PATH Interviews: Staff

SHIPS
Page 1

SHIPS Distress Log
Record ID.

Data Entry Date

Date of distress event

Study ID of participant in distress

What was the reason you were with the participant when
the distressed state occurred?

You indicated that the reason you were with the
participant who experienced distress was not listed.
Please describe the reason you were with the
participant when the distressed state occurred.

__________________________________

__________________________________

__________________________________

__________________________________
baseline interview
quarterly interview
final interview
IPS appointment
case management appointment
other

__________________________________________

What level of distress did the participant experience?

no distress noted
modest distress
moderate distress
serious distress

Who did you FIRST contact in response to the distress
the participant was experiencing (select all that
apply)?

emergency services (911)
the participant's case manager
SHIPS Project Manager (Benjamin Henwood)
PATH management
SHIPS Project Director (Justin Metcalfe)
other
I did not contact anyone

You indicated that the first person you contacted was
not included in the prior list. Who did you first
contact?
Who did you contact in response to the distress the
participant was experiencing (select all that apply)?

You indicated that you contacted someone not included
in the prior list. Who did you contact?

05/01/2024 12:10pm

__________________________________________
emergency services (911)
the participant's case manager
SHIPS Project Manager (Benjamin Henwood)
PATH management
SHIPS Project Director (Justin Metcalfe)
other
I did not contact anyone

__________________________________________

projectredcap.org

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Please describe, in your own words, the event during
which the participant experienced distress. Please
describe
1) where the event took place (for example, the
participant's apartment)
2) the distressed behaviors that the participant
exhibited
3) how you responded to those behaviors
4) the participant's state of mind when you last saw
them (for example, were they still in distress?)
5) any other observations that may be relevant to the
event

05/01/2024 12:10pm

__________________________________________

projectredcap.org