62 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLAN NER INTERVENTIONS IMPLEM ENTED 1. Remove Substances (1) * A. After obtaining permission from the client, illicit substances were removed from his/her immediate access and disposed of. B. The client was assisted with disposing of his/her available illicit mood-altering substances. C. The client refused to dispose of or give permission for r emoval of his/her illicit mood-altering substance despite being urged to do so. 2. Refer to an Emergency Room (2) A. The client was referred to an emergency room for immediate medical assessment and care relative to present substance use and intoxication. B. Transportation to an emergency room was provided for the client for immediate medical assessment and care. C. The client required an ambulance to assist him/her in obtaining emergency medical care. D. The client declined to submit to emergency medi cal care or assessment relative to his/her present substance use and intoxication. 3. Assess Intoxication (3) A. The client's current level of intoxication was assessed by subjective means (e. g., reviewing his/her behavior or speech). B. Based on subjec tive means, the client is identified as being significantly intoxicated. C. The client's level of intoxication was reviewed through objective means, such as a Breathalyzer or blood test. D. Based on objective assessment, the client meets the legal standa rd for intoxication. E. Based on the results of both a subjective and objective evaluation, the client is not intoxicated. 4. Refer to Detoxification (4) A. The client was referred to an acute detoxification unit within a substance abuse treatment progr am. B. The client was referred to a hospital-based acute detoxification unit. C. The client was supported as he/she willingly admitted himself/herself to an acute detoxification unit. D. The client declined to admit himself/herself to an acute detoxific ation unit, despite being urged to do so. * The numbers in parentheses correlate to th e number of the Therapeutic Intervention statement in the companion chapter with the same title in The Severe and Persistent Mental Illness Treatment Planner, 2nd ed. (Berghuis and Jongsma) by John Wiley & Sons, 2008. 