Illinois Interim Risk Level Matrix (IRLM)

Illinois Interim Risk Level Matrix (IRLM)  Updated 03/21/24


*EMERGENT RISK (LEVEL 4) TO HEALTH OR SAFETY*

Distressed caller/situation with:

  • Immediate threats to life
  • Active situation with weapons involved, lethal weapons present
  • History of severe violence
  • High level of intoxication; high risk of medical situation
  • Barricaded subjects, extensive damage to property
  • Physical aggression, high level of verbal aggression
  • Psychosis with risk to self or others
  • Unknown risk areas, limited ability to gather information in an escalating situation
  • Wellbeing check

Dispatch Response Type:

  • Law Enforcement and/or EMS Response once scene is secured
  • Law Enforcement/ Co-Response team

Dispatching Entity:

  • 911/988 for Mobile Crisis Response Team Dispatch

Response time:

  • Immediate

*URGENT RISK (LEVEL 3) TO HEALTH OR SAFETY*

Distressed caller/situation with:

  • No immediate threats to life with active assault on others
  • No weapons actively involved; non-lethal weapons present with plans to access them
  • Homicidal statements with no plans or means to act
  • Suicidal statements with no active suicide attempt
  • Implied physical aggression toward others (without touching)
  • Escalating verbal aggression

Dispatch Response Type(s):

  • Law Enforcement/ Co-Response team
  • Law Enforcement and/or EMS Response with Mobile Crisis Response Team
  • Law Enforcement

Dispatching Entity:

  • 911/988 for Mobile Crisis Response Team Dispatch

Response Time:

  • Immediate

*MODERATE RISK (LEVEL 2) TO HEALTH OR SAFETY*

Distressed caller/situation with:

  • No immediate threats to life/ minor self-injurious behavior
  • No weapons actively involved
  • No homicidal statements
  • Vague suicidal statements with no plans or means
  • No physical aggression with minor verbal aggression and unusual behavior
  • Psychosis with possibility of escalation due to intoxication

Dispatch Response Type(s):

  • Law Enforcement / Co-Response team
  • Law Enforcement with BH Mobile Crisis Response Team (30 min)
  • Law Enforcement and/or EMS Response with Mobile Crisis Response Team
  • Law Enforcement

Dispatching Entity:

  • 911 & 988 (for MCRT dispatch)

Response Time:

  • LE/EMS---Immediate
  • MCRT: up to 30 min

*LOW RISK (LEVEL 1) TO HEALTH OR SAFETY*

Distressed caller/situation with:

  • No immediate threats to life
  • No lethal weapons present and no plans to access non-lethal weapons
  • Psychosis with no intoxication
  • No physical or verbal aggression
  • Vague expressions of suicidal ideation with no plans or means to act
  • Odd or unusual behavior that is a concern of others
  • Known history of mental health struggles with no history of severe acts of violence
  • Moderate or minimal intoxication
  • Distress with imminent need of BH support
  • Other concerns of a non-emergent nature
  • Need for social supports

Dispatch Response Type:

  • 988 Mental Health Crisis Counselor and/or MCRT

Dispatching Entity:

  • 988 or MCRT

MCRT Response Time:

  • Up to 60 min

Interim Risk Level Matrix - Incident Type, Response Type, and Response Time

Risk Level Risk Area Description Short Description Response Type Response Time

   4

Emergent

  Risk

Threats to life and property Immediate threats to life, active suicide attempts, homicidal statements with plans and access, active assaults to others, hostages taken, high-risk, self-injurious behavior with or without suicide intent
  • Immediate threats to life

LE/EMS

TBD by RAC/PSAP

Recommend Co-responder model if available and response can be immediate; otherwise LE/EMS1

Immediate

  4

Emergent

  Risk

Weapons Active suicide attempt or assault with weapons, lethal weapons present, non-lethal weapons accessed
  • Active situations with weapons involved
  • Lethal weapons present

LE

TBD by RAC/PSAP

Recommend Co-responder model if available and response can be immediate; otherwise LE1

Immediate

  4

Emergent

   Risk

History Known history of severe acts of violence or escalation in previous low-level risk calls
  • History of severe violence

LE

TBD by RAC/PSAP

Recommend Co-responder model if available and response can be immediate; otherwise LE1

Immediate

   4

Emergent

  Risk

Intoxication High level of intoxication on substance with high risk of overdose (opioids, alcohol poisoning), apparent intoxication with belligerent or aggressive behavior, expressed desire for medically supervised withdrawal
  • High level of intoxication
  • High risk of medical situation

LE/EMS

TBD by RAC/PSAP

Recommend Co-responder model if available and response can be immediate; otherwise LE/EMS1

Immediate

    4

Emergent

  Risk

Aggression Barricaded subjects, active/ongoing extensive damage to property, physical aggression towards others, escalating verbal aggression towards others or call taker
  • Physical aggression displayed
  • High level of verbal aggression

LE

TBD by RAC/PSAP

Recommend Co-responder model if available and response can be immediate; otherwise LE1

Immediate

   4

Emergent

  Risk

Unknown Status of risk areas

Inability to gather pertinent info

Unknown status of an immediate threat to life, weapons status, or aggression status, symptoms or behaviors that may be reflective of a medical emergency
  • Unknown risk areas

LE

TBD by RAC/PSAP

Recommend Co-responder model if available and response can be immediate; otherwise LE1

Immediate

  4

Emergent

  Risk

Psychosis Psychosis: symptoms of delusions, hallucinations, disorganized thinking and speech, irrational/hysterical statements with an imminent risk to self and /or others
  • Psychosis with risk to self or others

LE/EMS

TBD by RAC/PSAP

Recommend Co-responder model if available and response can be immediate; otherwise LE/EMS1

Immediate
  • Risk Levels 2, 3, and 4, a situational assessment by the 911 call taker may result in a reassignment of risk levels for any incident type. The additional information garnered from this assessment is essential for assigning the appropriate response type. This is particularly the case in incidents involving aggression and psychosis. For example, in the matter of aggression, if others in the environment or the environment itself, are likely to promote an escalation, higher risk level assignment and associated response type may be indicated. And, in the event that the individual experiencing psychotic symptoms also is under the influence of drugs or alcohol, the risk level may be modified.
  • Upon LE/EMS arrival and following initial scene security (or assessment), cases may be diverted to 988/MCRT.
Risk Level Risk Area Description Short Description Response Type Response Time

  3

Urgent

  Risk

Threats to life and property No immediate threats to life, active assault on others with minimal ability to cause significant harm, homicidal statements with no plans or access, suicidal statements with plan and access but no active behaviors, recent damage to property, active minor damage to property
  • No immediate threats to life

TBD by RAC/PSAP

Recommend Co-responder model if available and response can be immediate; otherwise LE

Immediate

  3

Urgent

  Risk

Weapons Access to (non-lethal) weapons with plans to access them
  • No lethal weapons actively involved; Nonlethal weapons present

TBD by RAC/PSAP

Recommend Co-responder model if available and response can be immediate; otherwise LE

Immediate

  3

Urgent

  Risk

Aggression Implied physical aggression towards others (without touching), verbal aggression towards others or call taker
  • No active physical aggression
  • Moderate level of verbal aggression

TBD by RAC/PSAP

Recommend co-responder model if available and response can be immediate; otherwise LE

Immediate
Risk Level Risk Area Description Short Description Response Type Response Time

   2

Moderate

  Risk

Threats to life and property No immediate threat to life or property, no homicidal statements, vague suicidal statements with no plans, minor self-injurious behaviors without suicide intent
  • No immediate threats to life but minor self-injurious behavior

TBD by RAC/PSAP

988/MCRT with EMS; if 988/MCRT is not available, EMS response only

Immediate

   2

Moderate

  Risk

Aggression No physical aggression, intermittent or minor and escalating verbal aggression towards others or call taker
  • No physical aggression
  • Minor/escalating level of verbal aggression

TBD by RAC/PSAP

Recommend Co-responder model if available and response can be immediate; otherwise LE

Immediate or within 30 minutes

   2

Moderate

  Risk

Psychosis Psychosis: symptoms of delusions, hallucinations, disorganized thinking and speech, irrational/hysterical statements that do not imply there is an imminent risk to others, inability to maintain a conversation over the phone; evidence of intoxication with drugs or alcohol
  • Psychosis with no immediate risk to self or others with possibility of escalation due to intoxication

TBD by RAC/PSAP

988/MCRT with EMS; if 988/MCRT is not available within 30 min, EMS response only

Immediate or within 30 minutes
Risk Level Risk Area Risk Description Short Description Response Type Response Time

 1

Low Risk

Threats to life and property No immediate threats to life, no homicidal statements, suicidal statements with no active behaviors, plans or, access,
  • No immediate threats to life with threatening statements regarding self
988 / MCRT Or Mental Health Crisis Counselor Up to 60 min

  1

Low Risk

Weapons Access to (nonlethal) weapons with no plans to use them
  • No weapons actively involved
  • No access to lethal weapons
  • No plans to access/use nonlethal weapons

988 / MCRT or Mental Health Crisis Counselor if available within 30 min., otherwise, Co-responder model.

If Co-responder not available, LE

ASAP; up to 30 minutes

 1

Low Risk

History Known history of mental health struggles with no history of severe acts of violence, aggression, or urgent level 2 response
  • No known history
988 / MCRT or Mental Health Crisis Counselor Up to 60 minutes

  1

Low Risk

Intoxication Observed or admitted moderate or minimal levels of intoxication without any other risk areas in level 1, 2 or 3.
  • Moderate or minimal intoxication
988 / MCRT or Mental Health Crisis Counselor Up to 60 minutes

  1

Low Risk

Aggression No physical aggression, or stabilized verbal aggression towards others or call taker; clear distress displayed through profanity and emotional statements that is responsive to call handler
  • No physical aggression
  • Minor or no verbal aggression
988 / MCRT or Mental Health Crisis Counselor if available within 30 min; otherwise Co-responder model ifavailable, if not available, LE ASAP or within 30 minutes

 1

Low Risk

Psychosis Psychosis: symptoms of delusions, hallucinations, disorganized thinking and speech, with no threat to self or others, and ability to maintain a conversation over the phone
  • Psychosis without risk to life or safety
988/ MCRT or Mental Health Crisis Counselor Up to 60 minutes

1 Language updated in the details of level 4 of the Interim Risk Level Matrix to comport with the approved change noted in the summary Level 4 Interim Risk Level Matrix that added co-responder as a dispatch type (3/21/2024).