When a person is on a Colorado emergency mental health hold (M-1), the evaluating facility documents its assessment on this form to decide whether the person needs further treatment, will accept it voluntarily, or should be certified. It records the presenting problem, suicide and violence risk, grave disability, access to lethal means, treatment history, psychosocial factors, collateral information and the statutory certification factors.
An evaluating professional completes and signs it, with a co-signature line. Non-designated emergency medical services facilities complete only Section I; designated facilities complete the entire form.
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Comprehensive Evaluation
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No. The form states that non-designated emergency medical services facilities only have to complete Section I, including its disposition and transfer details to a designated facility. Other facilities initiating or receiving a person on an M-1 hold complete the entire form.
Yes. The form says both emergency medical services facilities and designated facilities may incorporate its requirements into their electronic health record instead of completing the form directly, as long as the same information is captured for each person on a hold.
It records the diagnostic impression (danger to self, danger to others, gravely disabled), whether further treatment is needed, and whether the person will accept it voluntarily. If not, certification is completed; if no treatment is needed, a safety plan is completed.