When it matters most, your employees need more than a hotline.
Refill Health's clinical crisis protocol combines five identification pathways. Crisis is not an event. It's a lifecycle. And every employee who enters it stays inside the protocol until clinical leadership confirms resolution.
CLINICAL CRISIS PROTOCOL
Lifecycle — not event.
01
Navigator engagement
02
Clinical supervisor review
03
Outreach and safety planning
04
Emergency referral if needed
05
HR notification — anonymised
06
Four weeks structured follow-up
100% protocol adherence · Zero premature closures
WHY HOTLINES AREN'T ENOUGH
A crisis line answers. A clinical protocol stays.
Hotlines exist because crisis support has historically been treated as a single moment. Three differences make the distinction operational.
The Hotline Event
Moment 1: Identification
Waits for the employee to dial in. Crisis only enters the system when the employee self-identifies and reaches out.
Moment 2: Management
A counsellor talks with the employee for the duration of the call. The call ends. The employee continues alone.
Moment 3: After acute resolution
No structured follow-up. The employee may be referred to a service. The thread typically ends there.
The Refill Health Protocol
Moment 1: Identification
Identifies crisis through five pathways. The system finds crisis; it doesn't wait for crisis to find the system.
Moment 2: Management
A clinically trained Care Navigator takes ownership. The case stays inside the protocol — not outside it.
Moment 3: After acute resolution
Structured post-acute follow-up across the four weeks following resolution. No premature closures.
Why this matters at workforce scale
A hotline is not wrong. It's incomplete. The data Refill Health has published — 100% crisis protocol adherence and zero premature closures — isn't achievable on a hotline model.
HOW CRISIS IS IDENTIFIED
Five pathways. One outcome — no employee enters crisis alone.
Most platforms identify crisis when an employee picks up the phone. Refill Health identifies crisis through five distinct pathways, ensuring multiple layers of visibility even when an individual isn't ready to reach out.
01
Onboarding screening
WHEN: AT ENROLMENT
Validated instruments are administered at onboarding — including C-SSRS — to establish a clinical baseline before care begins.
02
Therapist-detected, in-session
WHEN: DURING CLINICAL SESSIONS
Therapists follow a documented clinical protocol for identifying acute risk within session, triggering immediate protocol activation.
03
Direct message to navigator or therapist
WHEN: ANY TIME
Employees can reach the Care Navigator or therapist via secure messaging, bypassing automated flows for direct human connection.
04
AI-detected distress signals
WHEN: CONTINUOUS
Refill Foresight™ monitors clinical risk language within the platform. The employee does not need to articulate the crisis for the system to find it.
05
HR or manager-reported concern
WHEN: WORKPLACE OBSERVATION
Managers trained through Refill Health's Manager Guide can surface concerns without being involved in clinical assessment.
WHAT MAKES THE IDENTIFICATION NET COMPREHENSIVE
This is what makes the identification net genuinely comprehensive — five pathways, two of which work without the employee initiating contact, ensuring no one falls through the gaps of silence.
SEVERITY ASSESSMENT
Crisis is not binary. The response shouldn't be either.
Once a signal is identified, it's assessed for severity using validated clinical instruments, triggering a tiered response protocol matched to individual risk.
ACUTE / IMMINENT
What it indicates:
Active suicidal intent, plan, or recent attempt indicators detected via C-SSRS.
What the protocol does:
Immediate navigator engagement. Clinical leadership review. Emergency referral coordinated where clinically required.
HIGH / ACTIVE RISK
What it indicates:
Severe scores on validated instruments, or active ideation without imminent plan.
What the protocol does:
Same-day navigator outreach. Evidence-based safety planning conducted and documented.
ELEVATED / EMERGING
What it indicates:
Score deterioration between sessions, passive ideation, or warning signs surfacing.
What the protocol does:
Proactive navigator outreach within documented response window. Signal addressed before escalation.
The clinical credibility behind it
Severity is not a clinical judgement applied informally. It's graded using internationally validated instruments — including C-SSRS and PHQ-9. Every severity tag is logged and traceable, providing a verifiable audit trail of clinical care.
THE PROTOCOL LIFECYCLE
Every crisis case stays inside the protocol — until clinical leadership confirms resolution.
Identification and severity assessment surface the case. The protocol takes over from there. The lifecycle has six steps — and it doesn't end when the acute moment does.
Immediate navigator engagement
A clinically trained Care Navigator takes ownership of the case, initiates contact according to severity SLA, and completes safety assessment.
Clinical supervisor review
All crisis cases are escalated to a Senior Clinical Supervisor for review, ensuring oversight and adherence to evidence-based protocols.
Employee outreach and safety planning
Collaborative development of a documented safety plan with the employee, identifying triggers, coping strategies, and support networks.
Emergency referral if needed
If acute risk is determined, the Navigator coordinates with local emergency services or specialised higher-level care facilities.
Anonymised HR notification
Aggregated, de-identified reporting to HR leadership to maintain visibility on workforce risk levels without compromising individual privacy.
Structured four-week follow-through
Post-acute check-ins scheduled and tracked for four weeks. The case is only closed when clinical leadership verifies sustained stability.
WHAT 'NO PREMATURE CLOSURES' MEANS
A crisis case isn't closed because the acute moment passed. It is actively managed through a structured post-acute phase until clinical leadership signs off on resolution.
Across Refill Health's published deployment data: 100% protocol adherence. Zero premature closures.
COMMON QUESTIONS
Understanding the protocol
Yes. Refill Foresight™ continuously monitors all platform interactions and clinical notes for risk indicators. Critical signals trigger immediate alerts to our on-call clinical team, regardless of the time of day, ensuring rapid response outside standard operating hours.
THE COMPLETE PLATFORM
Crisis support is just one part of the clinical model.
Care Navigation
Dedicated clinical guides ensuring employees find the right care pathway.
EAP+
Next-generation employee assistance beyond standard session limits.
Clinical Model
Evidence-based therapeutic interventions with measurable outcomes.
Outcomes & ROI
Transparent reporting on clinical improvement and business impact.