(line: str) -> str | None:
+    """The line's text if it is a section heading, else `None`."""
+    if len(line) > MAX_TITLE_CHARS or line.startswith("|"):
+        return None
+    if SUBSECTION.match(line) or TOPLEVEL.match(line) or NAMED.match(line):
+        return line
+    return None
+
+
+def _is_short_title(block: list[str], next_block: list[str] | None) -> bool:
+    """A lone short line followed by a body paragraph (unnumbered headings in team docs)."""
+    return (
+        len(block) == 1
+        and bool(SHORT_TITLE.match(block[0]))
+        and next_block is not None
+        and not PAGE_MARKER.match(next_block[0])
+        and (len(next_block) > 1 or len(next_block[0]) > 80 or next_block[0].startswith("|"))
+    )
+
+
+def _blocks(text: str) -> list[list[str]]:
+    """Blank-line separated blocks of non-empty lines."""
+    return [[ln for ln in b.splitlines() if ln.strip()] for b in re.split(r"\n\s*\n", text) if b.strip()]
+
+
+def _sections(text: str, skip: list[str]) -> list[_Section]:
+    blocks = _blocks(text)
+    sections = [_Section(title="")]
+    page = 1
+    skipping = False
+    for i, block in enumerate(blocks):
+        first = block[0]
+        if first.startswith("# ") or first.startswith("Источник:"):
+            continue  # file header written by the converter
+        m = PAGE_MARKER.match(first)
+        if m:
+            page = int(m.group(1))
+            continue
+        nxt = next((b for b in blocks[i + 1 :] if not PAGE_MARKER.match(b[0])), None)
+        if first.startswith("|"):
+            if not skipping:
+                sections[-1].units.extend(_table_units(block, page))
+            continue
+        if first.startswith("[Изображение"):
+            if not skipping:  # transcribed figure: one unit, keeps its own line breaks
+                sections[-1].units.append(_new_unit("\n".join(block[1:]) if len(block) > 1 else first, page))
+            continue
+        for j, line in enumerate(block):
+            title = heading(line)
+            if title is None and j == 0 and _is_short_title(block, nxt):
+                title = line
+            if title is not None:
+                skipping = any(title.startswith(s) for s in skip)
+                sections.append(_Section(title=title))
+                continue
+            if skipping:
+                continue
+            units = sections[-1].units
+            if COMMENT.match(line) and units and units[-1].table_header is None:
+                units[-1].append(line, page, "\n")
+            elif line[0].islower() and units and units[-1].table_header is None:
+                units[-1].append(line, page, " ")  # paragraph continued after a page break or a figure
+            else:
+                units.append(_new_unit(line, page))
+    return [s for s in sections if s.units]
+
+
+def _table_units(block: list[str], page: int) -> list[_Unit]:
+    if len(block) >= 2 and TABLE_DIVIDER.match(block[1]):
+        header = f"{block[0]}\n{block[1]}"
+        rows = block[2:]
+    else:  # continuation without a header line (should not happen with the converter, but be safe)
+        header, rows = "", block
+    return [_Unit(row, page, table_header=header) for row in rows]
+
+
+def split_sentences(text: str) -> list[str]:
+    """Sentences of one line/paragraph; does not split after "см.", "т.е.", initials."""
+    out: list[str] = []
+    for part in SENTENCE_SPLIT.split(text):
+        if out and ABBREVIATION_END.search(out[-1]):
+            out[-1] += " " + part
+        else:
+            out.append(part)
+    return [p.strip() for p in out if p.strip()]
+
+
+def _split_long(unit: _Unit, max_chars: int) -> list[_Unit]:
+    if len(unit.text) <= max_chars or unit.table_header is not None:
+        return [unit]
+    parts: list[str] = []
+    for sentence in split_sentences(unit.text):
+        if parts and len(parts[-1]) + 1 + len(sentence) <= max_chars:
+            parts[-1] += " " + sentence
+        else:
+            parts.append(sentence)
+    out: list[_Unit] = []
+    pos = 0
+    for part in parts:
+        start = unit.text.find(part[:40], pos)
+        start = pos if start < 0 else start
+        end = start + len(part) - 1
+        first, last = unit.page_at(start), unit.page_at(end)
+        out.append(_Unit(part, first, breaks=[(len(part) - 1, last)] if last != first else []))
+        pos = start + len(part)
+    return out
+
+
+def _render(units: list[_Unit]) -> str:
+    out: list[str] = []
+    header: str | None = None
+    for u in units:
+        if u.table_header is not None:
+            if header != u.table_header:
+                header = u.table_header
+                if header:
+                    out.append(header)
+            out.append(u.text)
+        else:
+            header = None
+            out.append(u.text)
+    return "\n".join(out)
+
+
+def _pack(section: _Section, max_chars: int, min_chars: int) -> list[list[_Unit]]:
+    units = [p for u in section.units for p in _split_long(u, max_chars)]
+    groups: list[list[_Unit]] = [[]]
+    size = 0
+    for u in units:
+        if groups[-1] and size + len(u.text) > max_chars:
+            groups.append([])
+            size = 0
+        groups[-1].append(u)
+        size += len(u.text) + 1
+    if len(groups) > 1 and sum(len(u.text) for u in groups[-1]) < min_chars:
+        groups[-2].extend(groups.pop())
+    return [g for g in groups if g]
+
+
+def chunk_document(doc: DocumentMeta, text: str, cfg: ChunkingConfig) -> list[Chunk]:
+    chunks: list[Chunk] = []
+    for section in _sections(text, cfg.skip_sections):
+        for group in _pack(section, cfg.max_chars, cfg.min_chars):
+            chunks.append(
+                Chunk(
+                    id=f"{doc.id}#{len(chunks)}",
+                    doc=doc,
+                    section=section.title,
+                    page_start=group[0].page,
+                    page_end=max(u.page_end for u in group),
+                    text=_render(group),
+                )
+            )
+    return chunks
+
+
+@lru_cache
+def load_chunks(config_path: Path | None = None) -> tuple[Chunk, ...]:
+    cfg = load_config(config_path)
+    base = (config_path.parent if config_path else rag_dir()).resolve()
+    out: list[Chunk] = []
+    for doc in cfg.documents:
+        out.extend(chunk_document(doc, (base / doc.file).read_text(encoding="utf-8"), cfg.chunking))
+    return tuple(out)

app/llm/rag/index.py

@@ -0,0 +1,229 @@
+"""Lexical retrieval over the corpus: Okapi BM25 on Russian Snowball stems + synonym expansion.
+
+Offline and deterministic (ADR-004): no embeddings, no network. Stop words are dropped before stemming;
+the section title is indexed `title_weight` times so a match with "3.2 Психофармакотерапия" counts more
+than a passing mention in the body.
+
+Re-ranking: the best `rerank_candidates` chunks by BM25 get a bonus for their densest passage — a window
+of `window_sentences` consecutive sentences scored by the idf of query terms it contains. A chunk that
+answers in one place beats a long one that mentions the words in passing; the passage itself is returned
+with the hit and is what `answer()` quotes from.
+"""
+
+import math
+import re
+from collections import Counter
+from dataclasses import dataclass
+from functools import lru_cache
+
+from app.llm.rag.corpus import Audience, Chunk, RagConfig, load_chunks, load_config, split_sentences
+from app.llm.rag.stemmer import stem
+
+_WORD = re.compile(r"[а-яёa-z0-9]+(?:-[а-яёa-z0-9]+)*", re.IGNORECASE)
+# `privacy.scrub()` placeholders ("[NAME]", "[PHONE]") are not words of the question.
+_PLACEHOLDER = re.compile(r"\[[A-Z_]+\]")
+
+# Function words and generic KR boilerplate that carry no topical signal.
+STOP_WORDS = frozenset(
+    """
+    а без более бы был была были было быть в вам вас ваш весь во вот все всего всех вы где да даже для до его
+    ее если есть еще же за и из или им их к как ко когда кто ли либо мне может можно мой мы на над не него нее
+    нет ни них но ну о об однако он она они оно от по под при про с со так также такой там те то тоже только
+    том тот у уже хотя чего чем что чтобы эта эти это этот я ли ней нем
+    какой какая какое какие каков такое такая такие сколько почему зачем меня мой моя мое мои себя сегодня будет
+    """.split()  # noqa: SIM905 — a word list reads better as text
+)
+
+
+def tokens(text: str) -> list[str]:
+    """Stems of content words (hyphenated words are kept whole and also split: "когнитивно-поведенческая")."""
+    out: list[str] = []
+    for word in _WORD.findall(_PLACEHOLDER.sub(" ", text).lower().replace("ё", "е")):
+        parts = [p for p in word.split("-") if p not in STOP_WORDS and (len(p) > 1 or p.isdigit())]
+        if "-" in word and len(parts) > 1:
+            out.append("-".join(stem(p) for p in parts))  # the compound itself, in any case form
+        out.extend(stem(p) for p in parts)
+    return out
+
+
+EXPANSION_WEIGHT = 0.7
+SYNONYM_CREDIT = 0.8
+PREFIX_LEN = 6
+
+
+@dataclass(frozen=True)
+class Hit:
+    chunk: Chunk
+    score: float  # BM25 + passage bonus (ranking key)
+    bm25: float
+    passage: str  # densest window of the chunk for the query
+
+
+def sentences(text: str) -> list[str]:
+    """Sentences of a chunk; every line (table row, list item) is split on its own."""
+    return [s for line in text.splitlines() for s in split_sentences(line)]
+
+
+class SynonymExpander:
+    """Adds the stems of every phrase in a synonym group when any phrase of the group is in the query.
+
+    Added stems weigh `EXPANSION_WEIGHT`: they widen recall but should not outrank the patient's own words.
+    """
+
+    def __init__(self, groups: list[list[str]]) -> None:
+        self._groups = [[tokens(phrase) for phrase in group] for group in groups]
+        # stem -> stems of the other phrases of its groups ("отменя" -> {"отмен", "брос", ...})
+        self.related: dict[str, set[str]] = {}
+        for group in self._groups:
+            stems = {t for phrase in group for t in phrase}
+            for t in stems:
+                self.related.setdefault(t, set()).update(stems - {t})
+
+    def expand(self, query_tokens: list[str]) -> dict[str, float]:
+        weights: dict[str, float] = {}
+        for t in query_tokens:
+            weights[t] = weights.get(t, 0.0) + 1.0
+        present = set(query_tokens)
+        for group in self._groups:
+            if any(phrase and set(phrase) <= present for phrase in group):
+                for phrase in group:
+                    for t in phrase:
+                        if t not in present:  # a 3-word expansion of "птср" is one concept, not three
+                            weights[t] = max(weights.get(t, 0.0), EXPANSION_WEIGHT / len(phrase))
+        return weights
+
+
+class BM25Index:
+    def __init__(self, chunks: tuple[Chunk, ...], cfg: RagConfig) -> None:
+        r = cfg.retrieval
+        self._k1, self._b, self._min_score, self._top_k = r.bm25_k1, r.bm25_b, r.min_score, r.top_k
+        self._candidates, self._window, self._window_weight = r.rerank_candidates, r.window_sentences, r.window_weight
+        self._section_boost = r.section_boost
+        self._doc_cues = {doc: re.compile("|".join(cues), re.IGNORECASE) for doc, cues in r.doc_cues.items() if cues}
+        self._doc_cue_boost = r.doc_cue_boost
+        self.chunks = chunks
+        self._sentences = [[(s, set(tokens(s))) for s in sentences(c.text)] for c in chunks]
+        self._expander = SynonymExpander(cfg.synonyms)
+        self._tf: list[Counter[str]] = []
+        df: Counter[str] = Counter()
+        for c in chunks:
+            tf = Counter(tokens(c.text) + tokens(c.section) * r.title_weight)
+            self._tf.append(tf)
+            df.update(tf.keys())
+        self._len = [sum(tf.values()) for tf in self._tf]
+        self._avg_len = sum(self._len) / max(len(self._len), 1)
+        n = len(chunks)
+        self._idf = {t: math.log(1 + (n - f + 0.5) / (f + 0.5)) for t, f in df.items()}
+
+    def query_terms(self, query: str) -> dict[str, float]:
+        """Query stems -> weight (repeated words count more, synonym expansions less)."""
+        return self._expander.expand(tokens(query))
+
+    def _score(self, i: int, terms: dict[str, float]) -> float:
+        tf, norm = self._tf[i], self._k1 * (1 - self._b + self._b * self._len[i] / self._avg_len)
+        score = 0.0
+        for term, weight in terms.items():
+            f = tf.get(term)
+            if f:
+                score += self._idf[term] * f * (self._k1 + 1) / (f + norm) * weight
+        return score
+
+    def boost(self, chunk: Chunk, audience: Audience | None, cued: set[str] | None = None) -> float:
+        """Section multiplier for the audience (`retrieval.section_boost`) × disease-cue multiplier."""
+        boosts = self._section_boost.get(audience or "", {})
+        section = next((b for prefix, b in boosts.items() if chunk.section.startswith(prefix)), 1.0)
+        return section * (self._doc_cue_boost if cued and chunk.doc.id in cued else 1.0)
+
+    def cued_docs(self, query: str) -> set[str]:
+        """Documents whose disease the query names ("ТМС при депрессии" -> {"kr_depression"}).
+
+        Only a one-sided mention counts: a question naming both disorders favours neither.
+        """
+        q = _PLACEHOLDER.sub(" ", query).replace("ё", "е")
+        cued = {doc for doc, cue in self._doc_cues.items() if cue.search(q)}
+        return cued if len(cued) < len(self._doc_cues) else set()
+
+    def overlap(self, text: str, terms: dict[str, float]) -> float:
+        """Sum of idf × weight of the query terms present in `text` (sentence relevance for `answer()`)."""
+        present = set(tokens(text))
+        return sum(self._idf.get(t, 0.0) * w for t, w in terms.items() if t in present)
+
+    def coverage(self, text: str, query: str) -> float:
+        """Share of the query's own (not synonym-expanded) idf mass found in `text`, 0..1.
+
+        A query word whose synonym — or a word with the same `PREFIX_LEN`-letter prefix, for stems Snowball
+        leaves apart ("скрининговый"/"скрининг") — is in the text counts as `SYNONYM_CREDIT` of itself.
+        A word absent from the corpus counts with twice the maximal idf — the strongest sign of an off-topic
+        question: "как установить windows" is then mostly uncovered and `answer()` says there is
+        no answer instead of quoting the nearest paragraph about "установить диагноз".
+        """
+        own = set(tokens(query))
+        if not own:
+            return 0.0
+        unseen = 2 * max(self._idf.values(), default=1.0)
+        total = sum(self._idf.get(t, unseen) for t in own)
+        present = set(tokens(text))
+        prefixes = {p[:PREFIX_LEN] for p in present if len(p) >= PREFIX_LEN}
+        covered = 0.0
+        for t in own:
+            if t in present:
+                covered += self._idf[t]
+            elif self._expander.related.get(t, set()) & present or (
+                len(t) >= PREFIX_LEN and t[:PREFIX_LEN] in prefixes
+            ):
+                covered += SYNONYM_CREDIT * self._idf.get(t, unseen)  # said in the corpus' own words
+        return min(1.0, covered / total)
+
+    def _passage(self, i: int, terms: dict[str, float]) -> tuple[float, str]:
+        sents = self._sentences[i]
+        best = (0.0, sents[0][0] if sents else "")
+        for start in range(len(sents)):
+            window = sents[start : start + self._window]
+            present = set().union(*(toks for _, toks in window))
+            score = sum(self._idf.get(t, 0.0) * w for t, w in terms.items() if t in present)
+            if score > best[0]:
+                best = (score, " ".join(text for text, _ in window))
+        return best
+
+    def search(
+        self,
+        query: str,
+        *,
+        audience: Audience | None = None,
+        docs: set[str] | None = None,
+        top_k: int | None = None,
+        min_score: float | None = None,
+    ) -> list[Hit]:
+        """Best chunks for `query`, filtered by audience/doc ids; empty if nothing passes `min_score` (BM25)."""
+        terms = self.query_terms(query)
+        if not terms:
+            return []
+        threshold = self._min_score if min_score is None else min_score
+        scored = [
+            (s, i)
+            for i, c in enumerate(self.chunks)
+            if (audience is None or audience in c.doc.audiences)
+            and (docs is None or c.doc.id in docs)
+            and (s := self._score(i, terms)) >= threshold
+        ]
+        scored.sort(key=lambda x: (-x[0], x[1]))
+        cued = self.cued_docs(query)
+        hits = []
+        for bm25, i in scored[: max(self._candidates, top_k or 0)]:
+            bonus, passage = self._passage(i, terms)
+            chunk = self.chunks[i]
+            hits.append(
+                Hit(chunk, (bm25 + self._window_weight * bonus) * self.boost(chunk, audience, cued), bm25, passage)
+            )
+        hits.sort(key=lambda h: -h.score)  # stable: BM25 order breaks ties
+        return hits[: top_k or self._top_k]
+
+
+@lru_cache
+def get_index() -> BM25Index:
+    return BM25Index(load_chunks(), load_config())
+
+
+def retrieve(query: str, **kwargs) -> list[Hit]:
+    """Module-level shortcut: `retrieve("когда начинает действовать антидепрессант", audience="patient")`."""
+    return get_index().search(query, **kwargs)

app/llm/rag/qa.py

@@ -0,0 +1,320 @@
+"""Grounded answers from the knowledge base: every sentence shown is quoted from a cited chunk.
+
+Pipeline (deterministic except for the optional patient rephrasing):
+
+1. **Dose guard (patient).** Dose questions are never answered — the dose is the doctor's decision.
+2. **Retrieve.** Top `answer.max_chunks` chunks for the audience (`team` documents never reach patients
+   or doctors, see `config/rag/sources.yaml`).
+3. **Sentences.** Chunks are split into sentences; KR boilerplate is stripped (literature refs "[1, 15]").
+   Doctors also get table rows as "column: value; ..." lines and evidence grades. For patients, sentences
+   about prescribing/dosing or with forbidden content (`QUOTE_FILTER`) are dropped.
+4. **Passage.** In each chunk the best sentence (idf-weighted overlap with the query) is extended with
+   adjacent relevant sentences into one contiguous passage — the answer reads as written in the source,
+   not as a collage. The best passage, plus a second one if it scores close, is kept.
+5. **No-answer gate.** If the passages cover less than `answer.min_coverage` of the question's idf mass
+   (e.g. "рецепт борща"), there is no answer -> `None`.
+6. **Rephrase (patient only).** The excerpt may be simplified via `gateway.phrase("rag_answer")`; a
+   rephrasing that adds content (`med_qa.adds_content`) is rejected and the excerpt is shown verbatim.
+   Doctors always get the verbatim text.
+7. **Framing.** Intro, citations "[КР ПТСР 2023, стр. 28]" and the doctor note from `config/texts/rag.yaml`
+   are added outside the LLM, so they are always present.
+
+Safety screening of the incoming message is the caller's job (guardrail #2): `answer()` expects text that
+already passed `app.core.safety` and `privacy.scrub()`. Logs carry only codes and counts.
+"""
+
+import logging
+import re
+from dataclasses import dataclass
+from functools import lru_cache
+from pathlib import Path
+
+import yaml
+from pydantic import BaseModel
+
+from app.config import get_settings
+from app.core.types import ScrubbedText
+from app.llm.gateway import FORBIDDEN_OUTPUT, MAX_REPLY_CHARS, get_gateway
+from app.llm.med_qa import DOSE_QUESTION, DOSING_SENTENCE, adds_content
+from app.llm.rag.corpus import TABLE_DIVIDER, AnswerConfig, Audience, Chunk, load_config, split_sentences
+from app.llm.rag.index import BM25Index, get_index, tokens
+
+log = logging.getLogger(__name__)
+
+PHRASE_INTENT = "rag_answer"
+
+LIT_REFS = re.compile(r"\s*\[\d+(?:\s*[-–,]\s*\d+)*\s*,?\]")  # "[1, 15, 16]", "[48]", "[1-3]"
+GRADE = re.compile(r"\s*Уровень убедительности рекомендаций\s+[ABCАВС]\b.*$", re.IGNORECASE)
+BULLET = re.compile(r"^\s*(?:[-–—●•▪◦*]|\d+[.)])\s+")
+COMMENT_LABEL = re.compile(r"^Комментари[йи]\s*[:.]\s*")
+# KR sentences about prescribing are for the doctor: a patient reading "рекомендуется назначение
+# пароксетина" or "дозировка титруется" out of context takes it as advice (SPEC §7: no drug/dose advice).
+PRESCRIBING = re.compile(
+    r"назнач|дозиров|титр|мг\b|мг/|доз[аеуыо]\b|дозы\b|/сут|в сутки|раза? в день|разово"
+    r"|\d+\s*(?:[-–]\s*\d+\s*)?таблет",
+    re.IGNORECASE,
+)
+# "что такое флэшбек" -> the term; its definition "Флэшбек (flashback – англ.) – ..." is preferred.
+DEFINITION_QUESTION = re.compile(r"^\s*что (?:такое|значит|означает|это за)\s+(.+?)[?.!\s]*$", re.IGNORECASE)
+LEADING_PLACEHOLDERS = re.compile(r"^(?:\s*\[[A-Z_]+\][\s,.:;!-]*)+")  # "[NAME], что такое ПТСР?"
+DEFINITION_HEAD = re.compile(r"\s[–—-]\s(?![^(]*\))|\s[–—-]?\s?это\s")  # dash outside "(… – англ.)", or "это"
+DEFINITION_HEAD_CHARS = 60
+DEFINITION_BONUS = 2.0  # multiplier for a sentence that starts with the asked term (picks it within a chunk)
+# The gateway's output filter targets the bot's own words. Two of its patterns also hit neutral quotes from
+# the KR — the definition "ПТСР – это расстройство, которое..." and "диагноз ставится на основании..." —
+# and would cut exactly the patient-information text. Quotes are checked against the rest of the filter
+# (dose/drug imperatives, "у вас депрессия", confidentiality promises).
+QUOTE_EXEMPT_PREFIXES = ("диагноз", "(это|похоже на|признаки)")
+QUOTE_FILTER = tuple(p for p in FORBIDDEN_OUTPUT if not p.pattern.startswith(QUOTE_EXEMPT_PREFIXES))
+MIN_SENTENCE_CHARS = 25
+LEAD_IN_CHARS = 80
+# A best sentence opening with a reference back ("Это помогает...") needs the sentence it refers to.
+ANAPHORA = re.compile(
+    r"^(Это|Эти|Этот|Эта|Он|Она|Оно|Они|Такие|Такой|Данн\w+|При этом|Кроме того|Однако|Поэтому)\b"
+)  # a best sentence this short ("Что такое ПТСР?") pulls in the next one as its answer
+
+
+class Citation(BaseModel):
+    doc: str  # document id from sources.yaml
+    short: str  # "КР ПТСР 2023"
+    title: str
+    section: str
+    pages: str  # "28" | "28–29"
+
+    @property
+    def label(self) -> str:
+        return f"{self.short}, стр. {self.pages}"
+
+
+class RagAnswer(BaseModel):
+    text: str  # framed answer: intro + body + sources (+ doctor note for patients)
+    excerpt: str  # the quoted passages, verbatim
+    citations: list[Citation]
+    audience: Audience
+    coverage: float  # share of the question covered by the passages (0..1)
+    phrased_by_llm: bool
+
+
+class AudienceTexts(BaseModel):
+    fallback: str
+    intro: str
+    sources_label: str
+    doctor_note: str = ""
+
+
+@dataclass(frozen=True)
+class Passage:
+    chunk: Chunk
+    text: str
+    score: float
+    definition: bool = False  # starts with the term asked in "что такое X?"
+
+
+@lru_cache
+def load_rag_texts(path: Path | None = None) -> dict[str, AudienceTexts]:
+    path = path or get_settings().config_dir / "texts" / "rag.yaml"
+    raw = yaml.safe_load(path.read_text(encoding="utf-8"))
+    return {k: AudienceTexts.model_validate(v) for k, v in raw.items()}
+
+
+def fallback_text(audience: Audience = "patient") -> str:
+    """What the caller sends when `answer()` returns `None`."""
+    return load_rag_texts()[audience].fallback
+
+
+def _clean(sentence: str, *, keep_grade: bool) -> str:
+    s = BULLET.sub("", sentence)
+    s = COMMENT_LABEL.sub("", s)
+    if not keep_grade:  # evidence grades matter to doctors, to a patient they are noise
+        s = GRADE.sub("", s)
+    s = LIT_REFS.sub("", s)
+    return " ".join(s.split()).strip(" ;")
+
+
+def _cells(line: str) -> list[str]:
+    return [c.strip() for c in line.strip().strip("|").split("|")]
+
+
+def _row_text(header: list[str], row: list[str]) -> str:
+    pairs = [f"{h}: {v}" if h else v for h, v in zip(header, row, strict=False) if v]
+    return LIT_REFS.sub("", "; ".join(pairs))
+
+
+def chunk_sentences(chunk: Chunk, *, clinical: bool) -> list[str | None]:
+    """Readable sentences of a chunk in reading order. `clinical` (doctor/team) keeps table rows as
+    "column: value" lines and evidence grades. `None` marks a dropped row: passages do not span it."""
+    out: list[str | None] = []
+    lines = chunk.text.splitlines()
+    header: list[str] | None = None
+    for i, line in enumerate(lines):
+        if line.startswith("|"):
+            if TABLE_DIVIDER.match(line):
+                continue
+            if i + 1 < len(lines) and TABLE_DIVIDER.match(lines[i + 1]):
+                header = _cells(line)
+                continue
+            out.append(_row_text(header or [], _cells(line)) if clinical else None)
+            continue
+        header = None
+        out.extend(s for s in (_clean(p, keep_grade=clinical) for p in split_sentences(line)) if s)
+    return out
+
+
+def _allowed(sentence: str | None, audience: Audience) -> bool:
+    if sentence is None or len(sentence) < MIN_SENTENCE_CHARS and not sentence.endswith(("?", ":")):
+        return False
+    if sentence[0].islower():
+        return False  # tail of a paragraph cut by the chunk boundary: unreadable without its start
+    if audience == "patient":
+        return not (
+            DOSING_SENTENCE.search(sentence)
+            or PRESCRIBING.search(sentence)
+            or any(p.search(sentence) for p in QUOTE_FILTER)
+        )
+    return True
+
+
+def _defined_term(question: str) -> set[str] | None:
+    m = DEFINITION_QUESTION.match(LEADING_PLACEHOLDERS.sub("", question))
+    return set(tokens(m.group(1))) or None if m else None
+
+
+def _is_definition(sentence: str, defined: set[str]) -> bool:
+    """ "Флэшбек (flashback – англ.) – возврат..." / "ПТСР – это расстройство...": the term, then a dash."""
+    head = DEFINITION_HEAD.split(sentence, maxsplit=1)
+    return len(head) == 2 and len(head[0]) <= DEFINITION_HEAD_CHARS and bool(set(tokens(head[0])) & defined)
+
+
+def _sentence_score(index: BM25Index, sentence: str, terms: dict[str, float], defined: set[str] | None) -> float:
+    score = index.overlap(sentence, terms)
+    if defined and score > 0 and _is_definition(sentence, defined):
+        score *= DEFINITION_BONUS
+    return score
+
+
+def best_passage(
+    index: BM25Index,
+    chunk: Chunk,
+    terms: dict[str, float],
+    audience: Audience,
+    cfg: AnswerConfig,
+    defined: set[str] | None = None,
+    cued: set[str] | None = None,
+) -> Passage | None:
+    """Best sentence of the chunk extended by adjacent relevant sentences (contiguous, within limits)."""
+    sents = [s if _allowed(s, audience) else None for s in chunk_sentences(chunk, clinical=audience != "patient")]
+    scores = [_sentence_score(index, s, terms, defined) if s else 0.0 for s in sents]
+    if not scores or max(scores) <= 0:
+        return None
+    best = max(range(len(sents)), key=lambda i: (scores[i], -i))
+    head = sents[best]
+    assert head is not None  # score > 0 implies an allowed sentence
+    lo = hi = best
+    size = len(head)
+
+    def fits(j: int) -> bool:
+        if not 0 <= j < len(sents):
+            return False
+        s = sents[j]
+        return s is not None and size + len(s) + 1 <= cfg.max_chars
+
+    # A short lead-in (question-like heading, "Комментарии:"-style intro) needs the sentence after it.
+    def length(j: int) -> int:
+        return len(sents[j] or "") + 1
+
+    if (size < LEAD_IN_CHARS or head.endswith(("?", ":"))) and fits(best + 1):
+        hi += 1
+        size += length(hi)
+    if ANAPHORA.match(head) and fits(best - 1):
+        lo -= 1
+        size += length(lo)
+    floor = cfg.neighbor_ratio * scores[best]
+    while hi - lo + 1 < cfg.max_sentences:
+        nxt = next((j for j in (hi + 1, lo - 1) if fits(j) and scores[j] > 0 and scores[j] >= floor), None)
+        if nxt is None:
+            break
+        lo, hi = min(lo, nxt), max(hi, nxt)
+        size += length(nxt)
+    text = " ".join(s for s in sents[lo : hi + 1] if s)
+    definition = scores[best] > index.overlap(head, terms)  # got DEFINITION_BONUS
+    return Passage(chunk, text, index.overlap(text, terms) * index.boost(chunk, audience, cued), definition)
+
+
+def select(index: BM25Index, question: str, audience: Audience, docs: set[str] | None = None) -> list[Passage]:
+    """Best passage, plus a second one from another chunk if it scores within `second_passage_ratio`."""
+    cfg = load_config().answer
+    hits = index.search(question, audience=audience, docs=docs, top_k=cfg.max_chunks)
+    terms = index.query_terms(question)
+    defined = _defined_term(question)
+    cued = index.cued_docs(question)
+    passages = [p for h in hits if (p := best_passage(index, h.chunk, terms, audience, cfg, defined, cued))]
+    if not passages:
+        return []
+    # A definition answers "что такое X?" better than any passage that merely mentions X often.
+    passages.sort(key=lambda p: (not p.definition, -p.score))  # stable: retrieval rank breaks ties
+    top = passages[0]
+    chosen = [top]
+    for p in passages[1:]:
+        if len(chosen) >= cfg.max_passages:
+            break
+        if p.score >= cfg.second_passage_ratio * top.score and p.text != top.text:
+            chosen.append(p)
+    return chosen
+
+
+def _citation(chunk: Chunk) -> Citation:
+    return Citation(
+        doc=chunk.doc.id, short=chunk.doc.short, title=chunk.doc.title, section=chunk.section, pages=chunk.pages
+    )
+
+
+async def _rephrase(excerpt: str, question: str) -> tuple[str, bool]:
+    if len(excerpt) > MAX_REPLY_CHARS or any(p.search(excerpt) for p in FORBIDDEN_OUTPUT):
+        return excerpt, False  # the gateway would reject any reply this long / with these words anyway
+    text = await get_gateway().phrase(PHRASE_INTENT, {"excerpt": excerpt, "question": question})
+    if " ".join(text.split()) == " ".join(excerpt.split()):
+        return excerpt, False
+    if adds_content(text, excerpt, question):
+        log.warning("rag rephrasing rejected: adds content")
+        return excerpt, False
+    return text, True
+
+
+async def answer(
+    question: ScrubbedText,
+    *,
+    audience: Audience = "patient",
+    docs: set[str] | None = None,
+    index: BM25Index | None = None,
+) -> RagAnswer | None:
+    """Answer strictly from the knowledge base, with citations; `None` -> caller sends `fallback_text()`."""
+    if audience == "patient" and DOSE_QUESTION.search(question.lower()):
+        log.info("rag: dose question redirected to doctor")
+        return None
+    index = index or get_index()
+    passages = select(index, question, audience, docs)
+    if not passages:
+        log.info("rag: no relevant fragment audience=%s", audience)
+        return None
+    coverage = index.coverage(" ".join(p.text for p in passages), question)
+    if coverage < load_config().answer.min_coverage:
+        log.info("rag: low coverage audience=%s coverage=%.2f", audience, coverage)
+        return None
+    citations = [_citation(p.chunk) for p in passages]
+    texts = load_rag_texts()[audience]
+
+    if audience == "patient":
+        excerpt = " ".join(p.text for p in passages)
+        body, by_llm = await _rephrase(excerpt, question)
+        sources = "; ".join(dict.fromkeys(c.label for c in citations))
+        text = f"{texts.intro} {body}\n\n{texts.sources_label}: {sources}."
+    else:  # doctor/team: verbatim quotes, each with its own citation
+        excerpt = "\n".join(f"{p.text} [{c.label}]" for p, c in zip(passages, citations, strict=True))
+        by_llm = False
+        text = f"{texts.intro}\n{excerpt}"
+    if texts.doctor_note:
+        text += f"\n\n{texts.doctor_note}"
+    log.info("rag: answered audience=%s passages=%d coverage=%.2f llm=%s", audience, len(passages), coverage, by_llm)
+    return RagAnswer(
+        text=text, excerpt=excerpt, citations=citations, audience=audience, coverage=coverage, phrased_by_llm=by_llm
+    )

app/llm/rag/stemmer.py

@@ -0,0 +1,112 @@
+"""Russian Snowball stemmer (https://snowballstem.org/algorithms/russian/stemmer.html).
+
+Self-contained because `pyproject.toml` is a frozen contract (#34): no new dependencies for the RAG.
+Latin words and digits pass through lowercased; "ё" is folded to "е".
+"""
+
+import re
+from functools import lru_cache
+
+_VOWELS = set("аеиоуыэюя")
+
+# (suffixes, needs_a_ya): group-1 suffixes count only when preceded by "а"/"я" (which stays in the stem).
+_PERFECTIVE_GERUND = ((("вшись", "вши", "в"), True), (("ившись", "ывшись", "ивши", "ывши", "ив", "ыв"), False))
+_REFLEXIVE = ((("ся", "сь"), False),)
+_ADJECTIVE = (
+    (
+        (
+            "ими", "ыми", "его", "ого", "ему", "ому", "ее", "ие", "ые", "ое", "ей", "ий", "ый", "ой", "ем",
+            "им", "ым", "ом", "их", "ых", "ую", "юю", "ая", "яя", "ою", "ею",
+        ),
+        False,
+    ),
+)  # fmt: skip
+_PARTICIPLE = ((("ем", "нн", "вш", "ющ", "щ"), True), (("ивш", "ывш", "ующ"), False))
+_VERB = (
+    (("ла", "на", "ете", "йте", "ли", "й", "л", "ем", "н", "ло", "но", "ет", "ют", "ны", "ть", "ешь", "нно"), True),
+    (
+        (
+            "ила", "ыла", "ена", "ейте", "уйте", "ите", "или", "ыли", "ей", "уй", "ил", "ыл", "им", "ым", "ен",
+            "ило", "ыло", "ено", "ят", "ует", "уют", "ит", "ыт", "ены", "ить", "ыть", "ишь", "ую", "ю",
+        ),
+        False,
+    ),
+)  # fmt: skip
+_NOUN = (
+    (
+        (
+            "иями", "ями", "ами", "ией", "иям", "ием", "иях", "ев", "ов", "ие", "ье", "еи", "ии", "ей", "ой",
+            "ий", "ям", "ем", "ам", "ом", "ах", "ях", "ию", "ью", "ия", "ья", "а", "е", "и", "й", "о", "у",
+            "ы", "ь", "ю", "я",
+        ),
+        False,
+    ),
+)  # fmt: skip
+_DERIVATIONAL = ((("ость", "ост"), False),)
+_SUPERLATIVE = ((("ейше", "ейш"), False),)
+
+_CYRILLIC_WORD = re.compile(r"^[а-я]+$")
+
+
+def _strip(word: str, start: int, groups: tuple[tuple[tuple[str, ...], bool], ...]) -> str | None:
+    """Remove the longest matching suffix lying in word[start:], or `None` if none matches."""
+    best: tuple[int, str] | None = None
+    for suffixes, needs_a_ya in groups:
+        for suffix in suffixes:
+            if not word.endswith(suffix) or len(word) - len(suffix) < start:
+                continue
+            if needs_a_ya and (len(word) - len(suffix) - 1 < start or word[-len(suffix) - 1] not in "ая"):
+                continue
+            if best is None or len(suffix) > best[0]:
+                best = (len(suffix), word[: -len(suffix)])
+    return None if best is None else best[1]
+
+
+def _regions(word: str) -> tuple[int, int]:
+    """RV (after the first vowel) and R2 start indices."""
+    rv = next((i + 1 for i, ch in enumerate(word) if ch in _VOWELS), len(word))
+
+    def after_vc(start: int) -> int:
+        for i in range(start + 1, len(word)):
+            if word[i] not in _VOWELS and word[i - 1] in _VOWELS:
+                return i + 1
+        return len(word)
+
+    return rv, after_vc(after_vc(0))
+
+
+@lru_cache(maxsize=65536)
+def stem(word: str) -> str:
+    word = word.lower().replace("ё", "е")
+    if not _CYRILLIC_WORD.match(word):
+        return word
+    rv, r2 = _regions(word)
+
+    # Step 1
+    out = _strip(word, rv, _PERFECTIVE_GERUND)
+    if out is None:
+        word = _strip(word, rv, _REFLEXIVE) or word
+        out = _strip(word, rv, _ADJECTIVE)
+        if out is not None:
+            out = _strip(out, rv, _PARTICIPLE) or out
+        else:
+            out = _strip(word, rv, _VERB)
+            if out is None:
+                out = _strip(word, rv, _NOUN)
+    word = out if out is not None else word
+
+    # Step 2
+    if word.endswith("и") and len(word) - 1 >= rv:
+        word = word[:-1]
+    # Step 3
+    word = _strip(word, r2, _DERIVATIONAL) or word
+    # Step 4
+    if word.endswith("нн") and len(word) - 1 >= rv:
+        return word[:-1]
+    sup = _strip(word, rv, _SUPERLATIVE)
+    if sup is not None:
+        word = sup
+        return word[:-1] if word.endswith("нн") else word
+    if word.endswith("ь") and len(word) - 1 >= rv:
+        word = word[:-1]
+    return word

app/main.py

@@ -30,12 +30,24 @@ async def lifespan(_: FastAPI) -> AsyncGenerator[None, None]:
         # In compose Postgres is required and healthy before the app starts; this branch is for running the
         # API (and its tests) without a database. Endpoints touching the DB will fail until it is reachable.
         log.error("db init failed, continuing without db: %s", type(exc).__name__)
+        if settings.max_enabled:
+            raise  # MAX requires persistent bindings and a delivery queue.
     # Lanes fill these in (#13, #11); main.py itself stays frozen (#34).
-    await scheduler.start()
+    max_channel = None
+    try:
         await telegram.start()
+        if settings.max_enabled:
+            from app.channels import max_bot
+
+            max_channel = max_bot
+            await max_channel.start()
+        await scheduler.start()
         yield
-    await telegram.stop()
+    finally:
         await scheduler.stop()
+        if max_channel is not None:
+            await max_channel.stop()
+        await telegram.stop()
         await dispose()
 
 

app/scheduler/demo.py

@@ -0,0 +1,257 @@
+"""Demo scheduler on the virtual clock (#13, SPEC §8, ADR-005).
+
+`run_until(now)` replays, in time order, every event that is due by `now` and still fresh
+(`config/scheduler.yaml`):
+
+  * med_reminder  — a `doses` row (pending) per prescription time, then `system:med_reminder {dose_id, drug, dose}`;
+  * missed        — a reminded dose still pending `missed_after_hours` later → status `missed` → monitoring;
+  * daily_checkin — `system:daily_checkin` at the check-in time;
+  * scale_due     — scales due by the module schedules (`config/modules.yaml`) → `system:scale_due`;
+  * evaluation    — once a day `MonitoringService.after_data_change()`: catches silence > N days (rule
+                    `no_contact_3d`) and missed doses even when the patient writes nothing.
+
+The rules decide (ADR-007); the scheduler only turns their dialog actions into system events for the engine
+(`reach_out` → `system:reach_out`, `schedule_scale` → `system:scale_due`). Replies go to `integrations.outbox`.
+
+Idempotent: a delivered event is stored in `scheduler_events` under a unique key and never sent again; a failed
+delivery is not stored and is retried on the next run while it is fresh (at least once). Only patients with
+consent (and adult) are contacted; while a crisis is open no reminders, check-ins or scales are sent.
+Time comes only from the arguments / `app.core.clock` (guardrail #4).
+"""
+
+from __future__ import annotations
+
+import logging
+from dataclasses import dataclass, field
+from datetime import date, datetime, time, timedelta
+from functools import lru_cache
+from pathlib import Path
+from typing import Any
+
+import yaml
+from pydantic import BaseModel, ConfigDict, Field
+from sqlalchemy import select
+from sqlalchemy.ext.asyncio import AsyncSession
+
+from app.config import get_settings
+from app.core.modules import due_scales, load_modules
+from app.core.rules import Action
+from app.db import repo
+from app.db.clinical import DialogState, Dose, PatientProfile, Prescription
+from app.db.scheduler import SchedulerEvent
+from app.db.session import get_clinical_session
+from app.dialog.contracts import Event, Reply, get_engine
+from app.integrations.base import integrations
+from app.services.contracts import get_monitoring
+
+log = logging.getLogger(__name__)
+
+# ------------------------------------------------------------------------------------------------ config
+
+
+class _Strict(BaseModel):
+    model_config = ConfigDict(extra="forbid", frozen=True)
+
+
+class DosesConfig(_Strict):
+    late_hours: float = Field(gt=0)
+    missed_after_hours: float = Field(gt=0)
+
+
+class Window(_Strict):
+    time: time
+    late_hours: float = Field(gt=0)
+
+
+class SchedulerConfig(_Strict):
+    enabled: bool = True
+    tick_seconds: float = Field(gt=0)
+    doses: DosesConfig
+    daily_checkin: Window
+    scales: Window
+    evaluation: Window
+
+
+@lru_cache
+def load_config(path: Path | None = None) -> SchedulerConfig:
+    path = path or get_settings().config_dir / "scheduler.yaml"
+    return SchedulerConfig.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
+
+
+# ------------------------------------------------------------------------------------------------ jobs
+
+# Same due time → this order: the dose before the check-in that asks about it.
+_ORDER = {"evaluation": 0, "missed": 1, "med_reminder": 2, "scale_due": 3, "daily_checkin": 4}
+
+
+@dataclass(order=True)
+class Job:
+    due: datetime
+    rank: int
+    token: str
+    key: str
+    kind: str = field(compare=False)
+    params: dict[str, Any] = field(default_factory=dict, compare=False)
+
+
+def _job(due: datetime, token: str, key: str, kind: str, **params: Any) -> Job:
+    return Job(due=due, rank=_ORDER[kind], token=token, key=key, kind=kind, params=params)
+
+
+def _at(day: date, t: time, now: datetime) -> datetime:
+    return datetime.combine(day, t, tzinfo=now.tzinfo)
+
+
+def _fresh(due: datetime, now: datetime, late_hours: float) -> bool:
+    return due <= now < due + timedelta(hours=late_hours)
+
+
+def _window(day: date, w: Window, now: datetime) -> datetime | None:
+    due = _at(day, w.time, now)
+    return due if _fresh(due, now, w.late_hours) else None
+
+
+async def _dose_jobs(s: AsyncSession, p: PatientProfile, now: datetime, cfg: SchedulerConfig) -> list[Job]:
+    jobs: list[Job] = []
+    today = now.date()
+    for rx in (await s.scalars(select(Prescription).where(Prescription.token == p.token))).all():
+        start = rx.start_date or p.therapy_start
+        for day in (today - timedelta(days=1), today):  # a fresh dose is never older than a day
+            if (start and day < start) or (rx.end_date and day > rx.end_date):
+                continue
+            for raw in (rx.schedule or {}).get("times", []):
+                planned = _at(day, time.fromisoformat(raw), now)
+                if _fresh(planned, now, cfg.doses.late_hours):
+                    key = f"dose:{rx.id}:{planned.isoformat(timespec='minutes')}"
+                    jobs.append(_job(planned, p.token, key, "med_reminder", rx_id=rx.id, planned_at=planned))
+    return jobs
+
+
+async def _missed_jobs(s: AsyncSession, token: str, now: datetime, cfg: SchedulerConfig) -> list[Job]:
+    after = timedelta(hours=cfg.doses.missed_after_hours)
+    stmt = select(Dose).where(Dose.token == token, Dose.status == "pending", Dose.planned_at <= now - after)
+    return [_job(d.planned_at + after, token, f"missed:{d.id}", "missed", dose_id=d.id) for d in await s.scalars(stmt)]
+
+
+async def _scale_jobs(s: AsyncSession, p: PatientProfile, now: datetime, cfg: SchedulerConfig) -> list[Job]:
+    due_at = _window(now.date(), cfg.scales, now)
+    if due_at is None:
+        return []
+    last: dict[str, date] = {}
+    for r in await repo.list_scale_results(s, p.token):
+        if r.complete:
+            last[r.scale] = r.ts.astimezone(now.tzinfo).date()
+    if p.therapy_start:
+        # A scale never taken counts from the visit where therapy started, not as overdue on day 0.
+        for mod in load_modules().modules.values():
+            for entry in mod.schedule:
+                last.setdefault(entry.scale, p.therapy_start)
+    therapy_day = (now.date() - p.therapy_start).days if p.therapy_start else 0
+    scales = due_scales(set(p.modules or []), therapy_day, last, now.date())
+    return [_job(due_at, p.token, f"scale:{sc}:{now.date()}", "scale_due", scale=sc) for sc in scales]
+
+
+async def collect(now: datetime, cfg: SchedulerConfig | None = None) -> list[Job]:
+    """Due and fresh, not yet delivered events of all contactable patients, in time order."""
+    cfg = cfg or load_config()
+    jobs: list[Job] = []
+    async with get_clinical_session() as s:
+        for p in (await s.scalars(select(PatientProfile).order_by(PatientProfile.token))).all():
+            state = await s.get(DialogState, p.token)
+            data = state.data if state is not None else {}
+            if data.get("consent") is not True or data.get("adult") is not True:
+                continue
+            mine = await _missed_jobs(s, p.token, now, cfg)
+            if (due := _window(now.date(), cfg.evaluation, now)) is not None:
+                mine.append(_job(due, p.token, f"eval:{now.date()}", "evaluation"))
+            if not (data.get("crisis") or {}).get("open"):
+                mine += await _dose_jobs(s, p, now, cfg)
+                mine += await _scale_jobs(s, p, now, cfg)
+                if (due := _window(now.date(), cfg.daily_checkin, now)) is not None:
+                    mine.append(_job(due, p.token, f"checkin:{now.date()}", "daily_checkin"))
+            done = set((await s.scalars(select(SchedulerEvent.key).where(SchedulerEvent.token == p.token))).all())
+            jobs += [j for j in mine if j.key not in done]
+    return sorted(jobs)
+
+
+# ------------------------------------------------------------------------------------------------ delivery
+
+
+async def _system(token: str, kind: str, **params: Any) -> None:
+    replies: list[Reply] = await get_engine().handle(
+        token,
+        Event(type="system", system=kind, params=params),  # type: ignore[arg-type]
+    )
+    if replies:
+        await integrations.outbox.push(token, replies)
+
+
+async def _after_rules(token: str) -> None:
+    """Monitoring pass outside a dialog: hand the rules' dialog actions to the engine as system events."""
+    actions: list[Action] = await get_monitoring().after_data_change(token)
+    for a in actions:
+        if a.type == "reach_out":
+            await _system(token, "reach_out", **a.params)
+        elif a.type == "schedule_scale" and a.params.get("scale"):
+            await _system(token, "scale_due", scale=a.params["scale"], scheduled=bool(a.params.get("scheduled")))
+        elif a.type == "crisis":
+            log.warning("scheduler crisis action token=%s code=%s", token, a.code)  # alert already persisted
+
+
+async def _ensure_dose(token: str, rx_id: int, planned_at: datetime) -> tuple[int, Prescription]:
+    async with get_clinical_session() as s:
+        rx = await s.get(Prescription, rx_id)
+        assert rx is not None
+        dose = await s.scalar(
+            select(Dose).where(Dose.token == token, Dose.prescription_id == rx_id, Dose.planned_at == planned_at)
+        )
+        if dose is None:
+            dose = Dose(token=token, prescription_id=rx_id, planned_at=planned_at, status="pending")
+            s.add(dose)
+            await s.flush()
+        return dose.id, rx
+
+
+async def _mark_missed(dose_id: int) -> bool:
+    async with get_clinical_session() as s:
+        dose = await s.get(Dose, dose_id)
+        if dose is None or dose.status != "pending":
+            return False  # answered meanwhile
+        dose.status = "missed"
+        return True
+
+
+async def _run(job: Job, now: datetime) -> None:
+    if job.kind == "med_reminder":
+        dose_id, rx = await _ensure_dose(job.token, job.params["rx_id"], job.params["planned_at"])
+        await _system(job.token, "med_reminder", dose_id=dose_id, drug=rx.drug, dose=rx.dose)
+    elif job.kind == "missed":
+        if await _mark_missed(job.params["dose_id"]):
+            await _after_rules(job.token)
+    elif job.kind == "daily_checkin":
+        await _system(job.token, "daily_checkin")
+    elif job.kind == "scale_due":
+        await _system(job.token, "scale_due", scale=job.params["scale"], scheduled=True)
+    elif job.kind == "evaluation":
+        await _after_rules(job.token)
+
+
+async def _done(job: Job, now: datetime) -> None:
+    async with get_clinical_session() as s:
+        s.add(SchedulerEvent(token=job.token, key=job.key, kind=job.kind, due_at=job.due, done_at=now))
+
+
+async def run_until(now: datetime, cfg: SchedulerConfig | None = None) -> list[Job]:
+    """Deliver every due event up to `now` in time order; returns the delivered jobs."""
+    delivered: list[Job] = []
+    for job in await collect(now, cfg):
+        try:
+            await _run(job, now)
+        except Exception as exc:  # noqa: BLE001 — one patient's failure must not stop the others
+            log.error("scheduler job failed token=%s kind=%s error=%s", job.token, job.kind, type(exc).__name__)
+            continue
+        await _done(job, now)
+        delivered.append(job)
+    if delivered:
+        log.info("scheduler delivered=%s", [(j.token, j.kind) for j in delivered])
+    return delivered

app/scheduler/jobs.py

@@ -1,13 +1,210 @@
-"""Scheduler on the (virtual) demo clock — stub until #13. Called from app.main lifespan."""
+"""Scheduler on the demo clock: questionnaire jobs when that release is on, else the demo scheduler (#13).
+
+One scheduler per database. PostgreSQL's advisory transaction lock serializes
+workers; an asyncio lock does the same within a SQLite demonstration process.
+Deliveries are at least once: the channel protocol offers no idempotency key.
+"""
+
+import asyncio
+import logging
+from contextlib import suppress
+from datetime import datetime
+from zoneinfo import ZoneInfo
+
+from sqlalchemy import select, text
+from sqlalchemy.exc import SQLAlchemyError
+
+from app.core import clock
+from app.core.intake_questions import DIARY_KINDS
+from app.core.intake_runtime import due_scales, intake_enabled, load_runtime
+from app.core.questionnaire import load_policy
+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 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
+_lock = asyncio.Lock()
 
 
-async def start() -> None:
+async def plan():
-    """Start periodic ticking (#13)."""
+    now = clock.now()
+    p = load_runtime()
+    local = now.astimezone(ZoneInfo(p.timezone))
+    async with get_clinical_session() as session:
+        profiles = (await session.scalars(select(PatientProfile))).all()
+        for profile in profiles:
+            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:
+                continue
+            diaries = [r.day for r in rows if r.kind in DIARY_KINDS and r.status == "complete"]
+            last_activity = max([*diaries, initial.day])
+            high_risk = profile.enhanced_monitoring or bool(state.data.get("crisis"))
+            if high_risk and (local.date() - last_activity).days >= p.high_risk_silence_days:
+                await service.alert(session, profile.token, f"silence:{last_activity}", "high_risk_silence", now)
+            if (state.data.get("crisis") or {}).get("open") or state.data.get("intake_review_required"):
+                continue
+            done = {r.kind for r in rows if r.day == local.date() and r.status == "complete"}
+            # Stage 2 diary: morning block after waking, evening block at evening_hour («Этап 2», p.2).
+            for kind, hour in (("diary_morning", p.morning_hour), ("diary_evening", p.evening_hour)):
+                if local.hour >= hour and kind not in done:
+                    await service.queue_task(session, profile.token, kind, f"{kind}:{local.date()}", now)
+            last = {}
+            for row in rows:
+                if row.status != "complete":
+                    continue
+                for sid in ("phq9", "pcl5", "rus_audit_s"):
+                    if row.details.get("totals", {}).get(sid, {}).get("complete"):
+                        last[sid] = row.completed_at.astimezone(ZoneInfo(p.timezone)).date()
+            route = initial.details["decision"]["primary_route"]
+            prescriptions = await integrations.prescriptions.get_prescriptions(profile.token)
+            changes = [
+                v.start_date
+                for v in prescriptions
+                if v.start_date and v.start_date <= local.date() and (v.end_date is None or v.end_date >= local.date())
+            ]
+            if profile.therapy_start and profile.therapy_start <= local.date():
+                changes.append(profile.therapy_start)
+            closed = (state.data.get("crisis") or {}).get("closed_at")
+            crisis_date = datetime.fromisoformat(closed).astimezone(ZoneInfo(p.timezone)).date() if closed else None
+            scales = due_scales(
+                today=local.date(),
+                enrolled=initial.day,
+                last=last,
+                route="self_help" if route == "self_help" else "specialist",
+                medication_changed=max(changes) if changes else None,
+                after_crisis=crisis_date,
+                policy=p,
+            )
+            # Suicide-risk module: C-SSRS «since last contact» every day, only under risk monitoring.
+            if profile.enhanced_monitoring and local.hour >= p.evening_hour and "cssrs_since_contact" not in done:
+                await service.queue_task(session, profile.token, "cssrs_since_contact", f"cssrs:{local.date()}", now)
+            totals = initial.details.get("totals", {})
+            modules = set(profile.modules or [])
+            policy = load_policy()
+            # PHQ-9 only with depression or a positive PHQ-2; PCL-5 only with PTSD or a positive TSQ («Этап 2», p.3).
+            wanted = {
+                "phq9": "depression" in modules or bool(totals.get("phq9", {}).get("complete")),
+                "pcl5": "veteran" in modules or (totals.get("tsq", {}).get("total") or 0) >= policy.tsq_expand_at,
+                "rus_audit_s": True,
+            }
+            for sid in scales:
+                if wanted[sid]:
+                    await service.queue_task(session, profile.token, sid, f"{sid}:{local.date()}", now)
 
 
-async def stop() -> None:
+async def deliver():
-    """Stop the scheduler (#13)."""
+    async with get_clinical_session() as session:
+        task_ids = list(
+            (
+                await session.scalars(
+                    select(QuestionnaireTask.id)
+                    .where(
+                        QuestionnaireTask.sent_at.is_(None),
+                        QuestionnaireTask.status != "cancelled",
+                        QuestionnaireTask.due_at <= clock.now(),
+                    )
+                    .order_by((QuestionnaireTask.kind != "cssrs_since_contact"), QuestionnaireTask.id)
+                )
+            ).all()
+        )
+    for task_id in task_ids:
+        async with get_clinical_session() as session:
+            task = await session.get(QuestionnaireTask, task_id)
+            state = await repo.get_dialog_state(session, task.token)
+            if not state or state.data.get("consent") is not True or state.data.get("adult") is not True:
+                task.status, task.delivery = "cancelled", []
+                continue
+            if (state.data.get("crisis") or {}).get("open"):
+                continue
+            if task.status == "done" and not task.delivery:
+                continue
+            token = task.token
+            payload = task.delivery
+            if not payload and state.state not in ("idle", "intake.collect"):
+                continue
+        if not payload:
+            await get_engine().handle(
+                token, Event(type="system", system="daily_checkin", params={"questionnaire_task": task_id})
+            )
+        # Serialize delivery with withdrawal of consent and user answers.
+        async with get_clinical_session() as session:
+            await service.lock_patient(session, token)
+            state = await repo.get_dialog_state(session, token)
+            task = await session.get(QuestionnaireTask, task_id)
+            if not state or state.data.get("consent") is not True or not task.delivery:
+                continue
+            try:
+                await asyncio.wait_for(
+                    integrations.outbox.push(token, [Reply.model_validate(r) for r in task.delivery]), timeout=10
+                )
+            except Exception as exc:
+                log.warning("questionnaire outbox error=%s", type(exc).__name__)
+            else:
+                task.sent_at = clock.now()
 
 
-async def run_until_now() -> None:
+async def run_until_now():
-    """Replay all due events up to `app.core.clock.now()` in order, idempotently (#13)."""
+    async with _lock, get_clinical_session() as guard:
+        if guard.bind.dialect.name == "postgresql" and not await guard.scalar(
+            text("SELECT pg_try_advisory_xact_lock(520053)")
+        ):
+            return
+        await service.dispatch_notices()
+        if not intake_enabled():
+            # Questionnaire release off → the demo scheduler (doses, check-ins, scales, silence) runs instead.
+            if demo.load_config().enabled:
+                await demo.run_until(clock.now())
+            return
+        await plan()
+        await deliver()
+        await service.dispatch_notices()
+
+
+async def _run():
+    while True:
+        try:
+            await run_until_now()
+        except Exception as exc:
+            log.error("questionnaire scheduler error=%s", type(exc).__name__)
+        await asyncio.sleep(demo.load_config().tick_seconds)
+
+
+async def start():
+    global _worker
+    try:
+        await monitoring.init_clock_persistence()
+    except (OSError, SQLAlchemyError) as exc:
+        log.error("clock persistence unavailable error=%s", type(exc).__name__)
+    if _worker is None and (intake_enabled() or demo.load_config().enabled):
+        _worker = asyncio.create_task(_run())
+
+
+async def stop():
+    global _worker
+    if _worker is not None:
+        _worker.cancel()
+        with suppress(asyncio.CancelledError):
+            await _worker
+        _worker = None

app/services/anonymous_care.py

@@ -0,0 +1,24 @@
+"""Pseudonymous care routing; no identity fields or changes to clinical release gates."""
+
+from hashlib import sha256
+
+import yaml
+from pydantic import BaseModel, ConfigDict, Field
+
+from app.config import get_settings
+
+
+class AnonymousCare(BaseModel):
+    model_config = ConfigDict(extra="forbid", str_strip_whitespace=True)
+    doctor_id: str = Field(min_length=1, max_length=64)
+
+
+def doctor_id() -> str:
+    path = get_settings().config_dir / "anonymous_care.yaml"
+    return AnonymousCare.model_validate(yaml.safe_load(path.read_text())).doctor_id
+
+
+def display_name(token: str) -> str:
+    # Do not use a piece of the bearer token itself as the public patient label.
+    label = sha256(("anonymous-patient:" + token).encode()).hexdigest()[:10].upper()
+    return f"Пациент {label}"

app/services/followup.py

@@ -0,0 +1,43 @@
+"""Follow-up after a crisis (clinical review 2026-10-04: «план безопасности и звонок после кризиса — обязательно»).
+
+Every crisis — from the safety lexicon, a rule (PHQ-9 item 9, C-SSRS high) or the questionnaire (red flags, high
+risk) — leaves a task for the doctor on duty: call the patient back, about 24 hours as a guide. The task is an alert
+on the dashboard; «позвонили» is its acknowledgement (`repo.ack_alert`, audited). One open task per patient: a
+repeated crisis signal does not pile up callbacks. On the next day the app itself asks how the person is, with the
+safety plan at hand (`app/scheduler/jobs.py`).
+"""
+
+from datetime import datetime, timedelta
+
+from sqlalchemy.ext.asyncio import AsyncSession
+
+from app.core.types import AlertLevel
+from app.db import repo
+from app.db.clinical import Alert
+
+POST_CRISIS_CALL = "post_crisis_call"
+ON_DUTY = "on-duty"
+CALL_WITHIN = timedelta(hours=24)  # a guide, not a guarantee
+NEXT_DAY_CHECK_AFTER = timedelta(hours=20)
+
+
+async def schedule_post_crisis_call(session: AsyncSession, token: str, now: datetime, *, source: str) -> Alert | None:
+    if POST_CRISIS_CALL in await repo.open_alert_codes(session, token):
+        return None
+    return await repo.add_alert(
+        session,
+        token=token,
+        level=AlertLevel.HIGH,
+        code=POST_CRISIS_CALL,
+        reason="Перезвонить пациенту после кризиса — дежурный специалист, ориентир 24 ч. Отметка «позвонили» — "
+        "подтверждение этого сигнала.",
+        ts=now,
+        params={"due_at": (now + CALL_WITHIN).isoformat(), "assignee": ON_DUTY, "source": source},
+    )
+
+
+def next_day_check_due(crisis: dict | None, now: datetime) -> bool:
+    """The day after a crisis the app asks how the person is — once per crisis episode."""
+    if not crisis or not crisis.get("opened_at") or crisis.get("followup_sent"):
+        return False
+    return now - datetime.fromisoformat(crisis["opened_at"]) >= NEXT_DAY_CHECK_AFTER

app/services/monitoring.py

@@ -0,0 +1,159 @@
+"""Monitoring service (#38): patient snapshot → deterministic rules → persisted alerts (ADR-007).
+
+`after_data_change(token)` is called by the dialog engine after it commits clinical data (and by the scheduler
+on silence). It builds a `PatientSnapshot`, runs `app.core.rules.evaluate`, then in one transaction:
+  * writes every `alert`/`crisis` action to `alerts` (a crisis is an `acute` alert) and, for a crisis,
+    an audit record `crisis_acute` (guardrail #6);
+  * applies `enhanced_monitoring` to the profile;
+  * refreshes the cached `status_color` of the profile (ADR-006; the source of truth stays the open alerts).
+After the commit the doctor is notified through `integrations.notifier` (a crisis also goes to the doctor on
+duty), and only the *dialog* actions are returned to the engine — it never creates alerts itself.
+
+A crisis rule whose acute alert is still open stays silent: the crisis script is already running and the
+doctor already knows, so it is neither restarted nor re-alerted (`rules.evaluate` never suppresses crises).
+
+The virtual clock offset is persisted in `clock_state` (ADR-005) by `init_clock_persistence()`.
+"""
+
+import asyncio
+import logging
+from datetime import datetime, timedelta
+
+from sqlalchemy.exc import SQLAlchemyError
+from sqlalchemy.ext.asyncio import AsyncSession
+
+from app.core import clock
+from app.core.rules import Action, evaluate, patient_status
+from app.core.types import AlertLevel
+from app.db import repo
+from app.db.audit import audit
+from app.db.session import get_clinical_session
+from app.integrations.base import integrations
+from app.services.contracts import register_monitoring
+from app.services.followup import schedule_post_crisis_call
+from app.services.snapshot import build_snapshot
+
+log = logging.getLogger(__name__)
+
+SYSTEM_ACTOR = "system"
+# Notification address of the doctor on duty: acute alerts must reach someone even when the attending doctor
+# is off (SPEC: crisis → immediate escalation). The notifier maps it to the duty channel.
+ON_DUTY_DOCTOR = "on-duty"
+# Persisted by the service itself, never passed to the dialog engine.
+_SERVICE_ACTIONS = frozenset({"alert", "enhanced_monitoring"})
+
+
+async def refresh_status(session: AsyncSession, token: str) -> str:
+    """Recompute and cache the dashboard colour from open alerts (also call it after an ack)."""
+    alerts = await repo.list_alerts(session, token=token, open_only=True)
+    status = patient_status(AlertLevel[a.level.upper()] for a in alerts)
+    await repo.upsert_profile(session, token=token, status_color=status.color)
+    return status.color
+
+
+def _drop_running_crises(actions: list[Action], open_acute: set[str]) -> list[Action]:
+    """Silence every action of a crisis rule whose acute alert is still open (see module docstring)."""
+    running = {a.code for a in actions if a.type == "crisis" and a.code in open_acute}
+    return [a for a in actions if a.code not in running]
+
+
+class RuleMonitoring:
+    async def after_data_change(self, token: str) -> list[Action]:
+        now = clock.now()
+        notify: list[tuple[str, str, str]] = []  # (doctor_id, level, text) — sent after the commit
+        async with get_clinical_session() as s:
+            profile = await repo.get_profile(s, token)
+            snapshot = await build_snapshot(s, token, now, profile=profile)
+            if profile is None or snapshot is None:
+                return []
+            open_acute = {a.code for a in await repo.list_alerts(s, token=token, open_only=True) if a.level == "acute"}
+            actions = _drop_running_crises(evaluate(snapshot), open_acute)
+            for action in actions:
+                if action.type == "enhanced_monitoring":
+                    profile.enhanced_monitoring = True
+                if not action.creates_alert or action.level is None:
+                    continue
+                alert = await repo.add_alert(
+                    s,
+                    token=token,
+                    level=action.level,
+                    code=action.code,
+                    reason=action.reason_ru,
+                    ts=now,
+                    params=action.params,
+                )
+                level = action.level.name.lower()
+                notify.append((profile.doctor_id, level, action.reason_ru))
+                if action.type == "crisis":
+                    await audit(
+                        s,
+                        actor=SYSTEM_ACTOR,
+                        action="crisis_acute",
+                        token=token,
+                        details={"alert_id": alert.id, "code": action.code},
+                        ts=now,
+                    )
+                    notify.append((ON_DUTY_DOCTOR, level, action.reason_ru))
+                    await schedule_post_crisis_call(s, token, now, source=f"rule:{action.code}")
+            await refresh_status(s, token)
+        log.info("monitoring token=%s actions=%s", token, [a.code for a in actions])
+        for doctor_id, level, text in notify:
+            await _notify(doctor_id, level, text, token)
+        return [a for a in actions if a.type not in _SERVICE_ACTIONS]
+
+    async def is_in_crisis(self, token: str) -> bool:
+        async with get_clinical_session() as s:
+            alerts = await repo.list_alerts(s, token=token, open_only=True)
+        return any(a.level == "acute" for a in alerts)
+
+
+async def _notify(doctor_id: str, level: str, text: str, token: str) -> None:
+    # The alert is already committed and visible on the dashboard; a failing channel must not undo it.
+    try:
+        await integrations.notifier.send(doctor_id, level, text, token)  # type: ignore[arg-type]
+    except Exception as exc:  # noqa: BLE001 — any channel error
+        log.warning("notify failed token=%s level=%s error=%s", token, level, type(exc).__name__)
+
+
+register_monitoring(RuleMonitoring)
+
+
+# ---------------------------------------------------------------------------------- demo clock persistence
+
+_writes: set[asyncio.Task[None]] = set()
+
+
+async def _write_offset() -> None:
+    # Writes the offset current at write time, so out-of-order tasks still leave the latest value stored.
+    try:
+        async with get_clinical_session() as s:
+            await repo.save_clock_offset(s, clock.offset().total_seconds())
+    except (OSError, SQLAlchemyError) as exc:
+        log.warning("clock offset not saved error=%s", type(exc).__name__)
+
+
+def _save_offset(_: timedelta) -> None:
+    """Sync hook for `clock.register_persistence`: schedules the DB write on the running loop."""
+    try:
+        loop = asyncio.get_running_loop()
+    except RuntimeError:
+        log.warning("clock offset not saved: no running event loop")
+        return
+    task = loop.create_task(_write_offset())
+    _writes.add(task)
+    task.add_done_callback(_writes.discard)
+
+
+async def flush_clock_writes() -> None:
+    """Wait for pending offset writes (tests, shutdown)."""
+    if _writes:
+        await asyncio.gather(*list(_writes))
+
+
+async def init_clock_persistence() -> datetime:
+    """Restore the virtual clock offset from `clock_state` and save every later change there."""
+    async with get_clinical_session() as s:
+        stored = timedelta(seconds=await repo.load_clock_offset(s))
+    clock.register_persistence(lambda: stored, _save_offset)
+    log.info("clock offset restored seconds=%s", int(stored.total_seconds()))
+    return clock.now()

app/services/questionnaire.py

@@ -0,0 +1,277 @@
+"""Transactional questionnaire storage and a durable doctor notification queue.
+
+Notifier acceptance is not delivery or a doctor's acknowledgement. At-least-once
+retries can duplicate delivery if a process dies after sending but before commit.
+"""
+
+import asyncio
+from dataclasses import asdict
+from datetime import timedelta
+from uuid import uuid4
+from zoneinfo import ZoneInfo
+
+from sqlalchemy import select
+
+from app.core import clock
+from app.core.intake_questions import content, cssrs_answers, group_answers
+from app.core.intake_runtime import load_runtime, month_before
+from app.core.questionnaire import evaluate_intake, load_policy, score_alcohol, score_cssrs_recent
+from app.core.scales import load_scale, score
+from app.core.types import AlertLevel
+from app.db import repo
+from app.db.clinical import Alert, DialogState
+from app.db.intake import QuestionnaireNotice, QuestionnaireRecord, QuestionnaireTask
+from app.db.session import get_clinical_session
+from app.integrations.base import MemoryNotifier, integrations
+
+
+async def records(session, token):
+    return list(
+        (
+            await session.scalars(
+                select(QuestionnaireRecord)
+                .where(QuestionnaireRecord.token == token)
+                .order_by(QuestionnaireRecord.started_at, QuestionnaireRecord.id)
+            )
+        ).all()
+    )
+
+
+async def create_record(ctx, kind, *, task=None):
+    profile = await ctx.profile()
+    runtime = load_runtime()
+    prior = next(
+        (r for r in reversed(await records(ctx.session, ctx.token)) if r.kind == "intake" and r.status == "complete"),
+        None,
+    )
+    sex = profile.sex if profile else None
+    if sex is None and prior:
+        sex = prior.details.get("sex")
+    day = ctx.now.astimezone(ZoneInfo(runtime.timezone)).date()
+    row = QuestionnaireRecord(
+        id=uuid4().hex,
+        token=ctx.token,
+        kind=kind,
+        version=content()["version"],
+        policy_version=load_policy().version,
+        started_at=ctx.now,
+        day=day,
+        status="active",
+        answers={},
+        details={
+            "runtime_version": runtime.version,
+            "modules": list(profile.modules or []) if profile else [],
+            "sex": sex,
+            "medication_active": bool(
+                (profile and profile.therapy_start and profile.therapy_start <= ctx.now.date())
+                or (prior and prior.answers.get("psychotropics") == 1)
+            ),
+            "suicide_monitoring": bool(profile and profile.enhanced_monitoring),
+            "weekly_pcl": kind == "pcl5" and bool((ctx.data.get("crisis") or {}).get("closed_at")),
+            "answer_metadata": {},
+            "task_id": task.id if task else None,
+            # Days since stage 1: rotates the PHQ-9 items of the depression diary module (3 a day).
+            "day_index": (day - prior.day).days if prior else 0,
+        },
+    )
+    ctx.session.add(row)
+    await ctx.session.flush()
+    if task:
+        task.record_id = row.id
+        task.status = "active"
+    return row
+
+
+def save_answer(row, question, value, now, *, derived=False):
+    """Anchor recall windows to administration, never to the day of a resumed answer."""
+    day = row.day
+    starts = {
+        "past_month": month_before(day),
+        "past_3_months": month_before(day, 3),
+        "past_week": day - timedelta(days=7),
+        "past_day": day - timedelta(days=1),
+        "последние 2 недели": day - timedelta(days=14),
+        "последний месяц": month_before(day),
+        "последняя неделя": day - timedelta(days=7),
+        "прошлая неделя": day - timedelta(days=7),
+        "последние 12 месяцев": month_before(day, 12),
+    }
+    row.answers = {**row.answers, question.id: value}
+    if question.id == "sex" and value in ("m", "f"):
+        row.details = {**row.details, "sex": value}
+    row.details = {
+        **row.details,
+        "answer_metadata": {
+            **row.details.get("answer_metadata", {}),
+            question.id: {
+                "answered_at": now.isoformat(),
+                "period": question.period,
+                "period_start": starts[question.period].isoformat() if question.period in starts else None,
+                "period_end": day.isoformat(),
+                "source": "derived" if derived else "patient",
+                "derived": derived,
+            },
+        },
+    }
+
+
+def decision(row):
+    a = row.answers
+    sex = row.details.get("sex") or (a.get("sex") if a.get("sex") in ("m", "f") else None)
+    return evaluate_intake(
+        phq9=group_answers(a, "phq9"),
+        tsq=group_answers(a, "tsq"),
+        pcl5=group_answers(a, "pcl5"),
+        alcohol=group_answers(a, "rus_audit"),
+        cssrs=cssrs_answers(a),
+        sex=sex,
+        trauma_exposure=bool(a["trauma"]) if "trauma" in a else None,
+        traumatic_brain_injury=a.get("tbi") == 1,
+        psychotropics=a.get("psychotropics") == 1,
+    )
+
+
+def summary(row):
+    a = row.answers
+    totals = {}
+    for sid in ("phq9", "tsq", "pcl5"):
+        result = score(sid, group_answers(a, sid))
+        totals[sid] = {
+            "complete": result.complete,
+            "total": result.total if result.complete else None,
+            "answered": result.answered,
+        }
+    sex = row.details.get("sex") or (a.get("sex") if a.get("sex") in ("m", "f") else None)
+    for sid in ("rus_audit_s", "rus_audit"):
+        values = {k: a[k] for k in load_scale(sid).item_ids if k in a}
+        totals[sid] = asdict(score_alcohol(values, short=sid.endswith("_s"), sex=sex))
+    totals["cssrs_recent"] = asdict(score_cssrs_recent(cssrs_answers(a)))
+    return totals
+
+
+async def finish(ctx, row, status, *, extra=None):
+    row.status = status
+    row.completed_at = ctx.now if status == "complete" else None
+    row.details = {**row.details, **(extra or {})}
+    if row.details.get("task_id"):
+        task = await ctx.session.get(QuestionnaireTask, row.details["task_id"])
+        if task:
+            task.status = "done"
+
+
+async def alert(session, token, key, code, now, *, level=AlertLevel.MODERATE, params=None):
+    existing = await session.scalar(
+        select(QuestionnaireNotice).where(QuestionnaireNotice.token == token, QuestionnaireNotice.event_key == key)
+    )
+    if existing:
+        return existing
+    row = await repo.add_alert(session, token=token, level=level, code=code, reason=code, ts=now, params=params)
+    notice = QuestionnaireNotice(token=token, event_key=key, alert_id=row.id, created_at=now)
+    session.add(notice)
+    await session.flush()
+    return notice
+
+
+async def cancel_pending(session, token):
+    for row in await records(session, token):
+        if row.status in ("active", "paused"):
+            row.status = "cancelled"
+    tasks = await session.scalars(
+        select(QuestionnaireTask).where(
+            QuestionnaireTask.token == token, QuestionnaireTask.status.in_(("pending", "active"))
+        )
+    )
+    for task in tasks:
+        task.status = "cancelled"
+        task.delivery = []
+    notices = await session.scalars(
+        select(QuestionnaireNotice).where(QuestionnaireNotice.token == token, QuestionnaireNotice.status == "pending")
+    )
+    for notice in notices:
+        notice.status = "cancelled"
+
+
+async def dispatch_notices(token=None):
+    now = clock.now()
+    async with get_clinical_session() as session:
+        stmt = (
+            select(QuestionnaireNotice.id, QuestionnaireNotice.token)
+            .where(QuestionnaireNotice.status == "pending")
+            .order_by(QuestionnaireNotice.id)
+            .limit(100)
+        )
+        if token:
+            stmt = stmt.where(QuestionnaireNotice.token == token)
+        candidates = (await session.execute(stmt)).all()
+    for notice_id, patient_token in candidates:
+        async with get_clinical_session() as session:
+            # Same lock order as withdrawal: patient first, then notice.
+            await lock_patient(session, patient_token)
+            notice = await session.scalar(
+                select(QuestionnaireNotice).where(QuestionnaireNotice.id == notice_id).with_for_update()
+            )
+            if notice.status != "pending":
+                continue
+            if notice.attempted_at and now < notice.attempted_at + timedelta(
+                minutes=min(60, 2 ** min(notice.attempts, 6))
+            ):
+                continue
+            state = await repo.get_dialog_state(session, notice.token)
+            if state is None or state.data.get("consent") is not True:
+                notice.status = "cancelled"
+                continue
+            profile = await repo.get_profile(session, notice.token)
+            if not profile or not profile.doctor_id:
+                continue
+            item = await session.get(Alert, notice.alert_id)
+            notice.attempted_at, notice.attempts = now, notice.attempts + 1
+            try:
+                await asyncio.wait_for(
+                    integrations.notifier.send(profile.doctor_id, item.level, item.code, token=notice.token), timeout=10
+                )
+            except Exception as exc:
+                notice.error_code = type(exc).__name__[:80]
+            else:
+                notice.error_code = None
+                notice.accepted_at = now
+                notice.status = (
+                    "test_sink" if isinstance(integrations.notifier, MemoryNotifier) else "accepted_by_adapter"
+                )
+
+
+async def queue_task(session, token, kind, key, now):
+    existing = await session.scalar(
+        select(QuestionnaireTask).where(QuestionnaireTask.token == token, QuestionnaireTask.task_key == key)
+    )
+    if existing:
+        return existing
+    # Only one outstanding administration per form, however many ticks were missed.
+    existing = await session.scalar(
+        select(QuestionnaireTask).where(
+            QuestionnaireTask.token == token,
+            QuestionnaireTask.kind == kind,
+            QuestionnaireTask.status.in_(("pending", "active")),
+        )
+    )
+    if existing:
+        return existing
+    row = QuestionnaireTask(token=token, kind=kind, task_key=key, due_at=now)
+    session.add(row)
+    await session.flush()
+    return row
+
+
+async def outstanding_task(session, token, kind):
+    return await session.scalar(
+        select(QuestionnaireTask).where(
+            QuestionnaireTask.token == token,
+            QuestionnaireTask.kind == kind,
+            QuestionnaireTask.status.in_(("pending", "active")),
+        )
+    )
+
+
+async def lock_patient(session, token):
+    # PostgreSQL serializes callbacks from different workers. SQLite tests additionally
+    # use the engine's in-process lock. Consent and answers share this transaction.
+    await session.scalar(select(DialogState).where(DialogState.token == token).with_for_update())

app/services/snapshot.py

@@ -0,0 +1,93 @@
+"""Patient snapshot for the rules engine, assembled from the clinical DB (ADR-007).
+
+Maps storage names to `app.core.rules` names (`sleep_bucket` → `sleep_hours_bucket`, `alcohol_bucket` →
+`alcohol`), derives age from `birth_year` and the therapy day from `therapy_start`. Time comes in as `as_of`
+(from `app.core.clock`), never from the wall clock. Must not import `app.db.identity` (guardrail #5).
+"""
+
+from datetime import datetime, timedelta
+from typing import Any, get_args
+
+from sqlalchemy import func, select
+from sqlalchemy.ext.asyncio import AsyncSession
+
+from app.core.rules import (
+    CssrsRisk,
+    DailyCheckin,
+    DoseRecord,
+    Module,
+    PatientSnapshot,
+    ScalePoint,
+)
+from app.db import repo
+from app.db.clinical import Dose, Message, PatientProfile
+
+# Risk screens are stored as scale results but reach the rules as `cssrs_risk`, not as scale points.
+CSSRS_SCALES = frozenset({"cssrs_screen", "cssrs"})
+# A C-SSRS result counts as the current risk for this long (same window as PHQ-9 item 9 and the dialog's
+# C-SSRS cooldown): one old "high" must not restart the crisis protocol after the doctor has acted on it.
+CSSRS_RECENT = timedelta(hours=24)
+# Unknown sex/age fall back to the more cautious option: lower AUDIT-C cut-off, young-adult monitoring.
+_UNKNOWN_SEX = "f"
+_UNKNOWN_AGE = 0
+
+_MODULES = frozenset(get_args(Module))
+_CSSRS_RISKS = frozenset(get_args(CssrsRisk))
+
+
+def _cssrs_risk(results: list[Any], as_of: datetime) -> CssrsRisk | None:
+    recent = [r for r in results if r.scale in CSSRS_SCALES and as_of - CSSRS_RECENT < r.ts <= as_of]
+    if not recent:
+        return None
+    severity = recent[-1].severity
+    return severity if severity in _CSSRS_RISKS else None
+
+
+async def build_snapshot(
+    session: AsyncSession, token: str, as_of: datetime, *, profile: PatientProfile | None = None
+) -> PatientSnapshot | None:
+    """Snapshot of everything the rules may look at; None if the patient has no clinical profile."""
+    profile = profile or await repo.get_profile(session, token)
+    if profile is None:
+        return None
+
+    checkins = [
+        DailyCheckin(
+            day=c.day,
+            mood=c.mood,
+            med_taken=c.med_taken,
+            sleep_hours_bucket=c.sleep_bucket,  # type: ignore[arg-type]
+            alcohol=c.alcohol_bucket,  # type: ignore[arg-type]
+            side_effects=list(c.side_effects or []),
+            quit_intent=bool(c.quit_intent),
+            nightmares=c.nightmares,
+        )
+        for c in await repo.list_checkins(session, token)
+    ]
+    results = [r for r in await repo.list_scale_results(session, token) if r.complete]
+    doses = (await session.scalars(select(Dose).where(Dose.token == token).order_by(Dose.planned_at))).all()
+    last_in = await session.scalar(
+        select(func.max(Message.ts)).where(Message.token == token, Message.direction == "in")
+    )
+    state = await repo.get_dialog_state(session, token)
+    facts = (state.data.get("facts") or {}) if state is not None else {}
+
+    return PatientSnapshot(
+        token=token,
+        as_of=as_of,
+        age=as_of.year - profile.birth_year if profile.birth_year else _UNKNOWN_AGE,
+        sex=profile.sex if profile.sex in ("m", "f") else _UNKNOWN_SEX,  # type: ignore[arg-type]
+        modules={m for m in profile.modules or [] if m in _MODULES},  # type: ignore[misc]
+        therapy_day=(as_of.date() - profile.therapy_start).days if profile.therapy_start else 0,
+        checkins=checkins,
+        scale_results=[
+            ScalePoint(scale=r.scale, ts=r.ts, total=r.total, item9=r.item9, scheduled=r.scheduled)
+            for r in results
+            if r.scale not in CSSRS_SCALES
+        ],
+        doses=[DoseRecord(planned_at=d.planned_at, status=d.status) for d in doses],  # type: ignore[arg-type]
+        cssrs_risk=_cssrs_risk(results, as_of),
+        weapon_access=facts.get("weapon_access"),
+        last_patient_message_at=last_in,
+        open_alert_codes=await repo.open_alert_codes(session, token),
+    )

config/README.md

@@ -7,3 +7,4 @@
 - `modules.yaml` — модули и расписания шкал
 - `lexicon/risk_ru.yaml` — лексикон риска
 - `texts/` — тексты для пациента (кризисный скрипт, согласие, перефразировки)
+- `rag/` — база знаний (ADR-011): `sources.yaml` (документы, параметры поиска, синонимы) и `corpus/*.txt`, собранные из PDF в `docs/source/rag/`

config/anonymous_care.yaml

@@ -0,0 +1,3 @@
+# Routing for the current prototype: anonymous patients use the same doctor workspace,
+# without an identity record. Set this to the responsible clinic's doctor when deploying.
+doctor_id: doc-smirnova

config/instruments/cssrs_recent_ru.yaml

@@ -0,0 +1,61 @@
+# Verbatim source content; only whitespace/line wraps normalized. Not enabled in the legacy dialog.
+id: cssrs_recent_ru
+version: source-2026-10-03
+title: КОЛУМБИЙСКАЯ ШКАЛА ОЦЕНКИ ТЯЖЕСТИ СУИЦИДА
+subtitle: Screen Version - Recent
+period_label_original: Последние 1 месяца
+initial_instruction: Задайте вопросы 1 и 2
+branch_instruction: ЕСЛИ ДА 2, Задайте вопросы 3, 4, 5 и 6. ЕСЛИ Нет, Задайте вопросы 6.
+options:
+- value: 1
+  label: Да
+- value: 0
+  label: Нет
+items:
+- id: q1
+  text: Возникало ли у Вас желание умереть или заснуть и не просыпаться?
+  interviewer_guidance: null
+  recall_period: past_month
+  yes_risk: low
+- id: q2
+  text: Думали ли Вы в самом деле о том, чтобы убить себя?
+  interviewer_guidance: null
+  recall_period: past_month
+  yes_risk: low
+- id: q3
+  text: Думали ли Вы о том, как Вы могли бы это сделать?
+  interviewer_guidance: 'Пациент подтверждает, что его посещают мысли о самоубийстве и что в течение периода наблюдения
+    он/она думал(-а) хотя бы об одном способе самоубийства. Данная ситуация отлична от такой, когда пациент разработал
+    конкретный план: время, место или детали метода самоубийства (например, пациент думал о способе самоубийства,
+    но не о конкретном плане). Сюда относятся люди, которые скажут: “Я думал(-а) о передозировке таблеток, но так
+    и не построил(-а) конкретного плана о том, когда, где и как осуществить это…..и я бы никогда не довёл(-а) дело
+    до конца”.'
+  recall_period: past_month
+  yes_risk: moderate
+- id: q4
+  text: Посещали ли Вас подобные мысли, и было ли у Вас какое-нибудь намерение действовать в соответствии с ними?
+  interviewer_guidance: 'Активные мысли о самоубийстве при заявлении пациента о некотором намерении действовать
+    в соответствии с этими мыслями, в отличие от подобного утверждения: “Такие мысли посещают меня, но я определенно
+    не стану ничего предпринимать”.'
+  recall_period: past_month
+  yes_risk: high
+- id: q5
+  text: Начали ли Вы разрабатывать или уже разработали детальный план самоубийства? Намереваетесь ли Вы осуществить
+    этот план?
+  interviewer_guidance: null
+  recall_period: past_month
+  yes_risk: high
+- id: q6_lifetime
+  text: Вы когда-нибудь что-нибудь делали, начинали что-то делать или готовились сделать что-нибудь, чтобы покончить
+    с собой?
+  interviewer_guidance: 'Примеры: запаслись таблетками, приобрели пистолет, раздали ценные вещи, написали завещание
+    или предсмертную записку, запаслись таблетками, но не проглотили их, держали пистолет, но передумали стрелять
+    или его кто-то выхватил из вашей руки, поднялись на крышу, но не прыгнули; или принимали таблетки, пытались
+    застрелиться, порезались, пытался повеситься и т. д.'
+  recall_period: lifetime
+  yes_risk: moderate
+- id: q6_recent
+  text: ЕСЛИ ДА, то было ли это в последние 3 месяца?
+  interviewer_guidance: null
+  recall_period: past_3_months
+  yes_risk: high

config/instruments/diary.yaml

@@ -0,0 +1,84 @@
+# Stage 2 daily diary — «Этап 2: наблюдение после диагноза» (@Andrey, 2026-10-03), p.1–3.
+# Every block comes from an instrument checked for frequent use; there are no own questions. No validated thresholds
+# exist for daily data: the diary shows a trend and brings a full scale forward, routes come from full scales only.
+# Modules follow the screening result of stage 1 (profile modules): depression → «depression», PTSD → «veteran».
+version: diary-v3-2026-10-04
+
+# Core — everyone. Morning block after waking (the sleep diary is built for it), evening block at 20:00.
+morning:
+- id: sleep_hours
+  source: Consensus Sleep Diary
+  text: Сколько часов Вы спали этой ночью?
+  numeric: true
+  max: 24
+- id: sleep_quality
+  source: Consensus Sleep Diary
+  text: Как Вы оцениваете качество своего сна?
+  options:
+  - {value: 0, label: Очень плохо}
+  - {value: 1, label: Плохо}
+  - {value: 2, label: Удовлетворительно}
+  - {value: 3, label: Хорошо}
+  - {value: 4, label: Очень хорошо}
+- id: alcohol_portions
+  source: принцип Timeline Followback; порция по RUS-AUDIT
+  text: |-
+    Сколько стандартных порций алкоголя Вы выпили вчера?
+
+    Одна порция — 100 мл вина, 250 мл пива или 30 мл крепкого алкоголя. Если не пили — введите 0.
+  numeric: true
+  max: 50
+evening:
+- id: mood
+  source: ежедневная оценка настроения (недельные средние коррелируют с PHQ-9)
+  text: |-
+    Как Вы оцениваете своё настроение сегодня?
+
+    0 — самое плохое, 10 — самое хорошее.
+  options:
+  - {value: 0, label: '0'}
+  - {value: 1, label: '1'}
+  - {value: 2, label: '2'}
+  - {value: 3, label: '3'}
+  - {value: 4, label: '4'}
+  - {value: 5, label: '5'}
+  - {value: 6, label: '6'}
+  - {value: 7, label: '7'}
+  - {value: 8, label: '8'}
+  - {value: 9, label: '9'}
+  - {value: 10, label: '10'}
+- id: medication
+  source: КР ПТСР — дневник приёма лекарств
+  text: Приняли ли Вы сегодня лекарства, назначенные врачом?
+  options:
+  - {value: 'yes', label: Да}
+  - {value: 'no', label: Нет}
+  - {value: not_prescribed, label: Лекарства не назначены}
+- id: medication_reason
+  source: КР ПТСР — дневник приёма лекарств
+  text: Почему не приняли?
+  options:
+  - {value: forgot, label: Забыл(а)}
+  - {value: side_effects, label: Побочные эффекты}
+  - {value: declined, label: Решил(а) не принимать}
+  - {value: ran_out, label: Закончились}
+
+# Depression module: PHQ-9 items with the official Russian text (config/instruments/intake_forms.yaml), answer
+# options adapted to one day. Three items a day in rotation: day 1 — items 1–3, day 2 — 4–6, day 3 — 7–9.
+# Item 9 ≥1 → stop and the crisis protocol (stage 1 rule).
+depression:
+  form: phq9
+  items_per_day: 3
+  question: 'Насколько сегодня Вас беспокоило:'
+  options:
+  - {value: 0, label: Совсем нет}
+  - {value: 1, label: Немного}
+  - {value: 2, label: Умеренно}
+  - {value: 3, label: Сильно}
+
+# PTSD module: short 4-item PCL-5 (Price et al., 2016), one item per cluster B, C, D, E; «today» instead of «the
+# past month», options 0–4 of PCL-5. Item numbers must still be checked against the article (PDF p.7, «Медику»).
+ptsd:
+  form: pcl5
+  items: [pcl5_1, pcl5_7, pcl5_10, pcl5_18]
+  question: 'Насколько сильно сегодня Вас беспокоили:'

config/instruments/intake_forms.yaml

@@ -0,0 +1,167 @@
+version: mvp-v2-2026-10-03
+forms:
+  phq9:
+    id: phq9
+    title: Опросник здоровья пациента (PHQ-9)
+    recall_period: последние 2 недели
+    instruction: Как часто за последние 2 недели Вас беспокоили следующие проблемы?
+    license_note: PHQ-9 (Pfizer) — свободное использование, разрешения не требуется.
+    translation_note: Стандартная русская версия PHQ-9 (MAPI). Финальную формулировку утверждает психиатр.
+    options:
+    - value: 0
+      label: Ни разу
+    - value: 1
+      label: Несколько дней
+    - value: 2
+      label: Более недели
+    - value: 3
+      label: Почти каждый день
+    items:
+    - id: phq9_1
+      text: Вам не хотелось ничего делать
+    - id: phq9_2
+      text: У Вас было плохое настроение, Вы были подавлены или испытывали чувство безысходности
+    - id: phq9_3
+      text: Вам было трудно заснуть, у Вас был прерывистый сон, или Вы слишком много спали
+    - id: phq9_4
+      text: Вы были утомлены, или у Вас было мало сил
+    - id: phq9_5
+      text: У Вас был плохой аппетит, или Вы переедали
+    - id: phq9_6
+      text: 'Вы плохо о себе думали: считали себя неудачником (неудачницей), или были в себе разочарованы, или считали,
+        что подвели свою семью'
+    - id: phq9_7
+      text: Вам было трудно сосредоточиться (например, на чтении газеты или на просмотре телепередач)
+    - id: phq9_8
+      text: Вы двигались или говорили настолько медленно, что окружающие это замечали? Или, наоборот, Вы были настолько
+        суетливы или взбудоражены, что двигались гораздо больше обычного
+    - id: phq9_9
+      text: Вас посещали мысли о том, что Вам лучше было бы умереть, или о том, чтобы причинить себе какой-нибудь
+        вред
+      buttons_only: true
+    range:
+      min: 0
+      max: 27
+    severity:
+    - min: 0
+      max: 4
+      code: minimal
+      label: Минимальная
+    - min: 5
+      max: 9
+      code: mild
+      label: Лёгкая
+    - min: 10
+      max: 14
+      code: moderate
+      label: Умеренная
+    - min: 15
+      max: 19
+      code: moderately_severe
+      label: Умеренно-тяжёлая
+    - min: 20
+      max: 27
+      code: severe
+      label: Тяжёлая
+    flags:
+    - code: phq9_item9_positive
+      when:
+        item: phq9_9
+        op: '>='
+        value: 1
+  pcl5:
+    id: pcl5
+    title: Контрольный список симптомов ПТСР (PCL-5)
+    recall_period: последний месяц
+    instruction: 'Ниже перечислены проблемы, которые иногда возникают у людей после очень тяжёлого, стрессового
+      события. Держа в уме самое тяжёлое для Вас событие, внимательно прочитайте каждый пункт и выберите вариант,
+      который показывает, насколько сильно эта проблема беспокоила Вас за последний месяц.
+
+      Насколько сильно за последний месяц Вас беспокоили:'
+    license_note: PCL-5 — общественное достояние (VA National Center for PTSD); русская версия — лицензия на проверке.
+    translation_note: Рабочий перевод команды (демо-текст). Финальный русский перевод выбирает психиатр (SPEC §9).
+      Для еженедельного мониторинга используется та же шкала с периодом «последняя неделя».
+    options:
+    - value: 0
+      label: Совсем нет
+    - value: 1
+      label: Немного
+    - value: 2
+      label: Умеренно
+    - value: 3
+      label: Сильно
+    - value: 4
+      label: Крайне сильно
+    items:
+    - id: pcl5_1
+      text: Повторяющиеся тяжёлые и нежелательные воспоминания о стрессовом событии?
+    - id: pcl5_2
+      text: Повторяющиеся тяжёлые сны о стрессовом событии?
+    - id: pcl5_3
+      text: Внезапное ощущение или поведение, как будто стрессовое событие происходит снова (как будто Вы действительно
+        вернулись туда и переживаете его заново)?
+    - id: pcl5_4
+      text: Сильное расстройство, когда что-то напоминало Вам о стрессовом событии?
+    - id: pcl5_5
+      text: Сильные телесные реакции, когда что-то напоминало Вам о стрессовом событии (например, сердцебиение,
+        затруднённое дыхание, потливость)?
+    - id: pcl5_6
+      text: Избегание воспоминаний, мыслей или чувств, связанных со стрессовым событием?
+    - id: pcl5_7
+      text: Избегание внешних напоминаний о стрессовом событии (например, людей, мест, разговоров, занятий, предметов
+        или ситуаций)?
+    - id: pcl5_8
+      text: Трудности с тем, чтобы вспомнить важные части стрессового события?
+    - id: pcl5_9
+      text: Сильные негативные убеждения о себе, других людях или мире (например, мысли «я плохой», «со мной что-то
+        серьёзно не так», «никому нельзя доверять», «мир абсолютно опасен»)?
+    - id: pcl5_10
+      text: Обвинение себя или кого-то другого в стрессовом событии или в том, что произошло после него?
+    - id: pcl5_11
+      text: Сильные негативные чувства, такие как страх, ужас, гнев, вина или стыд?
+    - id: pcl5_12
+      text: Потеря интереса к занятиям, которые раньше приносили Вам удовольствие?
+    - id: pcl5_13
+      text: Ощущение отдалённости или оторванности от других людей?
+    - id: pcl5_14
+      text: Трудности с тем, чтобы испытывать положительные чувства (например, неспособность чувствовать радость
+        или любовь к близким людям)?
+    - id: pcl5_15
+      text: Раздражительность, вспышки гнева или агрессивное поведение?
+    - id: pcl5_16
+      text: Чрезмерный риск или поступки, которые могут причинить Вам вред?
+    - id: pcl5_17
+      text: Повышенная бдительность, настороженность или ощущение, что нужно всё время быть начеку?
+    - id: pcl5_18
+      text: Взвинченность или склонность легко вздрагивать?
+    - id: pcl5_19
+      text: Трудности с концентрацией внимания?
+    - id: pcl5_20
+      text: Трудности с засыпанием или прерывистый сон?
+    range:
+      min: 0
+      max: 80
+    severity:
+    - min: 0
+      max: 32
+      code: below_threshold
+      label: Ниже порога ПТСР
+    - min: 33
+      max: 49
+      code: probable
+      label: Вероятное ПТСР
+    - min: 50
+      max: 80
+      code: high
+      label: Выраженная симптоматика ПТСР
+    flags:
+    - code: pcl5_probable_ptsd
+      when:
+        total: true
+        op: '>='
+        value: 33
+trauma_introduction: 'Иногда с людьми происходят события, которые оказываются необычайно пугающими, ужасными или
+  травмирующими. Например: серьёзная авария или пожар; физическое или сексуальное нападение или насилие; землетрясение
+  или наводнение; война; Вы видели, как кого-то убили или тяжело ранили; близкий человек погиб в результате убийства
+  или самоубийства.'
+trauma_filter: Случалось ли с Вами подобное событие?

config/instruments/red_flags.yaml

@@ -0,0 +1,25 @@
+# Red flags — asked first in stage 1, before any scale (clinical review 2026-10-04: «обязательно»).
+# Any «Да» stops the questionnaire: an acute alert to the doctor, a callback task for the doctor on duty and the
+# help screen (crisis script variant by `category`, config/texts/crisis.yaml). Wording — team draft, the doctor
+# approves it (#8). These are not a scale: there is no score, only a stop rule.
+version: red-flags-v1-2026-10-04
+intro: "Сначала несколько коротких вопросов о безопасности. Отвечайте так, как есть сейчас."
+options:
+- {value: 1, label: Да}
+- {value: 0, label: Нет}
+items:
+- id: rf_psychosis
+  text: Слышите ли Вы сейчас голоса или видите то, чего не видят и не слышат другие люди?
+  category: null
+- id: rf_harm_others
+  text: Есть ли у Вас сейчас мысли причинить вред другому человеку?
+  category: harm_others
+- id: rf_weapons
+  text: Есть ли у Вас дома или рядом доступ к оружию?
+  category: null
+- id: rf_violence
+  text: Угрожает ли Вам сейчас кто-то дома или применяет к Вам насилие?
+  category: domestic_violence
+- id: rf_intoxication
+  text: Находитесь ли Вы сейчас в состоянии сильного опьянения или тяжёлой отмены алкоголя либо других веществ?
+  category: null

config/intake_runtime.yaml

@@ -0,0 +1,36 @@
+version: intake-v3-2026-10-04
+enabled: false
+approval: null
+# Release decisions cover texts, diary anchors/thresholds, schedules and contact readiness.
+content_review: null
+contact_review: null
+timezone: Europe/Moscow
+# Stage 2 diary («Этап 2: наблюдение после диагноза»): morning block after waking, evening block at 20:00.
+morning_hour: 8
+evening_hour: 20
+# Personal norm = the first `norm_days` of observation; compared with the mean of the last `week_days`.
+# Flag numbers are the team's candidates (PDF «Этап 2», p.4) — agree with the doctor.
+norm_days: 14
+week_days: 7
+min_norm_values: 7
+min_week_values: 4
+mood_drop: 3                 # weekly mood mean fell ≥3 below the norm → unscheduled PHQ-9
+depression_item_rise: 1.0    # weekly mean of a PHQ-9 diary item rose ≥1 above its norm → PHQ-9 earlier
+ptsd_sum_rise: 3.0           # weekly mean of the 4-item PCL-5 sum rose ≥3 above the norm → PCL-5 earlier
+sleep_bad_days: 3            # <4 h or «очень плохо» three nights in a row → flag to the doctor
+sleep_hours_below: 4
+alcohol_heavy_portions: 6    # ≥6 standard drinks a day = heavy day (volumes of RUS-AUDIT item 3)
+alcohol_heavy_days: 2        # heavy days in a week → full RUS-AUDIT
+adherence_below: 0.8         # share of days with medication taken over a week
+missed_medication_days: 3
+high_risk_silence_days: 2
+medication_days: [7, 14, 28]
+medication_repeat_days: 28
+route_intervals:
+  after_crisis: {phq9: 7, pcl5: 14}
+  specialist: {phq9: 14, pcl5: 30}
+  self_help: {phq9: 28, pcl5: 28}
+alcohol_repeat_days: 30
+
+phq9_retriage_delta: 5
+pcl5_retriage_delta: 10

config/questionnaire.yaml

@@ -0,0 +1,13 @@
+# Review candidate from the supplied MVP PDF, not a signed clinical protocol.
+version: mvp-v2-review-2026-10-03
+approval: null
+# C01 decided by the team after the clinical review (2026-10-04, ADR-013): crisis screen at HIGH risk only.
+cssrs_positive_policy: graded
+rus_audit_s_expand_from_zone: null
+phq2_expand_at: 2
+tsq_expand_at: 6
+phq9_psychologist_at: 5
+phq9_specialist_at: 10
+phq9_priority_at: 20
+pcl5_specialist_at: 31
+pcl5_behavior_flag_at: 3

config/questionnaire_demo.yaml

@@ -0,0 +1,20 @@
+# DEMO ONLY (INTAKE_DEMO=1 + demo clock, synthetic data). NOT a clinical approval: the real policy is
+# config/questionnaire.yaml and stays closed until the doctor's decisions C01–C09 (docs/clinical/README.md).
+# Values follow the MVP PDF so the demo can reach a result and stage 2:
+#   C01 → graded: low C-SSRS risk shows the safety plan and continues (PDF p.11, routing table);
+#   C02 → full RUS-AUDIT from zone II of RUS-AUDIT-S (WHO zones, Bunova 2022).
+version: mvp-v2-demo-2026-10-04
+approval:
+  reviewer: "DEMO — синтетические данные, не клиническое согласование"
+  decision_reference: "INTAKE_DEMO"
+  approved_at: "2026-10-04T00:00:00+03:00"
+  policy_version: mvp-v2-demo-2026-10-04
+cssrs_positive_policy: graded
+rus_audit_s_expand_from_zone: 2
+phq2_expand_at: 2
+tsq_expand_at: 6
+phq9_psychologist_at: 5
+phq9_specialist_at: 10
+phq9_priority_at: 20
+pcl5_specialist_at: 31
+pcl5_behavior_flag_at: 3

config/rag/corpus/meds_module_spec.txt

@@ -0,0 +1,184 @@
+# Модуль «Лекарства»: спецификация для разработки
+
+Источник: meds_module_spec.pdf, страниц: 10. Документ команды от Oct 4, 2026, автор @Andrey. Текст перенесён вручную и сверен с PDF: автоматическое извлечение ломает вёрстку выносок и таблиц. Символ «|» внутри ячеек заменён на «/».
+
+--- стр. 1 ---
+
+Модуль следит не за абстрактными «лекарствами», а за конкретным препаратом пациента. Он напоминает о приёме, узнаёт причины пропусков, спрашивает о побочных эффектах этого препарата и работает по 10 правилам (M1–M10). Данные взяты из двух клинических рекомендаций Минздрава: по депрессии (2024) и по ПТСР (2023).
+
+Что передаём:
+- этот документ — логика модуля;
+- файл meds_reference.json (прилагается к ссылке) — справочник на 47 препаратов, тексты для пациента и параметры правил;
+- вкладка «Справочник препаратов» — тот же справочник в виде таблицы, для проверки медиком.
+
+Как модуль встраивается в этап 2. Вечерний вопрос о лекарствах, опрос о побочных эффектах на 7-й, 14-й и 28-й день и флаги «меньше 80% дней» и «пропуск 3 дня подряд» не меняются. Модуль добавляет к ним данные о препарате и новые правила.
+
+| В MVP | После хакатона |
+|---|---|
+| Справочник из JSON | Тексты инструкций из ГРЛС в карточке препарата |
+| Назначение: ввод в кабинете врача или из имитации ЕМИАС | Назначения из ЕМИАС (электронные рецепты) |
+| Напоминание о приёме и отметка в дневнике | Схема постепенной отмены препарата |
+| Опрос о побочных эффектах по профилю препарата | Ввод результатов анализов |
+| Правила M1–M10 и блок в сводке врачу | Проверка взаимодействий для врача |
+
+--- стр. 2 ---
+
+Границы: бот следит, но не лечит
+
+Препарат и дозу всегда выбирает врач. Если приложение начнёт давать советы о лечении, его могут счесть медицинским изделием, а к ним требования строже.
+
+| Бот делает | Бот не делает никогда |
+|---|---|
+| Хранит назначение врача: препарат, дозу, время приёма | Не предлагает препарат, дозу, смену или отмену |
+| Напоминает о приёме и отмечает, принят ли препарат | На вопросы «можно ли бросить» или «можно ли увеличить дозу» отвечает только «обсудите с врачом» и ставит флаг |
+| Спрашивает о побочных эффектах, характерных для этого препарата | Не исправляет и не блокирует дозу вне диапазона — только просит проверить ввод (M10) |
+| Показывает карточку препарата из проверенных источников | Не проверяет для пациента взаимодействия лекарств |
+| Сигналит врачу по правилам M1–M10 | Не ставит диагноз и не оценивает, «работает ли» лечение, — это делает врач по шкалам |
+
+Модель данных
+
+Шесть сущностей. Drug читается из JSON и в приложении не редактируется, остальные создаёт приложение.
+
+| Сущность | Поля | Откуда берётся |
+|---|---|---|
+| Drug | id, name_ru, class, indications.{depression/ptsd}.{min_mg, max_mg, start_mg, off_label}, diary_items[], red_flags[], monitoring[], withdrawal_risk, overdose_danger, max_course_days | meds_reference.json |
+
+--- стр. 3 ---
+
+| Сущность | Поля | Откуда берётся |
+|---|---|---|
+| Prescription | id, patient_id, drug_id, indication (F32/F33/F43.1), dose_mg_per_day, times[] (например, "09:00"), start_date, source (emias / doctor / patient), status (active / stopped), history[] (дата, старая и новая доза) | имитация ЕМИАС или кабинет врача; ввод пациентом — с пометкой «со слов пациента» |
+| DoseLog | prescription_id, date, taken (bool), reason (forgot / side_effects / decided_not_to / ran_out), logged_at | вечерний дневник |
+| SideEffectReport | date, trigger (scheduled / missed_dose / button), fibser.{freq, intensity, burden}, items[]: {item_id, severity: mild/severe}, red_flags[] | опрос о побочных эффектах |
+| MedEvent | prescription_id, type (start / dose_change / stop), date, baseline_scale_ids[] | создаётся при изменении Prescription |
+| MedFlag | rule_id (M1…M10), patient_id, prescription_id, created_at, recipient, due_at, status (open / acknowledged), evidence (ответы, по которым сработало правило) | движок правил |
+
+Связь с расписанием этапа 2. Любой MedEvent включает строку «Начало или смена лекарств»: полные шкалы и опрос о побочных эффектах на 7-й, 14-й, 28-й день, далее раз в 4 недели. Исходный замер для M5 — последняя полная шкала за 14 дней до события. Если её нет, шкалу проводят в день события.
+
+Дневник и опросы
+
+В обычный день добавляется только отметка по каждому препарату. Подробно спрашиваем по расписанию или после пропуска.
+
+--- стр. 4 ---
+
+1. Напоминание. Push-уведомление во время из Prescription.times: «Время принять {препарат} {доза}» и кнопка «Принял(а)». Нажатие сразу создаёт DoseLog с taken = true, и вечером этот препарат уже не спрашиваем.
+
+2. Вечерний вопрос (уже есть в ядре этапа 2), теперь по каждому препарату:
+   1. «Приняли ли Вы сегодня лекарства, назначенные врачом?» — да, все / не все / нет.
+   2. Если «не все» — выбрать, какие не приняты.
+   3. По каждому непринятому — причина: забыл(а) · побочные эффекты · решил(а) не принимать · закончились.
+   Причина напрямую запускает правила: «побочные эффекты» → внеплановый опрос (п. 3) и M8, «решил(а) не принимать» → M2, «закончились» → M3.
+
+3. Опрос о побочных эффектах. Проводится в трёх случаях: по расписанию этапа 2 (7-й, 14-й, 28-й день, далее раз в 4 недели), после пропуска «из-за побочных эффектов» и по кнопке «Сообщить о побочном эффекте», которая доступна всегда.
+   1. Три вопроса FIBSER: как часто, насколько сильно, насколько мешают жить (из этапа 2).
+   2. Если частота > 0 — «Что именно беспокоит?»: список из diary_items всех активных препаратов без повторов, плюс «другое» с текстом. У каждого пункта два ответа: немного / сильно мешает.
+   3. Вопросы о срочных симптомах — только из red_flags активных препаратов, с ответом да / нет. Ответ «да» → M7.
+   Список пунктов для препарата формируется так. Для 16 антидепрессантов берём эффекты с оценкой «++» и «+++» из таблицы 3 КР по депрессии. Для остальных препаратов — эффекты, которые названы в тексте КР. В JSON список уже собран: например, у сертралина это тошнота, бессонница, сексуальные проблемы и головная боль.
+
+4. Карточки о сроках эффекта. Текст expect_effect_depression показываем в 1-й и 14-й день после начала, expect_effect_ptsd — в 1-й и 7-й. Тексты лежат в JSON, в разделе texts.
+
+--- стр. 5 ---
+
+Контрольные точки после начала лечения
+
+[Изображение: текст перенесён вручную]
+Схема «Ответ оценивают к 4–6 неделе, лечение длится месяцы». Подзаголовок: «Фазы после начала или смены препарата: что делает модуль и что говорят КР». Таблица по фазам:
+
+| Строка | Недели 1–2 | Недели 3–6 | Месяцы и годы |
+|---|---|---|---|
+| Модуль (что делает бот) | Дни 7 и 14: шкалы и опрос о побочных. Карточка «когда ждать эффекта» | День 28: шкалы, побочные и проверка ответа — M5. Бензодиазепин дольше допустимого — M4 | Шкалы и опрос о побочных раз в 4 недели до конца курса |
+| Депрессия (КР 2024) | Раннее улучшение (1–2 недели) — благоприятный признак | Эффект через 3–4 недели, у СИОЗС — до 6–8 недель; снижение на 25–50% — ответ недостаточен | Тот же препарат и доза 4–6 мес. после улучшения; при РДР — 3–5 лет |
+| ПТСР (КР 2023) | СИОЗС: в 1-ю неделю тревога может усилиться; следить за суицидальным риском | Эффект оценивают через 4–6 недель; бензодиазепины — не дольше 3–4 недель | Курс 6–12 месяцев после стабилизации |
+
+Подпись под схемой: «Фазы после начала лечения · модуль, депрессия, ПТСР».
+
+M5 проверяет ответ на 28-й день при обоих диагнозах. Для ПТСР это ранняя граница окна из КР: окончательно эффект оценивают до 6-й недели, поэтому флаг — повод для врача посмотреть, а не сигнал тревоги.
+
+Правила сигналов M1–M10
+
+К флагам этапа 2 по лекарствам (меньше 80% дней с приёмом, пропуск 3 дня подряд, тяжёлый день алкоголя при приёме лекарств) добавляются десять правил. Пороги и сроки хранятся в rules[].params в JSON и меняются без правки кода. Строки с пометкой «черновик» нужно согласовать с психиатром.
+
+--- стр. 6 ---
+
+| ID | Условие | Что делает приложение | Кто получает, срок | Основание |
+|---|---|---|---|---|
+| M1 | У препарата withdrawal_risk = high (венлафаксин, пароксетин, ТЦА, бензодиазепины) и он пропущен 2 дня подряд | Текст withdrawal_missed и вопрос «Стало ли хуже после пропуска?» | Лечащий психиатр: ответ «хуже» — 24 ч, иначе — до 3 рабочих дней. Черновик | КР депрессия 3.6; КР ПТСР 3.2 |
+| M2 | Причина пропуска «решил(а) не принимать» | Тексты dont_stop_alone (+ why_continue_depression при F32/F33), флаг | Лечащий психиатр, до 3 рабочих дней. Черновик | КР депрессия, прил. В; КР ПТСР 6.1 |
+| M3 | Причина «закончились» | Текст ran_out; 2 дня подряд → флаг | Лечащий врач, до 3 рабочих дней. Черновик | команда |
+| M4 | Бензодиазепин принимается дольше max_course_days | Отметка в кабинете и сводке | Лечащий психиатр, к следующему визиту | КР ПТСР 3.2 |
+| M5 | 28-й день после MedEvent: PHQ-9 снизился меньше чем на 50% (F32/F33) или PCL-5 — меньше чем на 10 баллов (F43.1) от исходного | Флаг «нет ответа к 4-й неделе» | Лечащий психиатр, до 3 рабочих дней. Черновик | КР депрессия 3.1–3.2; КР ПТСР 3.2; пороги ответа — этап 2 |
+
+--- стр. 7 ---
+
+| ID | Условие | Что делает приложение | Кто получает, срок | Основание |
+|---|---|---|---|---|
+| M6 | Сработал сигнал C-SSRS (умеренный или высокий риск), а у пациента активен препарат с overdose_danger | Пометка «препарат опасен при передозировке» в этом же сигнале, новый сигнал не создаётся | Как у сигнала C-SSRS | КР депрессия 3.1.3 |
+| M7 | Пациент отметил срочный симптом из red_flags | Текст red_flag (врач сегодня; при тяжёлом состоянии 103/112), флаг | Лечащий психиатр, 24 ч. Черновик | КР депрессия 3.1, 3.3; КР ПТСР 3.2 |
+| M8 | FIBSER «насколько мешают» ≥ 5 из 6 или пропуск «из-за побочных» в 2 из 7 дней | Текст side_effects_general, флаг | Лечащий психиатр, до 3 рабочих дней. Черновик | КР депрессия, прил. В |
+| M9 | У активного препарата есть monitoring | Строка «Контроль по КР: …» в сводке врачу, это не сигнал | Лечащий врач, в сводке | КР депрессия 3.1, 3.3; КР ПТСР 3.2 |
+| M10 | При сохранении назначения доза вне min_mg – max_mg для этого диагноза | «Проверьте ввод» тому, кто вводит; пометка в сводке; сохранение не блокируется | Тот, кто вводит, сразу | Приложения А3 обеих КР |
+
+Все флаги попадают в кабинет врача с датой, правилом и ответами, по которым правило сработало, как в этапе 2.
+
+Карточка препарата, сводка врачу, демо
+
+Карточка препарата построена по списку «что сообщить пациенту» из КР по депрессии (приложение В). Поля с источником «инструкция» в MVP показывают «Уточните у врача или в инструкции». Для 2–3 демо-препаратов их можно заполнить вручную.
+
+--- стр. 8 ---
+
+| Поле | Источник | Пример: сертралин при ПТСР |
+|---|---|---|
+| Название, доза, время приёма | Prescription | Сертралин, 50 мг в сутки, в 09:00 |
+| Когда ждать эффекта | indications.*.expected_response | Эффект оценивают через 4–6 недель |
+| Сколько принимать | indications.*.course + решение врача | Обычно 6–12 месяцев после стабилизации |
+| Частые побочные эффекты | diary_items | Тошнота, бессонница, сексуальные проблемы, головная боль |
+| Когда срочно к врачу | red_flags | Необычные кровотечения или синяки |
+| Не прекращать самостоятельно | texts.dont_stop_alone | общий текст |
+| Как принимать, связь с едой, что делать при пропуске | инструкция (ГРЛС) | — |
+| Алкоголь, вождение, беременность | инструкция (ГРЛС) | — |
+
+Блок «Лекарства» в сводке врачу (дополняет сводку этапа 2), по каждому препарату:
+- препарат, доза, дата начала и неделя приёма рядом с ожидаемым сроком ответа (например, «неделя 3 из 4–6»);
+- доля дней с приёмом за 4 недели и причины пропусков;
+- побочные эффекты: FIBSER и пункты «что именно» по замерам, срочные симптомы;
+- ответ на 28-й день (M5), контроль по КР (M9), пометки M4 и M10.
+
+Демо: ветеран Иван, ПТСР. Этот сценарий стыкуется с демо этапа 2: там ухудшение на 3-й неделе, здесь видна его причина.
+
+--- стр. 9 ---
+
+1. День 0. Врач в кабинете назначает сертралин 50 мг в сутки (препарат 1-й линии по КР ПТСР). Включается расписание «Начало или смена лекарств», пациент получает карточку expect_effect_ptsd.
+2. День 3. Отметка «не принял — побочные эффекты». Внеплановый опрос: тошнота «немного», бессонница «сильно мешает».
+3. День 7. Плановые шкалы и опрос о побочных эффектах.
+4. Дни 17–19. Три дня подряд «решил не принимать». На 17-й день срабатывает M2 (карточка и флаг врачу), на 19-й — флаг этапа 2 «пропуск 3 дня».
+5. Неделя 3. Ухудшение по дневнику → внеплановый PCL-5 → повторный триаж (сценарий этапа 2). В сводке врач видит, что ухудшение совпало с прекращением приёма из-за бессонницы.
+
+Для питча: КР по ПТСР (раздел 3.2) прямо рекомендуют для соблюдения режима «ведение дневника приёма лекарств или телефонное приложение с напоминанием». В разделе 6.1 сказано, что пациенты часто бросают лекарства после улучшения и состояние ухудшается.
+
+Черновые параметры — согласовать с психиатрами
+
+Код можно писать сейчас: все числа ниже лежат в JSON и заменяются без правки логики. Вопросы к врачам по этапу 2 собраны в документе «Этап 2: вопросы к психиатрам».
+
+| Параметр | Черновое значение | Основание |
+|---|---|---|
+| M1: сколько дней пропуска препарата с риском отмены | 2 дня подряд | риск — КР; число — команда |
+| M4: предел курса бензодиазепинов | 21 день; диазепам 28; алпразолам 90 | КР ПТСР 3.2 |
+| M5: день проверки ответа | 28-й день для обоих диагнозов | КР: депрессия 3–4 недели, ПТСР 4–6 недель |
+| M5: исходный замер | последняя полная шкала за 14 дней до старта, иначе в день старта | команда |
+| M8: «сильно мешают» | FIBSER-бремя ≥ 5 из 6 или 2 пропуска из-за побочных за 7 дней | порог FIBSER сверить с оригиналом шкалы |
+
+--- стр. 10 ---
+
+| Параметр | Черновое значение | Основание |
+|---|---|---|
+| M7: список срочных симптомов и текст пациенту | 5 симптомов из JSON, текст red_flag | симптомы — КР; текст — команда |
+| Сроки реакции | 24 ч / до 3 рабочих дней / к визиту | как в этапе 2 |
+| Ввод назначения пациентом | разрешён, с пометкой «со слов пациента» | команда |
+| Все тексты для пациента из texts | черновики | вычитать врачу |
+
+Источники
+- Клинические рекомендации «Депрессивный эпизод, рекуррентное депрессивное расстройство», Минздрав РФ, 2024, Российское общество психиатров. Использованы разделы 3.1–3.6 и приложения А3 (табл. 2 — дозы, табл. 3 — побочные эффекты), Б5 (синдром отмены), В (информация для пациента).
+- Клинические рекомендации «Посттравматическое стрессовое расстройство», Минздрав РФ, 2023, ID 753, Российское общество психиатров. Использованы разделы 3.2 и 6.1, приложения А3 (дозы), Б1 (алгоритм терапии), В. Срок пересмотра — не позднее 2025 года: проверить, не вышла ли новая версия.
+- «Этап 2: наблюдение после диагноза» — наш документ о расписании, флагах и сроках реакции.
+
+Расхождения внутри КР отмечены в JSON в поле note. Пример: хлорпротиксен в тексте КР по ПТСР — 15–100 мг, а в таблице — 25–150 мг.

config/rag/sources.yaml

@@ -0,0 +1,108 @@
+# База знаний RAG (#60): документы, параметры поиска, синонимы.
+# Тексты в corpus/ собраны из PDF конвертером docs/source/rag/pdf_to_txt.py — правьте PDF/figures/manual
+# и перегенерируйте, а не редактируйте txt руками.
+#
+# audiences — кому можно показывать выдержки:
+#   doctor  — врач (дашборд, подсказки по КР);
+#   patient — пациент (только экстрактивно, без дозировок, с припиской «решение за врачом»);
+#   team    — внутренние документы команды (логика модулей), пациенту и врачу не показываются.
+
+documents:
+  - id: kr_ptsd
+    file: corpus/kr_ptsd.txt
+    title: "Клинические рекомендации «Посттравматическое стрессовое расстройство»"
+    short: "КР ПТСР 2023"
+    issuer: "Минздрав РФ, Российское общество психиатров"
+    year: 2023
+    icd: [F43.1]
+    audiences: [doctor, patient]
+  - id: kr_depression
+    file: corpus/kr_depression.txt
+    title: "Клинические рекомендации «Депрессивный эпизод, рекуррентное депрессивное расстройство»"
+    short: "КР Депрессия 2024"
+    issuer: "Минздрав РФ, Российское общество психиатров"
+    year: 2024
+    icd: [F32, F33]
+    audiences: [doctor, patient]
+  - id: meds_module_spec
+    file: corpus/meds_module_spec.txt
+    title: "Модуль «Лекарства»: спецификация для разработки"
+    short: "Спецификация модуля «Лекарства»"
+    issuer: "команда MedITron"
+    year: 2026
+    icd: []
+    audiences: [team]
+
+chunking:
+  max_chars: 1200      # целевой размер фрагмента; абзац длиннее режется по предложениям
+  min_chars: 200       # короткий хвост раздела приклеивается к предыдущему фрагменту того же раздела
+  # Разделы, которые не индексируются (шум для поиска). Сравнение — по началу заголовка.
+  skip_sections:
+    - "Список литературы"
+    - "Список сокращений"   # аббревиатуры раскрываются через synonyms ниже, сам список только засоряет поиск
+
+retrieval:
+  top_k: 5
+  bm25_k1: 1.5
+  bm25_b: 0.75
+  title_weight: 2      # заголовок раздела повторяется в индексе столько раз — совпадение с ним весомее
+  min_score: 3.0       # ниже — считаем, что в базе нет ответа
+  rerank_candidates: 30  # сколько лучших по BM25 фрагментов переранжировать по самому плотному отрывку
+  window_sentences: 2    # размер отрывка (предложений подряд)
+  window_weight: 0.5     # вес оценки отрывка относительно BM25
+  # Множитель оценки для разделов (по началу заголовка) в зависимости от аудитории.
+  # «Приложение В» в обеих КР — «Информация для пациента»: написано для пациента, ему и показываем в первую очередь.
+  # «Приложение Г» — бланки шкал и история их валидации, «Критерии оценки качества» — для организаторов
+  # здравоохранения: пациенту это шум.
+  section_boost:
+    patient:
+      "Приложение В": 1.5
+      "Приложение Г": 0.5
+      "Критерии оценки качества": 0.5
+  # Заболевание в вопросе -> профильная КР (регулярные выражения по вопросу в нижнем регистре).
+  # Если названы оба — ни одна не получает преимущества. Иначе «ТМС при депрессии» отвечался цитатой из КР ПТСР.
+  doc_cues:
+    kr_depression: ["(?<!анти)депресс", "\\bдэ\\b", "\\bрдр\\b"]
+    kr_ptsd: ["птср", "посттравмат", "травм", "\\bвойн", "боев", "фронт", "ветеран", "\\bсво\\b", "ptsd"]
+  doc_cue_boost: 2.0
+
+answer:
+  max_chunks: 5            # в скольких лучших фрагментах ищем отрывок
+  max_passages: 2          # отрывков в ответе (второй — только если почти так же хорош)
+  second_passage_ratio: 0.8
+  max_sentences: 3         # предложений в отрывке (подряд, как в источнике)
+  neighbor_ratio: 0.5      # соседнее предложение входит в отрывок, если его релевантность >= доли лучшего
+  max_chars: 600
+  min_coverage: 0.5        # доля «веса» слов вопроса, найденная в отрывках; ниже — «ответа нет»
+
+# Синонимы и аббревиатуры: запрос расширяется всеми формами группы (сравнение — по основам слов).
+synonyms:
+  - ["птср", "посттравматическое стрессовое расстройство"]
+  - ["кптср", "комплексное посттравматическое стрессовое расстройство"]
+  - ["рдр", "рекуррентное депрессивное расстройство"]
+  - ["дэ", "депрессивный эпизод"]
+  - ["ад", "антидепрессант"]
+  - ["сиозс", "селективные ингибиторы обратного захвата серотонина"]
+  - ["сиозсн", "ингибиторы обратного захвата серотонина и норадреналина"]
+  - ["тца", "трициклические антидепрессанты"]
+  - ["кпт", "когнитивно-поведенческая психотерапия"]
+  - ["дпдг", "emdr", "десенсибилизация и переработка травмы движениями глаз"]
+  - ["сопа", "синдром отмены антидепрессантов"]
+  - ["эст", "электросудорожная терапия"]
+  - ["ртмс", "транскраниальная магнитная стимуляция"]
+  - ["кошмар", "кошмарные сновидения"]
+  - ["бессонница", "инсомния", "нарушения сна"]
+  - ["флешбэк", "флэшбек", "навязчивые воспоминания"]
+  - ["суицид", "самоубийство", "суицидальные мысли"]
+  # Разговорная лексика пациента -> термины КР.
+  - ["таблетки", "препарат", "лекарство"]
+  - ["бросить", "отменять", "отменить", "отмена", "прекратить", "прекращение приема"]
+  - ["подействовать", "действовать", "помогать", "эффект", "улучшение"]
+  - ["антидепрессивный", "тимоаналептический"]
+  - ["привыкание", "зависимость"]
+  - ["спорт", "физическая активность", "физические упражнения", "физическая нагрузка"]
+  - ["побочка", "побочные эффекты", "нежелательные явления"]
+  - ["тошнит", "тошнота"]
+  - ["выпить", "спиртное", "алкоголь"]
+  - ["сколько длится", "продолжительность", "длительность"]
+  - ["психолог", "психотерапия"]

config/rules.yaml

@@ -62,7 +62,7 @@ rules:
     params: {}
     actions:
       - {type: alert, level: high}
-    reason_ru: "C-SSRS: умеренный риск, врачу в течение 24 ч"
+    reason_ru: "C-SSRS: умеренный риск, психиатр — ориентир 24 ч"
 
   # ---------------------------------------------------------------- scale thresholds (yellow)
   - id: phq9_severe
@@ -73,10 +73,12 @@ rules:
     reason_ru: "PHQ-9 = {total} (тяжёлая депрессия, порог {threshold})"
 
   - id: pcl5_severe
-    description: Latest PCL-5 total >= 50 → doctor within 24 h.
+    description: >
+      Latest PCL-5 total >= 50 → planned specialist review. Not a priority appointment by itself: risk and flags
+      come first, scales second (clinical review 2026-10-04).
     params: {threshold: 50}
     actions:
-      - {type: alert, level: high}
+      - {type: alert, level: moderate}
     reason_ru: "PCL-5 = {total} (порог {threshold})"
 
   - id: phq9_rise

config/scales/rus_audit.yaml

@@ -0,0 +1,58 @@
+id: rus_audit
+title: RUS-AUDIT
+recall_period: "Последние 12 месяцев; п.9 и п.10 также учитывают более ранние события"
+license_note: "RUS-AUDIT: © ВОЗ, 2021, CC BY-NC-SA 3.0 IGO; некоммерческое использование. См. docs/clinical/README.md."
+translation_note: "Текст из предоставленного PDF «Опросники для MVP», с.7–9. Самозаполнение полной интервью-формы не утверждено."
+notes: "Пункт 2 требует таблицы стандартных порций из исходного бланка. Не заменять произвольным калькулятором. Автопереходы не утверждены."
+options:
+  - {value: 0, label: "Никогда"}
+  - {value: 1, label: "Реже одного раза в месяц"}
+  - {value: 2, label: "Ежемесячно"}
+  - {value: 3, label: "Еженедельно"}
+  - {value: 4, label: "Ежедневно или почти ежедневно"}
+items:
+  - id: rus_audit_1
+    text: "Как часто Вы употребляете алкогольные напитки?"
+    options:
+      - {value: 0, label: "Никогда"}
+      - {value: 1, label: "Раз в месяц или реже"}
+      - {value: 2, label: "2–4 раза в месяц"}
+      - {value: 3, label: "2–3 раза в неделю"}
+      - {value: 4, label: "4 раза в неделю и чаще"}
+  - id: rus_audit_2
+    text: "Сколько алкогольных напитков (стандартных порций) Вы употребляете в типичный день, когда выпиваете? Если в типичный день Вы употребляете несколько разных алкогольных напитков, то суммируйте число СП."
+    options:
+      - {value: 0, label: "1–2"}
+      - {value: 1, label: "3–4"}
+      - {value: 2, label: "5–6"}
+      - {value: 3, label: "7–9"}
+      - {value: 4, label: "10 и больше"}
+  - {id: rus_audit_3, text: "Как часто Вы употребляете как минимум 1,5 л пива, или как минимум 180 мл крепкого алкоголя, или как минимум бутылку вина или шампанского (750 мл) в течение 24 часов?"}
+  - {id: rus_audit_4, text: "Как часто за последние 12 месяцев Вы не могли остановиться, начав употреблять алкогольные напитки?"}
+  - {id: rus_audit_5, text: "Как часто за последние 12 месяцев из-за выпивки Вы не сделали то, что от Вас обычно ожидалось?"}
+  - {id: rus_audit_6, text: "Как часто за последние 12 месяцев Вам необходимо было выпить утром, чтобы прийти в себя после выпивки (опохмелиться)?"}
+  - {id: rus_audit_7, text: "Как часто за последние 12 месяцев Вы испытывали чувство вины или сожаления после выпивки?"}
+  - {id: rus_audit_8, text: "Как часто за последние 12 месяцев Вы были неспособны вспомнить, что было накануне, из-за того, что Вы выпивали?"}
+  - id: rus_audit_9
+    text: "Являлось ли Ваше употребление алкогольных напитков причиной травмы у Вас или у других людей?"
+    options: &history
+      - {value: 0, label: "Никогда"}
+      - {value: 2, label: "Да, более 12 месяцев назад"}
+      - {value: 4, label: "Да, в течение последних 12 месяцев"}
+  - id: rus_audit_10
+    text: "Случалось ли, что Ваш близкий человек или родственник, друг или врач беспокоился насчёт употребления Вами алкоголя или советовал выпивать меньше?"
+    options: *history
+range: {min: 0, max: 40}
+severity:
+  - {min: 0, max: 40, code: unclassified, label: "Не выбран пол для интерпретации"}
+by_sex:
+  f:
+    - {min: 0, max: 4, code: zone_1, label: "Зона I"}
+    - {min: 5, max: 9, code: zone_2, label: "Зона II"}
+    - {min: 10, max: 10, code: zone_3, label: "Зона III"}
+    - {min: 11, max: 40, code: zone_4, label: "Зона IV"}
+  m:
+    - {min: 0, max: 8, code: zone_1, label: "Зона I"}
+    - {min: 9, max: 13, code: zone_2, label: "Зона II"}
+    - {min: 14, max: 16, code: zone_3, label: "Зона III"}
+    - {min: 17, max: 40, code: zone_4, label: "Зона IV"}

config/scales/rus_audit_s.yaml

@@ -0,0 +1,41 @@
+id: rus_audit_s
+title: RUS-AUDIT-S
+recall_period: "Последние 12 месяцев; п.9 и п.10 также учитывают более ранние события"
+license_note: "RUS-AUDIT: © ВОЗ, 2021, CC BY-NC-SA 3.0 IGO; некоммерческое использование. См. docs/clinical/README.md."
+translation_note: "Транскрипция рис.3 Буновой и соавт., 2022, DOI 10.17116/profmed20222508121; визуально сверена 2026-10-03. Интеграция не утверждена."
+notes: "Пункты 3,9,10 полной шкалы. Зоны не задают автоматический переход к полной шкале. Не применять пороги AUDIT-C."
+items:
+  - id: rus_audit_3
+    text: "Как часто Вы употребляете как минимум 1,5 литра пива, или как минимум 180 мл крепкого алкоголя, или как минимум бутылку вина или шампанского (750 мл) в течение 24 часов?"
+    options:
+      - {value: 0, label: "Никогда"}
+      - {value: 1, label: "Реже одного раза в месяц"}
+      - {value: 2, label: "Ежемесячно"}
+      - {value: 3, label: "Еженедельно"}
+      - {value: 4, label: "Ежедневно или почти ежедневно"}
+  - id: rus_audit_9
+    text: |-
+      Являлось ли Ваше употребление алкогольных напитков причиной травмы* у Вас или у других людей?
+
+      *Повреждение организма, вызванное внешним воздействием (ранением, ушибом, ожогом и т.д.).
+    options: &history
+      - {value: 0, label: "Никогда"}
+      - {value: 2, label: "Да, более 12 месяцев назад"}
+      - {value: 4, label: "Да, в течение последних 12 месяцев"}
+  - id: rus_audit_10
+    text: "Случалось ли, что Ваш близкий человек или родственник, друг или врач беспокоился насчет употребления Вами алкоголя или советовал выпивать меньше?"
+    options: *history
+range: {min: 0, max: 12}
+severity:
+  - {min: 0, max: 12, code: unclassified, label: "Не выбран пол для интерпретации"}
+by_sex:
+  f:
+    - {min: 0, max: 1, code: zone_1, label: "Зона I"}
+    - {min: 2, max: 4, code: zone_2, label: "Зона II"}
+    - {min: 5, max: 5, code: zone_3, label: "Зона III"}
+    - {min: 6, max: 12, code: zone_4, label: "Зона IV"}
+  m:
+    - {min: 0, max: 3, code: zone_1, label: "Зона I"}
+    - {min: 4, max: 6, code: zone_2, label: "Зона II"}
+    - {min: 7, max: 7, code: zone_3, label: "Зона III"}
+    - {min: 8, max: 12, code: zone_4, label: "Зона IV"}

config/scales/tsq.yaml

@@ -0,0 +1,59 @@
+id: tsq
+title: Опросник на скрининг ПТСР (TSQ)
+recall_period: прошлая неделя
+instruction: Эта анкета связана с вашими личными реакциями на травматическое событие, которое случилось с вами.
+  Ниже указаны некоторые реакции, которые иногда возникают у людей после травматического события. Пожалуйста, ответьте
+  «Да», если вы испытывали следующие симптомы по крайней мере дважды на прошлой неделе.
+translation_note: КР ПТСР 2023, ID 753, приложение Г1, с.129–130 PDF; копия emdr.ru. Опечатки сохранены. Актуальность
+  редакции не подтверждена.
+options:
+- value: 1
+  label: ДА
+- value: 0
+  label: НЕТ
+items:
+- id: tsq_1
+  text: Тяжелые мысли или воспоминания о событии приходили мне в голову против моей воли
+  buttons_only: true
+- id: tsq_2
+  text: Мне снились тяжелые сны о том, что со мной случилось
+  buttons_only: true
+- id: tsq_3
+  text: Я вдруг замечал(а), что действую и чувствую себя так, как будто бы ситуация повторяется снова
+  buttons_only: true
+- id: tsq_4
+  text: Когда что-то напоминает мне об этом событии, я чувствую себя подавленным
+  buttons_only: true
+- id: tsq_5
+  text: Когда что-то напоминало мне о случившемся, я испытывал(а) неприятные физические ощущения (потливость, сбой
+    дыхания, тошноту, учащение пульса и др.)
+  buttons_only: true
+- id: tsq_6
+  text: У меня нарушен сон (трудности засыпания или частые пробуждения)
+  buttons_only: true
+- id: tsq_7
+  text: Я чувствовал(а) постоянное раздражение и гнев
+  buttons_only: true
+- id: tsq_8
+  text: Мне было сложно сосредоточится
+  buttons_only: true
+- id: tsq_9
+  text: Я стал более осведомлён о потенциальных опасностях для себя и других
+  buttons_only: true
+- id: tsq_10
+  text: Я все время был(а) напряжен(а) и вздрагивал(а), если что-то внезапно пугало меня
+  buttons_only: true
+range:
+  min: 0
+  max: 10
+severity:
+- min: 0
+  max: 5
+  code: negative
+  label: Ниже порога
+- min: 6
+  max: 10
+  code: positive
+  label: Требуется уточнение
+
+license_note: "Текст приложения Г1 клинических рекомендаций 2023 года; условия использования и актуальную редакцию подтвердить до включения."

config/scheduler.yaml

@@ -0,0 +1,25 @@
+# Demo scheduler on the virtual clock (#13, SPEC §8, ADR-005). Local times are in settings.tz.
+# Read by app/scheduler/demo.py; used only while the questionnaire release (intake_runtime.yaml) is off.
+#
+# Every event is delivered once (idempotency key in `scheduler_events`) and only while it is fresh: an event
+# older than its late window is not sent at all — after a long jump of the demo clock the patient does not
+# receive a pile of yesterday's reminders, and an undelivered reminder never turns into a "missed" dose.
+
+enabled: true
+tick_seconds: 30
+
+doses:
+  late_hours: 2            # reminder not delivered if the dose time is older than this
+  missed_after_hours: 2    # reminded dose without an answer → status "missed" (SPEC §8)
+
+daily_checkin:
+  time: "20:00"
+  late_hours: 4
+
+scales:
+  time: "10:00"            # scales due today (config/modules.yaml schedules) are offered from this hour
+  late_hours: 10
+
+evaluation:
+  time: "09:00"            # daily monitoring pass: silence > N days, missed doses → caring contact
+  late_hours: 15

config/texts/crisis.yaml

@@ -1,4 +1,6 @@
 # Кризисный скрипт (guardrail №2, issue #4). Отправляется ДОСЛОВНО при safety = acute; LLM не вызывается.
+# `resources` — ЕДИНСТВЕННАЯ таблица телефонов приложения: остальные тексты и промпты ссылаются на неё через
+# `{phone:<ключ>}` (app/core/safety.py::fill_phones). Источники и проверка — docs/clinical/crisis-contacts.md.
 # СТАТУС: черновик, утверждает психиатр (#8).
 #
 # Выбор варианта (app/core/safety.py::crisis_reply): `<audience>.<категория>` по порядку category_priority,
@@ -14,9 +16,14 @@ resources:
     phone: "112"
     note: "если есть угроза жизни прямо сейчас"
   helpline:
-    name: "Телефон доверия"
+    name: "Психологическая помощь МЧС России"
+    phone: "+7 (495) 989-50-50"
+    note: "круглосуточно; стоимость звонка по тарифу оператора"
+  # For minors only (age gate stop text); not a general adult crisis line (docs/clinical/crisis-contacts.md).
+  child_helpline:
+    name: "Детский телефон доверия"
     phone: "8-800-2000-122"
-    note: "бесплатно, круглосуточно"
+    note: "для детей, подростков и родителей; бесплатно, анонимно"
   police:
     name: "Полиция"
     phone: "102"
@@ -30,7 +37,7 @@ variants:
       себе вред (оружие, таблетки), по возможности уберите это подальше или отдайте близкому человеку
       и побудьте рядом с кем-то, кому доверяете.
     resources: [emergency, helpline]
-    doctor_notified: "Ваш врач уже уведомлён и свяжется с вами."
+    doctor_notified: "Не ждите ответа врача, если помощь нужна сейчас: звоните 112."
     grounding: "Сейчас попробуйте сделать медленный вдох на 4 счёта и выдох на 6 — несколько раз. Я рядом."
 
   patient.harm_others:
@@ -39,7 +46,7 @@ variants:
       Пожалуйста, отойдите от человека и от всего, чем можно причинить вред, и побудьте там, где спокойнее.
       Если кому-то угрожает опасность прямо сейчас — позвоните 112.
     resources: [emergency, helpline]
-    doctor_notified: "Ваш врач уже уведомлён и свяжется с вами."
+    doctor_notified: "Не ждите ответа врача, если помощь нужна сейчас: звоните 112."
     grounding: "Поставьте ступни на пол, сделайте медленный вдох на 4 счёта и выдох на 6 — несколько раз."
 
   patient.domestic_violence:
@@ -48,7 +55,7 @@ variants:
       Если вам или детям угрожает опасность — уйдите в безопасное место (к соседям, родным) и позвоните 112.
       Кризисные службы и телефон доверия помогут найти безопасное место и поддержку.
     resources: [emergency, police, helpline]
-    doctor_notified: "Ваш врач уже уведомлён."
+    doctor_notified: "Не ждите ответа врача, если помощь нужна сейчас: звоните 112."
     grounding: "Если вы сейчас в безопасности — сделайте медленный вдох на 4 счёта и выдох на 6. Я рядом."
 
   family.default:
@@ -58,7 +65,7 @@ variants:
       спокойно уберите из доступа оружие, таблетки и острые предметы. Не спорьте и не стыдите —
       просто будьте рядом и слушайте.
     resources: [emergency, helpline]
-    doctor_notified: "Лечащий врач уже уведомлён."
+    doctor_notified: "Не ждите ответа врача, если помощь нужна сейчас: звоните 112."
     grounding: "Позаботьтесь и о себе: сделайте медленный вдох на 4 счёта и выдох на 6."
 
   family.domestic_violence:
@@ -68,5 +75,5 @@ variants:
       Если угрожает опасность — уйдите в безопасное место (к соседям, родным) и позвоните 112.
       Кризисные службы помогут с временным убежищем и поддержкой.
     resources: [emergency, police, helpline]
-    doctor_notified: "Лечащий врач уже уведомлён."
+    doctor_notified: "Не ждите ответа врача, если помощь нужна сейчас: звоните 112."
     grounding: "Когда будете в безопасности — сделайте медленный вдох на 4 счёта и выдох на 6."

config/texts/dialog.yaml

@@ -0,0 +1,120 @@
+# Тексты диалогового движка (issue #10): согласие, возраст, меню, кризис, шкалы, отзыв согласия.
+# СТАТУС: черновик, утверждает психиатр (#8).
+#
+# Правила текстов: без диагнозов и названий расстройств; без советов по дозам; не обещать конфиденциальность
+# сверх реальной; не использовать слова «учёт», «контроль», «психиатрический надзор» (проверяется тестом).
+# Кризисный скрипт — в crisis.yaml (отправляется дословно, LLM не вызывается).
+
+status: "черновик, утверждает психиатр (#8)"
+
+settings:
+  # Повторный C-SSRS по сигналу POSSIBLE не чаще, чем раз в N часов (сигнал всё равно пишется в safety_events).
+  cssrs_cooldown_hours: 24
+  # Сколько последних safety-событий хранить в dialog_state.data["safety_events"].
+  max_safety_events: 50
+  # Флаги шкал (config/scales/*.yaml), при которых сессия шкалы сразу уходит в кризисный путь.
+  crisis_flags: [phq9_item9_positive, cssrs_high]
+  # Шкала-скрининг суицидального риска (POSSIBLE и положительный п.9 PHQ-9 → эта шкала).
+  risk_screen_scale: cssrs_screen
+  # Брошенный шаг (чек-ин, шкала): если пациент молчит дольше N часов, следующее событие сначала возвращает
+  # диалог в idle (уже данные ответы сохранены), затем обрабатывается. 0 — выключено. На кризис не действует.
+  abandon_after_hours: 6
+
+commands:
+  # Текстовые команды отзыва согласия (сравниваются после приведения к нижнему регистру).
+  revoke: ["/revoke", "отозвать согласие", "отзываю согласие"]
+
+consent:
+  version: "v1-draft-2026-10-03"
+  text: |-
+    Здравствуйте! Я — цифровой помощник, который сопровождает вас между визитами к врачу: напоминаю о приёме препарата, спрашиваю о самочувствии и передаю важное вашему лечащему врачу.
+
+    Прежде чем начать, мне нужно ваше согласие на обработку персональных данных, в том числе сведений о здоровье (152-ФЗ «О персональных данных», ст. 9 и 10).
+
+    • Что обрабатывается: ваши ответы о самочувствии, сне, приёме препарата и результаты коротких опросников. Перед автоматической обработкой из сообщений удаляются имена, телефоны и другие личные данные.
+    • Кто видит данные: только ваш лечащий врач. Данные хранятся в России и не передаются третьим лицам без вашего согласия, кроме случаев, прямо предусмотренных законом.
+    • Я не ставлю диагнозов и не заменяю врача. Решения о лечении принимает только врач.
+    • Участие добровольное. Отказ никак не влияет на вашу медицинскую помощь.
+    • Отозвать согласие можно в любой момент в один шаг: кнопкой «Отозвать согласие» или командой /revoke.
+
+    Я не служба экстренной помощи. Если вам угрожает опасность прямо сейчас — звоните 112.
+  accept: "Согласен(на)"
+  decline: "Не согласен(на)"
+  refused: |-
+    Понимаю, это ваше право. Без согласия я не обрабатываю и не сохраняю ваши сообщения. Ваше лечение у врача продолжается как обычно.
+    Если передумаете — нажмите кнопку ниже или отправьте /start.
+  reconsider: "Я передумал(а)"
+  code_invalid: "Код подключения не найден или уже использован. Пожалуйста, уточните код у вашего врача и отправьте его ещё раз."
+
+age_gate:
+  question: "Уточните, пожалуйста: вам уже исполнилось 18 лет? Можно нажать кнопку или написать год рождения (например, 1990)."
+  adult: "Да, мне 18 или больше"
+  minor: "Нет, мне меньше 18"
+  unclear: "Не удалось понять ответ. Нажмите кнопку или напишите год рождения четырьмя цифрами, например 1990."
+  minor_stop: |-
+    Спасибо, что ответили. Этот помощник рассчитан на взрослых, поэтому дальше я не смогу с вами работать и не сохраняю ваши ответы.
+    Если вам тяжело или нужна поддержка — позвоните на Детский телефон доверия {phone:child_helpline} (бесплатно, анонимно) или расскажите взрослому, которому доверяете: родителям, учителю, школьному психологу.
+    Если есть угроза жизни прямо сейчас — звоните 112.
+
+idle:
+  welcome: |-
+    Спасибо, всё готово! Я буду на связи каждый день: напомню о препарате и спрошу о самочувствии. Если захотите что-то рассказать — просто напишите или выберите кнопку ниже.
+  menu_prompt: "Чем могу помочь?"
+  buttons:
+    checkin: "Как я сегодня"
+    med_question: "Вопрос о лекарстве"
+    kb_question: "Вопрос о лечении"
+    contact_doctor: "Связаться с врачом"
+    revoke: "Отозвать согласие"
+  # Заглушки кнопок меню; ветки ветерана (#36/#37) и med_qa (#15) подменяют их своими триггерами.
+  stub_checkin: "Короткий опрос о самочувствии скоро появится здесь. А пока можно просто написать, как вы себя чувствуете сегодня."
+  stub_med_question: "Напишите ваш вопрос о препарате. Я отвечаю только по официальной инструкции, а если ответа в ней нет — передам вопрос врачу."
+  contact_doctor_ack: "Я отметил вашу просьбу связаться с врачом — она появится в вашей карточке у врача. Если ситуация срочная, звоните 112."
+  visit_stub: "Онлайн-запись появится здесь позже. Пока вы можете записаться к своему врачу через регистратуру клиники."
+
+revoked:
+  confirm: |-
+    Согласие отозвано. Я больше не буду писать вам и обрабатывать ваши сообщения, а ваши данные помечены к удалению.
+    Если передумаете — отправьте /start. Если вам угрожает опасность — звоните 112.
+
+crisis:
+  # Повторный острый сигнал в уже открытом кризисе: скрипт второй раз не шлём, только это + ресурсы.
+  repeat: "Я рядом. Если вам угрожает опасность прямо сейчас — позвоните:"
+  # Любое другое сообщение, пока кризис открыт (до подтверждения врача).
+  hold: "Я на связи и читаю вас. Не ждите ответа врача, если помощь нужна сейчас. Если станет хуже — звоните 112 или на телефон доверия {phone:helpline}."
+  # Врач подтвердил кризисный алерт (doctor_ack): выходим из кризиса.
+  closed: "Ваш врач получил сообщение и в курсе вашей ситуации. Спасибо, что остаётесь на связи. Если снова станет тяжело — напишите мне в любой момент."
+
+scale:
+  intro: "Несколько коротких вопросов ({count}). {instruction}"
+  question: "{n}/{total}. {text}"
+  clarify: "Не совсем понял ответ. Выберите, пожалуйста, вариант кнопкой или опишите, как часто это было."
+  buttons_only: "На этот вопрос, пожалуйста, ответьте кнопкой."
+  done: "Спасибо, ответы сохранены. Ваш врач увидит результаты."
+  risk_screen_intro: "Спасибо, что поделились. Мне важно задать несколько коротких вопросов, чтобы лучше понять, как вы сейчас."
+
+safety_plan:
+  title: "Ваш план безопасности:"
+  # Шаблон Стэнли–Брауна, если план ещё не составлен с врачом на визите.
+  template:
+    - "Мои тревожные сигналы: что я замечаю, когда становится хуже."
+    - "Что помогает мне самому: прогулка, душ, дыхание, любимое дело."
+    - "Люди и места, которые отвлекают: к кому можно пойти."
+    - "Кому позвонить, если тяжело: близкий человек, сослуживец."
+    - "Специалисты: ваш врач, телефон доверия {phone:helpline}, экстренные службы 112."
+    - "Безопасная среда: оружие и лишние лекарства — на хранение близкому человеку."
+  means_restriction: "Если дома есть оружие или запас лекарств — попросите близкого человека временно хранить их у себя."
+
+reach_out:
+  silence: "Давно не было вестей от вас. Как вы? Можно ответить одним словом — мне важно знать, что с вами всё в порядке."
+  missed_doses: "Заметил, что несколько приёмов препарата пропущено. Всё ли в порядке? Если что-то мешает — расскажите, я передам врачу."
+  default: "Хотел узнать, как вы. Напишите пару слов, когда будет удобно."
+  # The day after a crisis (app/services/followup.py); the doctor on duty also calls back.
+  after_crisis: "Как вы сегодня? Вчера было очень тяжело — мне важно знать, что вы в порядке. Ваш план безопасности под кнопкой ниже. С вами также свяжется дежурный специалист. Если станет хуже — звоните 112 или на телефон доверия {phone:helpline}."
+
+visit:
+  button: "Записаться к врачу раньше"
+
+unavailable: |-
+  Сейчас у меня технические неполадки, и я не могу сохранить ваше сообщение. Пожалуйста, напишите чуть позже.
+  Если вам плохо прямо сейчас — звоните 112 или на телефон доверия {phone:helpline}.

config/texts/intake.yaml

@@ -0,0 +1,37 @@
+unavailable: "Этот опрос пока недоступен. Если нужна помощь, свяжитесь с врачом."
+done: "Ответы сохранены. Дальнейшие действия можно обсудить с врачом."
+review: "Опрос приостановлен. Для продолжения нужна оценка специалиста. Если есть непосредственная угроза жизни — позвоните 112."
+paused: "Опрос приостановлен, ответы сохранены."
+invalid: "Выберите один из предложенных вариантов ответа."
+numeric: "Введите число часов от 0 до 24, например 6,5."
+help: "Мне нужна помощь сейчас"
+pause: "Продолжить позже"
+resume: "Продолжить опрос"
+start: "Пройти первичный опрос"
+comment_skip: "Не добавлять комментарий"
+recent_trauma: "Событие произошло менее месяца назад?"
+sex: "Укажите пол для интерпретации алкогольной шкалы."
+tbi: "Были ли у Вас контузия или черепно-мозговая травма?"
+psychotropics: "Принимаете ли Вы сейчас психотропные препараты?"
+missing_followup: "Для оценки изменений со времени прошлого контакта нужна консультация специалиста. Если Вам нужна помощь сейчас, нажмите кнопку ниже."
+side_effects: "Беспокоили ли Вас за последнее время побочные эффекты лекарств?"
+numeric_portions: "Введите число стандартных порций, например 0 или 2."
+diary_done: "Дневник на сегодня уже заполнен. Спасибо!"
+periods:
+  since_last_contact: "С момента Вашего последнего ответа на эти вопросы."
+  past_month: "За последний месяц."
+  lifetime: "За всю жизнь."
+  past_3_months: "За последние три месяца."
+standard_drinks: |-
+  Стандартная порция (СП) = 10 г этанола. Таблица бланка RUS-AUDIT:
+  Вино/шампанское · пиво · креплёное вино · крепкий алкоголь
+  1–2 СП: до 250 мл · до 650 мл · до 170 мл · до 80 мл
+  3–4 СП: 251–450 мл · 651–1200 мл · 171–300 мл · 81–140 мл
+  5–6 СП: 451–660 мл · 1201–1750 мл · 301–430 мл · 141–210 мл
+  7–9 СП: 661–970 мл · 1751–2500 мл · 431–640 мл · 211–300 мл
+  10+ СП: более 970 мл · более 2500 мл · более 640 мл · более 300 мл
+  Если напитков несколько, учитывайте суммарное число стандартных порций.
+
+as_of: "Период отсчитывается от даты начала этого опроса: {day}."
+
+alcohol_advice: "Обсудите с врачом, как сократить употребление алкоголя и составить безопасный план."

config/texts/knowledge.yaml

@@ -0,0 +1,51 @@
+# Вопросы пациента о состоянии и лечении → база знаний по клиническим рекомендациям (#64, RAG #60).
+# Зона clinical вычитывает формулировки. Сам ответ — только цитата из КР с источником (config/texts/rag.yaml
+# задаёт его обрамление); здесь — тексты диалога и признаки того, что свободное сообщение — вопрос.
+
+# Кнопка меню «Вопрос о лечении» → бот просит написать вопрос.
+prompt: |-
+  Напишите ваш вопрос о состоянии или лечении — например, «что такое флэшбек?» или «помогает ли психотерапия?».
+  Я отвечу цитатой из клинических рекомендаций Минздрава и укажу источник. Вопросы о дозе и о вашем препарате решает врач.
+
+# Вопрос о дозе (увеличить, уменьшить, полтаблетки): бот не отвечает по существу — это решение врача.
+dose_redirect: "Дозу и схему приёма подбирает только ваш врач — менять их самостоятельно нельзя. Могу передать ваш вопрос врачу: нажмите «Связаться с врачом»."
+
+# Свободное сообщение считается вопросом, если в нём есть «?» или оно начинается с одного из этих слов.
+# Тогда бот ищет ответ в базе знаний; если ответа нет — отвечает обычной фразой поддержки.
+question_starts:
+  - "что такое"
+  - "что значит"
+  - "что означает"
+  - "почему"
+  - "зачем"
+  - "как"
+  - "когда"
+  - "сколько"
+  - "можно ли"
+  - "нужно ли"
+  - "надо ли"
+  - "помогает ли"
+  - "поможет ли"
+  - "правда ли"
+  - "бывает ли"
+  - "что делать"
+  - "что будет"
+  - "чем"
+  - "где"
+  - "есть ли"
+
+# Бытовые фразы — не вопросы о лечении, даже со «?»: «как дела?», «как ты?». База знаний для них не ищется
+# (иначе «как дела» находит «линия делит» — у слов одна основа), бот отвечает обычной фразой поддержки.
+small_talk:
+  - "как дела"
+  - "как ты"
+  - "как вы"
+  - "как жизнь"
+  - "как поживаете"
+  - "что нового"
+  - "кто ты"
+  - "ты кто"
+  - "ты бот"
+  - "ты робот"
+  - "привет"
+  - "спасибо"

config/texts/max.yaml

@@ -0,0 +1,8 @@
+connected: "Уведомления подключены. Здесь будут появляться напоминания с сайта. Отключить их можно командой /stop."
+not_connected: "Чтобы получать уведомления, откройте сайт и подключите MAX в настройках уведомлений."
+invalid: "Не удалось подключить уведомления. Создайте новую ссылку на сайте. Если MAX уже подключён к другому аккаунту, сначала отключите прежнюю привязку."
+stopped: "Уведомления отключены. Подключить их снова можно по новой ссылке с сайта."
+help: "Этот бот присылает уведомления. Пройти тесты, посмотреть результаты и продолжить общение можно на сайте. Команда /stop отключает уведомления."
+notification: "На сайте есть напоминание для вас. Откройте личный кабинет, чтобы продолжить."
+completed: "Прохождение теста завершено. Подробности доступны в личном кабинете на сайте."
+open_site: "Открыть сайт"

config/texts/meds.yaml

@@ -0,0 +1,98 @@
+# Тексты приёма препарата (issue #37): напоминание, пропуск, побочные эффекты, вопрос о лекарстве, ответы
+# на действия правил med_info (отсроченный эффект, алкоголь, побочные эффекты).
+# СТАТУС: черновик, утверждает психиатр (#8).
+#
+# Правила текстов: без диагнозов и названий расстройств; без советов по дозам и схеме приёма (решает врач);
+# не использовать слова, которые звучат как постановка на учёт или слежка (проверяется тестом). Ответы о
+# препарате берутся только из выдержки инструкции ГРЛС (app/llm/med_qa.py); тексты ниже — обрамление и
+# запасные варианты, если выдержки нет.
+
+status: "черновик, утверждает психиатр (#8)"
+
+reminder:
+  # {drug}, {dose} — из назначения врача (МНН и дозировка как в назначении, без изменений).
+  text: "Время принять {drug} {dose}. Отметьте, пожалуйста, как получилось."
+  text_no_drug: "Время принять препарат, назначенный врачом. Отметьте, пожалуйста, как получилось."
+  taken: "Принял(а)"
+  skip: "Пропущу"
+  side_effects: "Есть побочные эффекты"
+
+taken_ack: "Отлично, отметил приём. Спасибо!"
+# Кнопка от напоминания, которое уже неактуально (например, вчерашнего).
+stale: "Это напоминание уже неактуально. Если хотите отметить самочувствие — нажмите «Как я сегодня»."
+
+skip:
+  question: "Понял, отметил. Подскажите, что помешало? Это поможет вашему врачу."
+  reasons:
+    forgot: "Забыл(а)"
+    side_effects: "Из-за побочных эффектов"
+    quit: "Решил(а) бросить"
+    other: "Другое"
+  ack:
+    forgot: "Понял, бывает. Завтра напомню в обычное время."
+    quit: "Спасибо, что честно сказали — это важно, и решать это лучше вместе с врачом."
+    other: "Понял, отметил. Если захотите рассказать подробнее — просто напишите."
+
+side_effects:
+  question: "Что беспокоит? Выберите вариант или «Другое», чтобы описать своими словами."
+  options:
+    nausea: "Тошнота"
+    insomnia: "Бессонница"
+    headache: "Головная боль"
+    dizziness: "Головокружение"
+    agitation: "Беспокойство"
+    other: "Другое"
+  # Короткий вопрос к инструкции препарата (med_qa, раздел «побочные эффекты») для выбранного эффекта.
+  questions:
+    nausea: "тошнота после приёма, когда пройдёт"
+    insomnia: "бессонница, нарушения сна"
+    headache: "головная боль"
+    dizziness: "головокружение"
+    agitation: "беспокойство, тревога"
+  describe: "Опишите, пожалуйста, коротко, что вы заметили."
+  ack: "Спасибо, отметил. Ваш врач увидит это в вашей карточке."
+  # Тот же эффект был и вчера: инструкцию второй раз не повторяем.
+  repeat: "Понимаю, это неприятно. Я отмечаю это каждый день, и ваш врач увидит, если не проходит."
+  ask_dose: "А препарат сегодня приняли?"
+  dose_yes: "Да, принял(а)"
+  dose_no: "Нет"
+
+# Ежедневный чек-ин: если сегодня ещё нет отметки о приёме.
+checkin:
+  question: "Сегодня приняли {drug}?"
+  question_no_drug: "Сегодня приняли назначенный препарат?"
+  "yes": "Да"
+  "no": "Нет"
+  later: "Ещё нет"
+
+question:
+  prompt: "Напишите ваш вопрос о препарате. Я отвечаю только по официальной инструкции, а если ответа в ней нет — подскажу обратиться к врачу."
+  no_prescription: "Я не нашёл в карточке назначенного препарата. Пожалуйста, уточните вопрос у вашего врача."
+
+# Ответы на действие правила med_info. Ответ = lead + выдержка из инструкции (med_qa по разделу section,
+# вопрос question) + notice. Если выдержки нет — lead + fallback + notice.
+med_info:
+  delayed_effect:
+    section: onset
+    question: "когда начнёт действовать препарат, нет эффекта, только хуже"
+    lead: "Понимаю, что сейчас тяжело."
+    fallback: "Эффект таких препаратов обычно наступает не сразу, а через 2–4 недели регулярного приёма. Пожалуйста, не прекращайте приём самостоятельно."
+    notice: "Я сообщил вашему врачу — он свяжется с вами, чтобы обсудить, как вы себя чувствуете."
+  alcohol_interaction:
+    section: alcohol
+    question: "можно ли алкоголь вместе с препаратом, сон"
+    lead: "Спасибо, что честно рассказали."
+    fallback: "В инструкции к препарату есть предупреждение о совместном приёме с алкоголем, а алкоголь сам по себе ухудшает сон."
+    notice: "Я передал это вашему врачу."
+  nausea:
+    section: side_effects
+    question: "тошнота после приёма, когда пройдёт"
+    lead: ""
+    fallback: "Тошнота часто встречается в первые дни приёма и обычно проходит сама."
+    notice: "Если станет хуже — напишите мне, я передам врачу."
+  side_effects:
+    section: side_effects
+    question: "побочные эффекты в начале приёма"
+    lead: ""
+    fallback: "Спасибо, что сообщили о самочувствии. Я отмечу это для вашего врача."
+    notice: "Если станет хуже — напишите мне, я передам врачу."

config/texts/phrases.yaml

@@ -21,6 +21,8 @@ phrases:
   doctor_notified: "Я передал информацию вашему врачу. Он свяжется с вами."
   # med_qa: базовый смысл = выдержка из инструкции ГРЛС; LLM только упрощает её, ничего не добавляя.
   med_answer: "{excerpt}"
+  # RAG (#60): базовый смысл = выдержка из клинических рекомендаций; LLM только упрощает её, ничего не добавляя.
+  rag_answer: "{excerpt}"
 
 # Шаблон саммари для врача (только по структурированным данным).
 summary:

config/texts/rag.yaml

@@ -0,0 +1,24 @@
+# Тексты ответов из базы знаний (RAG, #60). Зона clinical вычитывает формулировки.
+# Сам ответ — ТОЛЬКО предложения из клинических рекомендаций (экстрактивно); здесь — обрамление.
+# Правила: без советов по дозам, без рекомендаций препаратов, решение о лечении — за врачом.
+
+patient:
+  # Ничего не нашлось / вопрос о дозе — честно говорим и отправляем к врачу.
+  fallback: "В клинических рекомендациях я не нашёл ответа на этот вопрос. Уточните, пожалуйста, у вашего врача."
+  # Пациент должен понимать, что это выдержка из документа для врачей, а не совет бота.
+  intro: "В клинических рекомендациях Минздрава сказано:"
+  sources_label: "Источник"
+  # Всегда в конце (не проходит через LLM).
+  doctor_note: "Это общая информация из документа для врачей. Что подходит именно вам, решает ваш лечащий врач."
+
+doctor:
+  fallback: "В базе знаний (КР ПТСР 2023, КР Депрессия 2024) нет фрагмента по этому запросу."
+  intro: "По клиническим рекомендациям:"
+  sources_label: "Источники"
+  doctor_note: ""
+
+team:
+  fallback: "В документах команды нет фрагмента по этому запросу."
+  intro: "По документам команды:"
+  sources_label: "Источники"
+  doctor_note: ""

config/texts/results.yaml

@@ -0,0 +1,120 @@
+# Patient-facing interpretation of questionnaire results (ADR-008: texts in config). The rules that pick a text are
+# deterministic (app/core/interpretation.py) and use the thresholds of config/questionnaire*.yaml, PDF «Опросники для
+# MVP» (stage 1) and «Этап 2» (follow-up). The app never diagnoses: every result is a screening result.
+disclaimer: "Это результат скрининга, а не диагноз. Диагноз ставит врач после очной консультации."
+
+intake:
+  ok:
+    title: "Признаков депрессии и ПТСР не выявлено"
+    text: "По Вашим ответам сейчас нет признаков, которые требуют обращения к специалисту. Можно спать спокойно: продолжайте короткий дневник — так Вы заметите изменения раньше."
+  attention:
+    title: "Есть признаки, которые стоит обсудить со специалистом"
+    text: "Это не диагноз, но ответы похожи на те, что бывают при состояниях ниже. Ниже — что именно мы заметили и что делать дальше."
+
+findings:
+  depression_suspected:
+    title: "Предположение депрессии"
+    text: "Ответы указывают на выраженные симптомы депрессии за последние 2 недели. Включаем модуль «Депрессия» в ежедневном дневнике."
+  depression_mild:
+    title: "Лёгкие симптомы депрессии"
+    text: "Есть отдельные симптомы сниженного настроения. Они часто проходят сами, но за ними стоит последить."
+  ptsd_suspected:
+    title: "Склонность к ПТСР"
+    text: "Ответы указывают на выраженные последствия пережитого травматического события за последний месяц. Включаем модуль «ПТСР» в ежедневном дневнике."
+  ptsd_signs:
+    title: "Отдельные признаки посттравматического стресса"
+    text: "После травматического события есть отдельные реакции, но их выраженность ниже порога вероятного ПТСР."
+  alcohol_risky:
+    title: "Рискованное употребление алкоголя"
+    text: "Употребление алкоголя выше безопасного уровня. Стоит сократить его и обсудить это с врачом."
+  alcohol_high:
+    title: "Высокий риск зависимости от алкоголя"
+    text: "Рекомендуем консультацию нарколога — параллельно с основным маршрутом."
+  suicide_low:
+    title: "Тяжёлые мысли"
+    text: "Вы отметили мысли о смерти. Мы добавили план безопасности и будем каждый день коротко спрашивать о самочувствии. Если станет тяжело — звоните 112 или на телефон доверия {phone:helpline}."
+  tbi:
+    title: "Контузия или ЧМТ"
+    text: "Рекомендуем консультацию невролога."
+
+routes:
+  urgent_psychiatrist: "Срочно свяжитесь с психиатром — ориентир: в течение 24 часов."
+  priority_psychiatrist: "Рекомендуем приоритетную запись к психиатру в ближайшие дни."
+  psychiatrist_or_psychotherapist: "Рекомендуем плановую запись к психиатру или психотерапевту."
+  psychologist: "Рекомендуем консультацию психолога."
+  self_help: "Достаточно самопомощи и короткого ежедневного дневника."
+
+modules:
+  title: "Что дальше"
+  diary: "Каждый день — короткий дневник: 3 вопроса утром и 2 вечером{modules}. Полные опросники — по расписанию."
+  names:
+    depression: "«Депрессия»"
+    veteran: "«ПТСР»"
+  with: ", плюс модуль {names}"
+
+scales:
+  phq9:
+    title: "Опросник PHQ-9 (депрессия)"
+    levels:
+      minimal: "минимальные симптомы"
+      mild: "лёгкие симптомы"
+      moderate: "умеренные симптомы"
+      moderately_severe: "умеренно тяжёлые симптомы"
+      severe: "тяжёлые симптомы"
+  pcl5:
+    title: "Опросник PCL-5 (ПТСР)"
+    levels:
+      below: "ниже порога вероятного ПТСР"
+      probable: "выше порога вероятного ПТСР"
+  rus_audit_s:
+    title: "Опросник RUS-AUDIT-S (алкоголь)"
+    levels:
+      zone_1: "относительно низкий риск"
+      zone_2: "опасное употребление"
+      zone_3: "пагубное употребление"
+      zone_4: "риск зависимости"
+      unknown: "нельзя оценить без указания пола"
+  score: "{title}: {total} — {level}."
+  change:
+    remission: "Это ремиссия по шкале — отличный результат."
+    response: "По сравнению с началом наблюдения — ответ на лечение."
+    improved: "По сравнению с началом наблюдения — клинически значимое улучшение."
+    stable: "По сравнению с началом наблюдения существенных изменений нет."
+    worse: "По сравнению с прошлым замером состояние ухудшилось. Врач получит сигнал и пересмотрит план."
+
+diary:
+  saved: "Спасибо, дневник за {part} сохранён."
+  parts:
+    morning: "утро"
+    evening: "вечер"
+  flags:
+    phq9_due_mood: "Настроение за неделю заметно ниже Вашей обычной нормы — предложим полный опросник PHQ-9 раньше срока."
+    phq9_due_depression: "Симптомы депрессии за неделю выше Вашей нормы — предложим полный опросник PHQ-9 раньше срока."
+    pcl5_due_ptsd: "Симптомы ПТСР за неделю выше Вашей нормы — предложим полный опросник PCL-5 раньше срока."
+    sleep_review: "Несколько ночей подряд очень плохой или короткий сон. Врач увидит это в сводке."
+    alcohol_on_medication: "Много алкоголя при приёме лекарств опасно. Врач получит отметку."
+    rus_audit_due_alcohol: "За неделю было несколько дней с большим количеством алкоголя — предложим опросник об алкоголе."
+    medication_contact: "Несколько дней подряд без лекарств. Не прекращайте приём без врача — мы сообщим ему."
+    adherence_review: "За неделю лекарства пропущены чаще, чем в 1 из 5 дней. Обсудите это с врачом."
+    side_effects_review: "Вы отметили побочные эффекты — врач получит отметку."
+
+cssrs:
+  none: "Спасибо за ответы."
+  low: "Спасибо, что ответили честно. Откройте план безопасности, если станет тяжело."
+
+kinds:
+  intake: "Первичный опрос"
+  diary_morning: "Дневник — утро"
+  diary_evening: "Дневник — вечер"
+  cssrs_since_contact: "Вопросы о безопасности"
+  phq9: "PHQ-9 по расписанию"
+  pcl5: "PCL-5 по расписанию"
+  rus_audit_s: "Алкоголь по расписанию"
+  diary: "Дневник"
+status:
+  complete: "пройден"
+  review_required: "остановлен для оценки специалиста"
+  interrupted: "прерван: открыта экстренная помощь"
+  active: "в процессе"
+  paused: "на паузе"
+  cancelled: "отменён"

config/texts/veteran_daily.yaml

@@ -0,0 +1,62 @@
+# Тексты ежедневного чек-ина и плановых шкал (issue #37, ADR-002, CLINICAL_MODULES §1–2).
+# Ядро (настроение + приём) задаётся всем; вопрос про сон и кошмары — модулю veteran; алкоголь — см. settings.
+# СТАТУС: черновик, утверждает психиатр (#8).
+#
+# Правила текстов: без диагнозов и названий расстройств; без советов по дозам; пациент не видит баллов шкал;
+# не использовать слова, которые звучат как постановка на учёт или слежка (проверяется тестом).
+
+status: "черновик, утверждает психиатр (#8)"
+
+settings:
+  # Модули, которым задаётся вопрос про сон и кошмары (modules.yaml: daily_question = sleep_nightmares).
+  sleep_modules: [veteran]
+  # Ежедневный вопрос об алкоголе: модули, где он задаётся всегда (у ветеранов алкоголь — частый способ
+  # «заглушить» бессонницу и фактор риска, CLINICAL_MODULES §1); остальным — при положительном AUDIT-C
+  # (порог берётся из правила auditc_positive в config/rules.yaml, ADR-002).
+  alcohol_daily_modules: [veteran]
+  # Плановые шкалы, перед которыми показывается дружелюбное вступление (см. scale_intros).
+  intro_scales: [pcl5, phq9, dar5, auditc]
+
+checkin:
+  start: "Добрый день! Короткая отметка о самочувствии — это займёт меньше минуты."
+  mood:
+    question: "Как ваше настроение сегодня по шкале от 0 до 10? 0 — очень плохо, 10 — отлично."
+  sleep:
+    question: "Сколько часов удалось поспать прошлой ночью?"
+    options:
+      "<4": "Меньше 4 ч"
+      "4-6": "4–6 ч"
+      "6-8": "6–8 ч"
+      ">8": "Больше 8 ч"
+  nightmares:
+    question: "Снились ли кошмары или тяжёлые сны?"
+    "yes": "Да"
+    "no": "Нет"
+  alcohol:
+    question: "Выпивали ли вы алкоголь за последние сутки?"
+    clarify: "Вы упомянули алкоголь. Сколько примерно выпили за последние сутки?"
+    options:
+      none: "Не пил(а)"
+      "1-2": "1–2 порции"
+      more: "Больше"
+  text:
+    question: "Как вы? Можно пару слов — что было за день, что беспокоит."
+    skip: "Пропустить"
+  buttons_hint: "Выберите, пожалуйста, вариант кнопкой."
+  done: "Спасибо, записал. Если что-то изменится — пишите в любое время."
+  already_done: "Сегодня вы уже отмечались, спасибо! Если хотите что-то добавить — просто напишите."
+
+visit:
+  # Нажата кнопка «Записаться к врачу раньше» (действие правила suggest_visit). Онлайн-записи пока нет —
+  # просьба передаётся врачу как факт в карточке.
+  requested: "Передал врачу просьбу о более раннем визите. С вами свяжутся, чтобы договориться о времени. Если станет хуже до визита — пишите мне или звоните 112."
+
+# Дружелюбное вступление перед шкалой (параметр intro у start_scale). Пациент не видит баллов.
+scale_intros:
+  scheduled:
+    pcl5: "Раз в две недели я прошу ответить на вопросы о том, как беспокоят тяжёлые воспоминания и их последствия. Это займёт 3–4 минуты. Так ваш врач увидит, что меняется со временем."
+    phq9: "Пора для короткого опроса о настроении и силах за последние две недели — 9 вопросов. Отвечайте так, как есть, правильных ответов нет."
+    dar5: "Несколько вопросов о раздражительности и вспышках гнева. После службы это бывает у многих, и врачу важно видеть, как это меняется."
+    auditc: "Три коротких вопроса об алкоголе. Отвечайте как есть: это нужно врачу, чтобы лечение было безопасным."
+  unscheduled:
+    phq9: "Последние дни настроение ниже обычного. Давайте я задам несколько вопросов — так ваш врач лучше поймёт, как вы сейчас."

config/texts/veteran_onboarding.yaml

@@ -0,0 +1,92 @@
+# Тексты стартового онбординга ветерана (issue #36): вступление, вопрос о травматическом опыте, пол для AUDIT-C,
+# вопрос о доступе к оружию, блок безопасного хранения, итог, FAQ.
+# СТАТУС: черновик, утверждает психиатр (#8). Ответы FAQ — формулировку проверяет юрист.
+#
+# Правила (проверяются тестом tests/test_dialog_veteran_onboarding.py):
+#   * тон — как у сослуживца: на «вы», коротко, без жалости и без нравоучений;
+#   * без слов «диагноз», «расстройство», «психолог», «психиатр», «болезнь», «псих»;
+#   * о сервисе — никогда «учёт», «контроль», «надзор» (страх пациента можно процитировать только в подписи
+#     кнопки FAQ — так человек узнаёт свой вопрос);
+#   * пациент не видит баллов и названий шкал.
+
+status: "черновик, утверждает психиатр (#8)"
+
+settings:
+  # Флаги шкал (config/scales/*.yaml), которые считаются сигналом риска для блока безопасного хранения оружия.
+  # Положительный п.9 PHQ-9 и C-SSRS — суицидальный риск; AUDIT-C — алкоголь как фактор риска при доступе к оружию.
+  weapon_risk_flags: [phq9_item9_positive, cssrs_high, cssrs_moderate, auditc_positive]
+
+intro:
+  text: |-
+    Рад, что вы здесь. Пара слов, прежде чем начнём.
+
+    После возвращения многие замечают одно и то же: сон сбит, в голову лезет прошлое, тело всё ещё «на дежурстве», раздражает то, что раньше не трогало, тянет выпить, чтобы отпустило. Это частая реакция на то, через что вы прошли, а не слабость — и с этим реально работают.
+
+    Сейчас будет несколько коротких вопросов про сон, напряжение, настроение и алкоголь — минут пять, почти всё кнопками. Ответы увидит только ваш лечащий врач: так он сможет помогать точнее.
+  go: "Начнём"
+  repeat: "Когда будете готовы — нажмите «Начнём». Если есть вопросы, ответы на частые — кнопками ниже."
+  resume: "Давайте продолжим с того места, где остановились. Осталось немного."
+
+buttons_hint: "Пожалуйста, выберите вариант кнопкой ниже."
+
+exposure:
+  question: |-
+    Бывало ли с вами событие, которое сильно напугало, потрясло или было по-настоящему опасным для жизни — на службе, в бою или в другое время?
+    Подробности рассказывать не нужно.
+  answer_yes: "Да"
+  answer_no: "Нет"
+  decline: "Не хочу отвечать"
+  ack_yes: "Понял. Несколько вопросов о том, как это даёт о себе знать сейчас."
+  ack_other: "Хорошо, идём дальше."
+
+sex:
+  question: "Один уточняющий вопрос: ваш пол? Он нужен только для того, чтобы правильно учесть ответы про алкоголь — нормы для мужчин и женщин разные."
+  male: "Мужской"
+  female: "Женский"
+  decline: "Не хочу отвечать"
+
+weapon:
+  question: |-
+    Последний вопрос, он про безопасность, а не про проверку: есть ли у вас сейчас доступ к оружию — табельному, охотничьему, наградному или любому другому?
+  no_access: "Нет"
+  self: "Есть, хранится у меня"
+  others_or_safe: "Есть, у других / в сейфе"
+  decline: "Не хочу отвечать"
+  ack: "Спасибо, что ответили."
+  # Блок безопасного хранения — фиксированный текст, показывается только при доступе к оружию И сигнале риска.
+  safety_block_self: |-
+    Одна просьба — без нравоучений. Пока вам тяжело, пусть оружие и патроны побудут у того, кому вы доверяете: у брата, друга, в сейфе, ключ от которого у другого человека. Дело не в недоверии к вам. В трудную минуту важно, чтобы между мыслью и действием было время — это одна из самых надёжных мер защиты, и так делают многие.
+    Это можно спокойно обсудить с врачом на приёме.
+  safety_block_stored: |-
+    Хорошо, что оружие хранится не под рукой. Пусть пока так и остаётся: ключ или код — у человека, которому вы доверяете, а патроны — отдельно. В трудную минуту важно, чтобы между мыслью и действием было время.
+    Это можно спокойно обсудить с врачом на приёме.
+  safety_block_unknown: |-
+    Понимаю, что не хочется об этом говорить. Просто на всякий случай: если дома есть оружие или большой запас лекарств, пусть пока они побудут у человека, которому вы доверяете. В трудную минуту важно, чтобы между мыслью и действием было время.
+
+result:
+  intro: "Спасибо, что ответили на всё. Коротко, что видно по ответам:"
+  calm: "Сейчас серьёзных трудностей по ответам не видно. Хорошо — будем держать руку на пульсе."
+  load: "Нагрузка сейчас заметная. Так бывает у многих после возвращения, и это то, с чем врач может помочь."
+  ptsd: "• Прошлое пока не отпускает: напряжение, воспоминания, сон."
+  mood: "• Настроение и силы ниже, чем хотелось бы."
+  alcohol: "• Алкоголь — стоит обсудить с врачом, особенно если назначат препараты: они с алкоголем плохо сочетаются."
+  next: "Ваши ответы уже у лечащего врача — он обсудит их с вами на приёме. А я буду на связи каждый день с одним коротким вопросом и напоминанием о препарате."
+
+faq:
+  who:
+    button: "Кто увидит мои ответы?"
+    # формулировку проверяет юрист
+    text: |-
+      Только ваш лечащий врач — тот, кто дал вам код подключения. Перед автоматической обработкой из сообщений удаляются имена, телефоны и другие личные данные. Данные хранятся в России.
+      Отозвать согласие и остановить обработку можно в любой момент — кнопкой «Отозвать согласие» или командой /revoke.
+  unit:
+    button: "Это попадёт на учёт / в часть?"
+    # формулировку проверяет юрист
+    text: |-
+      Нет. Это добровольная консультативная помощь между визитами к врачу. Ваши ответы не передаются в часть, военкомат, работодателю или кому-то ещё без вашего согласия — кроме случаев, прямо предусмотренных законом. Отказ от помощника никак не влияет на ваше лечение.
+  licences:
+    button: "Заберут права на оружие или вождение?"
+    # формулировку проверяет юрист
+    text: |-
+      Помощник не выдаёт заключений и не отправляет ваши ответы ни в ГИБДД, ни в Росгвардию, ни на медкомиссии. Допуск к оружию и вождению решает отдельная медицинская комиссия по своим правилам, установленным законом.
+      Как именно это связано с вашим лечением — спросите лечащего врача прямо. Это нормальный вопрос, его задают многие, и честный ответ лучше, чем откладывать помощь из-за неизвестности.

dashboard/api_client.py

@@ -0,0 +1,132 @@
+"""Thin HTTP client for the dashboard. The frozen API schemas (`app/api/schemas.py`) are the only contract.
+
+The dashboard never touches the databases: everything goes over HTTP to `API_BASE_URL`. Short timeouts keep the
+UI responsive when the backend is down; every failure is turned into `ApiError` with a Russian message that the
+page shows as a banner instead of a traceback.
+"""
+
+from __future__ import annotations
+
+import logging
+import os
+from typing import Any, TypeVar
+
+import httpx
+from pydantic import BaseModel, TypeAdapter, ValidationError
+
+from app.api.schemas import (
+    AckIn,
+    AlertOut,
+    ClockOut,
+    ConnectPatientIn,
+    ConnectPatientOut,
+    PatientCard,
+    PatientListItem,
+)
+
+log = logging.getLogger(__name__)
+
+DEFAULT_BASE_URL = "http://localhost:8000"
+DEFAULT_DOCTOR_ID = "doc-smirnova"
+API_PREFIX = "/api/v1"
+
+T = TypeVar("T")
+
+
+class ApiError(Exception):
+    """Any API failure, with a message safe to show to the doctor (no PII, no stack traces)."""
+
+    def __init__(self, message: str, status: int | None = None) -> None:
+        super().__init__(message)
+        self.message = message
+        self.status = status
+
+
+class ApiUnavailable(ApiError):
+    """Backend not reachable (connection refused, DNS, timeout)."""
+
+
+class ApiClient:
+    def __init__(
+        self,
+        base_url: str | None = None,
+        doctor_id: str | None = None,
+        *,
+        timeout: float = 3.0,
+        transport: httpx.BaseTransport | None = None,
+    ) -> None:
+        base = (base_url or os.environ.get("API_BASE_URL") or DEFAULT_BASE_URL).rstrip("/")
+        if not base.endswith(API_PREFIX):
+            base += API_PREFIX
+        self.base_url = base
+        self.doctor_id = doctor_id or os.environ.get("DOCTOR_ID") or DEFAULT_DOCTOR_ID
+        self._http = httpx.Client(
+            base_url=base, timeout=httpx.Timeout(timeout, connect=min(timeout, 1.5)), transport=transport
+        )
+
+    # ------------------------------------------------------------------ doctor endpoints
+    def patients(self) -> list[PatientListItem]:
+        return self._get(f"/doctors/{self.doctor_id}/patients", list[PatientListItem])
+
+    def patient_card(self, token: str) -> PatientCard:
+        return self._get(f"/patients/{token}", PatientCard, params={"doctor_id": self.doctor_id})
+
+    def alerts(self, since_id: int = -1, *, open_only: bool = False) -> list[AlertOut]:
+        params = {"since_id": since_id, "open_only": str(open_only).lower()}
+        return self._get(f"/doctors/{self.doctor_id}/alerts", list[AlertOut], params=params)
+
+    def ack(self, alert_id: int) -> AlertOut:
+        return self._request("POST", f"/alerts/{alert_id}/ack", AlertOut, json=AckIn(doctor_id=self.doctor_id))
+
+    def connect(self, body: ConnectPatientIn) -> ConnectPatientOut:
+        return self._request("POST", "/patients/connect", ConnectPatientOut, json=body)
+
+    def clock(self) -> ClockOut | None:
+        """Demo clock (ADR-005); optional decoration, so failures return None instead of raising."""
+        try:
+            return self._get("/demo/clock", ClockOut)
+        except ApiError:
+            return None
+
+    # ------------------------------------------------------------------ plumbing
+    def _get(self, path: str, model: type[T], params: dict[str, Any] | None = None) -> T:
+        return self._request("GET", path, model, params=params)
+
+    def _request(
+        self,
+        method: str,
+        path: str,
+        model: type[T],
+        *,
+        params: dict[str, Any] | None = None,
+        json: BaseModel | None = None,
+    ) -> T:
+        payload = json.model_dump(mode="json") if json is not None else None
+        try:
+            resp = self._http.request(method, path, params=params, json=payload)
+        except (httpx.ConnectError, httpx.TimeoutException) as exc:
+            log.warning("api unavailable: %s %s (%s)", method, _route(path), type(exc).__name__)
+            raise ApiUnavailable("API недоступен — проверьте, что сервис запущен") from exc
+        except httpx.HTTPError as exc:
+            log.warning("api transport error: %s %s (%s)", method, _route(path), type(exc).__name__)
+            raise ApiUnavailable("API недоступен — ошибка соединения") from exc
+
+        if resp.status_code == 404:
+            raise ApiError("Не найдено", 404)
+        if resp.status_code >= 400:
+            log.warning("api error: %s %s -> %s", method, _route(path), resp.status_code)
+            raise ApiError(f"Ошибка API ({resp.status_code})", resp.status_code)
+        try:
+            return TypeAdapter(model).validate_python(resp.json())
+        except (ValueError, ValidationError) as exc:
+            log.warning("api bad payload: %s %s", method, _route(path))
+            raise ApiError("API вернул неожиданный ответ") from exc
+
+    def close(self) -> None:
+        self._http.close()
+
+
+def _route(path: str) -> str:
+    """Path without identifiers, so logs carry no patient tokens."""
+    parts = path.strip("/").split("/")
+    return "/" + "/".join(p if not any(ch.isdigit() for ch in p) and not p.startswith("tok") else "*" for p in parts)

dashboard/app.py

@@ -1,18 +1,123 @@
-"""Doctor dashboard and demo console (Streamlit). Talks to the backend only via the API."""
+"""Doctor dashboard and demo console (Streamlit). Talks to the backend only via the API.
 
-import os
+Entry point: `streamlit run dashboard/app.py`. Pages are discovered from `dashboard/pages/*.py` — adding a page
+is adding a file, app.py never needs editing:
 
-import httpx
+* file name `<N>[letter]_<Title>.py` — N (and the optional letter) sets the order, underscores in the title become
-import streamlit as st
+  spaces (`2_Демо-консоль.py` → «Демо-консоль»);
+* section: pages with N == 1 go to «Кабинет врача», the rest to «Демо»;
+* optional module-level constants (read as text, the file is not imported):
+  `NAV_TITLE = "..."`, `NAV_ICON = ":material/terminal:"`, `NAV_SECTION = "..."`, `NAV_URL = "slug"`.
+"""
 
-API = os.environ.get("API_BASE_URL", "http://localhost:8000")
+from __future__ import annotations
 
-st.set_page_config(page_title="PTSRaiAgent — кабинет врача", page_icon="🩺", layout="wide")
+import re
-st.title("Кабинет врача")
+import sys
-st.caption("Прототип на синтетических данных")
+from dataclasses import dataclass
+from pathlib import Path
 
-try:
+ROOT = Path(__file__).resolve().parents[1]
-    status = httpx.get(f"{API}/health", timeout=2).json().get("status")
+_HERE = str(Path(__file__).resolve().parent)
-except httpx.HTTPError:
+# `streamlit run` puts dashboard/ on sys.path, where this very file would shadow the backend `app` package
-    status = "недоступен"
+# (needed for the frozen schemas). Import everything from the repo root as `dashboard.*` / `app.*` instead.
-st.write(f"API: **{status}**")
+sys.path[:] = [p for p in sys.path if p not in ("", _HERE) and Path(p or ".").resolve() != Path(_HERE)]
+if str(ROOT) not in sys.path:
+    sys.path.insert(0, str(ROOT))
+
+PAGES_DIR = Path(__file__).resolve().parent / "pages"
+DOCTOR_SECTION = "Кабинет врача"
+DEMO_SECTION = "Демо"
+DEFAULT_ICONS = {
+    "Пациенты": ":material/groups:",
+    "Подключить пациента": ":material/person_add:",
+    "Демо-консоль": ":material/smartphone:",
+    "Сплит-экран": ":material/splitscreen:",
+}
+
+_NAME_RE = re.compile(r"^(\d+)([a-z]?)_(.+)$")
+_META_RE = re.compile(r"""^NAV_(TITLE|ICON|SECTION|URL)\s*(?::\s*str\s*)?=\s*["'](.+?)["']\s*$""", re.MULTILINE)
+_TRANSLIT = dict(
+    zip(
+        "абвгдеёжзийклмнопрстуфхцчшщъыьэюя",
+        [*"abvgdee", "zh", *"zijklmnoprstufh", "ts", "ch", "sh", "sch", "_", "y", "_", "e", "yu", "ya"],
+        strict=True,
+    )
+)
+
+
+@dataclass(frozen=True)
+class PageSpec:
+    path: Path
+    title: str
+    icon: str
+    section: str
+    url_path: str
+    order: tuple[int, str]
+
+
+def slugify(title: str) -> str:
+    out = "".join(_TRANSLIT.get(ch, ch) for ch in title.lower())
+    out = out.replace("_", "")
+    return re.sub(r"[^a-z0-9]+", "-", out).strip("-") or "page"
+
+
+def discover_pages(pages_dir: Path = PAGES_DIR) -> list[PageSpec]:
+    specs = []
+    for path in pages_dir.glob("*.py"):
+        m = _NAME_RE.match(path.stem)
+        if not m:
+            continue
+        number, letter, raw = int(m.group(1)), m.group(2), m.group(3)
+        meta = dict(_META_RE.findall(path.read_text(encoding="utf-8")))
+        title = meta.get("TITLE", raw.replace("_", " "))
+        specs.append(
+            PageSpec(
+                path=path,
+                title=title,
+                icon=meta.get("ICON", DEFAULT_ICONS.get(title, ":material/description:")),
+                section=meta.get("SECTION", DOCTOR_SECTION if number == 1 else DEMO_SECTION),
+                url_path=meta.get("URL", slugify(title)),
+                order=(number, letter),
+            )
+        )
+    return sorted(specs, key=lambda s: s.order)
+
+
+def main() -> None:
+    import streamlit as st
+
+    from dashboard import theme
+    from dashboard.components import live_alerts, state, ui
+
+    st.set_page_config(page_title="Кабинет врача · MedITron", page_icon="🩺", layout="wide")
+    st.html(theme.CSS)
+    st.logo(str(ROOT / "dashboard" / "assets" / "logo.svg"), size="large")
+
+    specs = discover_pages()
+    nav: dict[str, list[st.Page]] = {}
+    section_of: dict[str, str] = {}
+    for i, s in enumerate(specs):
+        page = st.Page(str(s.path), title=s.title, icon=s.icon, url_path=s.url_path, default=i == 0)
+        nav.setdefault(s.section, []).append(page)
+        section_of[s.url_path] = s.section
+    current = st.navigation(nav, position="sidebar", expanded=True)
+
+    with st.sidebar:
+        st.html(
+            '<div class="mt-sidebar-note"><strong>Рядом между визитами</strong>'
+            "Наблюдение за состоянием пациента и поддержка назначенного лечения.</div>"
+        )
+        st.caption("Прототип на синтетических данных")
+
+    short, _ = state.doctor_names()
+    st.html(ui.workspace_header(short, current.title))
+    live_alerts.flush_pending_toasts()
+    # Full-app rerun on a new alert only on doctor pages: demo-console pages may be mid-scenario.
+    live_alerts.render(rerun_app_on_new=section_of.get(current.url_path) == DOCTOR_SECTION)
+    current.run()
+    ui.footer()
+
+
+if __name__ == "__main__":
+    main()

dashboard/assets/logo.svg

@@ -0,0 +1,8 @@
+<svg xmlns="http://www.w3.org/2000/svg" width="228" height="48" viewBox="0 0 228 48" role="img" aria-label="PTSRaiAgent — помощник врача">
+  <rect x="0" y="6" width="36" height="36" rx="11" fill="#285e4e"/>
+  <path d="M18 15v18M9 24h18" stroke="#fff" stroke-width="1.8" stroke-linecap="round"/>
+  <g font-family="-apple-system, BlinkMacSystemFont, Segoe UI, Arial, sans-serif">
+    <text x="47" y="25" fill="#213b38" font-size="21" font-weight="600" letter-spacing="-.7">PTSRaiAgent</text>
+    <text x="48" y="39" fill="#63736f" font-size="9" letter-spacing="1">ПОМОЩНИК ВРАЧА</text>
+  </g>
+</svg>