1. Talkspace Providers
  2. Clinical Risk Management
  3. Adverse Incident Reporting
  4. Understanding Adverse Incident Reporting

When is an Adverse Incident Report required?

Last Updated

The following events require submission of an Adverse Incident Report within 24 hours of becoming aware of the event. 

Suicidal Ideation 

(with Plan or Intent)

Any disclosure or identification of suicidal ideation involving a specific plan, intent to act, or other indicators of imminent or escalating suicide risk.

Suicide Attempt

Any suspected, reported, or confirmed suicide attempt, regardless of medical severity, outcome, or whether emergency medical treatment was received.

Emergency Services Involvement

Any involvement of emergency response services due to concerns about a client’s safety or well-being, including law enforcement, EMS, mobile crisis teams, or wellness checks.

Emergency Contact Involvement

Any communication with a client’s designated emergency contact due to immediate safety concerns or inability to maintain contact during a significant safety event.

Psychiatric Hospitalization or Emergency Evaluation

Any psychiatric hospitalization, psychiatric observation, emergency department evaluation, or other emergency mental health evaluation, whether voluntary or involuntary.

Violence or Serious Threats

Any disclosure or identification of a credible threat, plan, intent, or act of violence toward another person resulting in harm or indicating a significant risk to others. 

Abuse, Neglect, or Exploitation

Any suspected, disclosed, reported, or confirmed abuse, neglect, exploitation, or trafficking involving a child, older adult, or otherwise vulnerable person, including situations requiring or potentially requiring a mandated report.

Client Death

Any reported or confirmed death of a client who has received services within the previous ninety (90) days, regardless of the known or suspected cause of death.

Medication Safety Concerns

Any Medication-related event with the potential to cause harm, including serious adverse reactions, medication errors, overdoses, or other significant medication safety concerns.  

Provider Safety Concerns

Any event involving credible threats, harassment, stalking, intimidation, or other concerning behaviors directed toward a provider or other staff that may affect personal safety or the ability to safely provide care.

Legal or Regulatory Concerns

Any significant legal or regulatory event affecting the delivery of care, including licensing board complaints, subpoenas, court orders, or other legal matters requiring awareness or coordination.

 

Note: The reportable events above are not intended to represent every situation in which an Adverse Incident Report may be appropriate. The following section highlights additional circumstances where reporting may also be beneficial.

Additional situations that may need reporting 

Reporting may be appropriate when additional awareness, consultation, coordination, or follow-up would support client care, clinical decision-making, or continuity of care. 

In some situations, the Clinical Risk Management team may also recommend or request submission of an Adverse Incident Report to support review, documentation, or care coordination. 

Note: The following situations are intended to support clinical judgment and are not exhaustive. Providers should continue to use their clinical judgment when determining whether reporting may be appropriate based on the specific circumstances. 

 

Clinical Risk & Changes in Presentation

  • Escalation in suicidal or violent ideation compared to baseline
  • Frequent use of crisis-related resources
  • Crisis averted, but likely to recur
  • New or worsening symptoms that significantly impact functioning or safety (e.g., psychosis, paranoia, severe disorganization)
  • Significant therapeutic rupture or disengagement that may impact safety or continuity of care

Professional Practice Concerns

  • Boundary concerns that may affect treatment, therapeutic relationships, or safety
  • Complex ethical considerations
  • Concerns regarding potential violations of the Talkspace Terms of Service or inappropriate use of services
  • Persistent inability to obtain required client information necessary to safely provide treatment

Treatment, Medication, & Coordination Issues

  • Medication non-adherence that significantly increases clinical risk
  • Barriers to obtaining prescribed medication
  • Client confusion regarding medication dosing or regimen, resulting in safety concerns
  • Difficulty accessing a recommended higher level of care
  • Challenges coordinating care with outside providers, hospitals, emergency contacts, or other resources
  • Persistent barriers preventing access to recommended services

Environmental & System Risk Factors

  • Platform or technology issues that significantly interfere with clinical care or crisis intervention
  • Limited availability of community resources or referral options affecting client safety
  • Financial hardship, housing instability, or other social factors contributing to increased clinical risk
  • Environmental concerns observed during telehealth sessions (e.g., suspected abuse occurring in the home, unsafe living conditions, lack of privacy)
  • Acute medical conditions, substance intoxication, cognitive impairment, or physical injuries that substantially affect the client’s ability to safely participate in treatment
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