17-year-old female with a past medical history of depression, anxiety, history of child sexual abuse and homicidal ideation and a personal history of a traumatic brain injury in 2013 presents to the emergency department tonight, brought in by law enforcement after being called by her mother. Mom reports that she contacted them to bring her to the emergency department because she was told that she was not supposed to leave the house tonight, and unfortunately she did. When she got back, mom states that she tried to have a conversation with her and then she threatened to kill everyone in the house. She is not verbally responding to questions and is being asked to use non-verbal cues such as thumbs up/down or blinking to communicate during the interview, but still refuses to respond in any way. Her eyes are opened and she is turned a different direction, not engaging in conversation. Throughout the encounter, patient demonstrates limited responsiveness to questions and prompts. Provider attempts various methods to engage the patient, including offering time alone, asking about preferences for communication, and inquiring if there’s someone else patient would like to speak with.