Free OpenClaw Skill for Mental Health Practices: Intake and No-Show Coordinator (Download)

What this skill does for your mental health practices

• Chases intake paperwork (informed consent, HIPAA, financial responsibility, intake questionnaire) until 100% complete before the first session.
• Runs measurement-based care prompts for PHQ-9, GAD-7, PCL-5, and other validated screens at intake, every 4 to 6 weeks, and pre-termination.
• Recovers no-shows with a same-day rebook cadence sensitive to mental health avoidance dynamics, including a 'reach out when ready' option.
• Verifies insurance benefits 48 hours before each session including the in-network vs out-of-network and the deductible status, with patient-share estimate ready.
• Activates the waitlist when an active patient terminates or extends, drafting the warm welcome to the next-up patient with the clinician match logic visible.

What's inside this OpenClaw skill

The full file you download, indexed below for search engines and for operators who want to read before they install.

---
name: mental-health-intake-and-no-show
description: Intake form chase, PHQ-9 and GAD-7 measurement-based care, no-show recovery, insurance verification, and waitlist activation for outpatient mental health practices. Integrates with SimplePractice, TheraNest, TherapyNotes, Valant, Tebra, Owl Practice.
version: 1.0.0
author: OpenClaw Consult (Adhiraj Hangal)
license: MIT
url: https://openclawconsult.com/skills/mental-health-practices
---

# OpenClaw Skill: Mental Health Intake and No-Show Coordinator

## Overview

This skill turns the OpenClaw agent into an intake coordinator, measurement-based
care prompter, and no-show recovery specialist for an outpatient mental health
practice. It owns the daily paperwork chase, the PHQ-9 and GAD-7 cadence, the
no-show recovery cycle, and the waitlist activation when a slot opens.

It is designed for solo practitioners, group practices, and small psychiatric
practices running SimplePractice, TheraNest, TherapyNotes, Valant, Tebra
(formerly Kareo), Owl Practice, or SessionsHealth. It handles the unique
sensitivity of mental health communication: avoidance dynamics, crisis language
detection, 42 CFR Part 2 substance use disorder boundaries, and the
clinical-not-just-operational meaning of a no-show.

## What this skill does

1. Intake form chase (informed consent, HIPAA, financial responsibility, intake questionnaire) until 100% complete pre-session
2. Measurement-based care prompts for PHQ-9, GAD-7, PCL-5 at intake, every 4 to 6 weeks, and pre-termination
3. No-show recovery with same-day rebook cadence sensitive to avoidance dynamics
4. Insurance verification 48 hours before each session including in-network, out-of-network, and deductible status
5. Waitlist activation when an active client terminates with clinician-match logic
6. Crisis language detection that immediately escalates to the clinician

## Triggers

```yaml
triggers:
  - type: heartbeat
    schedule: "0 8 * * *"            # Daily 8am
    action: intake_chase_roster

  - type: heartbeat
    schedule: "0 8 * * 1-5"          # Weekdays 8am
    action: run_eligibility_verification
    lookahead_hours: 48

  - type: heartbeat
    schedule: "0 17 * * 1-5"         # Weekdays 5pm
    action: same_day_no_show_recovery

  - type: heartbeat
    schedule: "0 9 * * 1"            # Mondays 9am
    action: measurement_based_care_roster

  - type: on_event
    event: ehr.client_scheduled_first_session
    action: enter_intake_chase

  - type: on_event
    event: ehr.no_show_logged
    action: enter_no_show_recovery_queue

  - type: on_event
    event: incoming_message.crisis_keyword_detected
    action: immediate_clinician_escalation
```

## Workflow: intake chase

When a new client is scheduled for their first session, the agent:

1. Triggers the intake paperwork sequence on day of scheduling (informed consent, HIPAA acknowledgment, financial responsibility, intake questionnaire, credit card on file)
2. Sends a warm welcome with the paperwork link 24 hours after scheduling
3. Sends a gentle nudge at 72 hours if anything is incomplete
4. Sends a 'one day to session' check the day before to confirm all paperwork is done
5. If not 100% complete 4 hours before session, flags the office coordinator for a phone call
6. Does not send any clinical content; the agent's tone is warm administrative, not clinical

The skill is sensitive to the fact that some clients feel anxious about paperwork. The tone is supportive, not transactional.

## Workflow: measurement-based care

For each active client, the skill runs:

- Intake: PHQ-9 + GAD-7 (or PCL-5 if trauma-focused) sent on the day of first session
- Every 4 to 6 weeks during treatment: re-measurement prompt with the client's prior score visible to the clinician
- Pre-termination: final measurement to capture treatment-end status for outcomes reporting

The link goes to a HIPAA-compliant survey instance (built into SimplePractice / TheraNest, or a separate Qualtrics / REDCap). Scores are captured back to OpenClaw Memory.

Crisis-level scores trigger an immediate alert:

- PHQ-9 question 9 (suicidal ideation) above 0: clinician alert within 15 minutes
- PHQ-9 total over 20 (severe depression): clinician alert within 24 hours
- GAD-7 over 15 (severe anxiety): clinician alert within 24 hours

The skill does not respond to a crisis on behalf of the clinician. It surfaces the right client to the right clinician at the right speed.

## Workflow: no-show recovery

When a client no-shows, the agent:

1. Sends a same-day warm text with the option to rebook or to 'reach out when ready'
2. If the client has had zero prior no-shows, the tone is normalizing and non-pressuring
3. If 1 to 2 prior no-shows in 60 days, the tone is gentle but more direct about the importance of consistent attendance
4. If 3 prior no-shows in 60 days, the skill does not send another text. It flags the clinician for a phone call directly. The clinician decides whether to continue, address avoidance, or refer out.

The skill respects mental health no-show dynamics. A no-show is often itself clinical content. The agent does not pressure the client.

## Workflow: insurance verification

48 hours before each session the agent:

1. Polls the payer eligibility for in-network plans (Aetna, BCBS, Optum, UHC, Cigna, regional Blues)
2. For out-of-network clients, maintains the OON benefit estimate (typical reimbursement percentage, deductible status, superbill submission cadence)
3. Captures the active plan, copay, deductible met, mental health coverage parity status
4. Generates a patient-share estimate for the office coordinator
5. Flags any patient with exhausted benefits or coverage change

Mental health parity violations are common. The skill flags benefit changes that look like a parity violation for the practice to review.

## Workflow: waitlist activation

When an active client terminates or extends time-off, the agent:

1. Pulls the waitlist sorted by entry date and clinician fit
2. For each waitlisted client, captures the preferred clinician, the presenting concern, insurance, and the time window they are available
3. Drafts a warm welcome to the next-up client whose clinician fit matches the open slot
4. Routes to the office coordinator for approval
5. Updates the waitlist state when the new client accepts

Waitlist conversion is the single highest-leverage operational moment in a mental health group practice. Slow waitlist activation loses clients to other practices. The skill closes the gap from days to hours.

## Memory keys

```yaml
memory:
  - key: mh.intake_status[{client_id}]
    description: Pre-first-session paperwork state
    schema: { informed_consent: bool, hipaa: bool, financial: bool, intake_questionnaire: bool, credit_card_on_file: bool, complete: bool }

  - key: mh.mbc_status[{client_id}]
    description: Measurement-based care state
    schema: { last_phq9: int, last_gad7: int, last_pcl5: int, last_measured: date, next_due: date, crisis_flag: bool }

  - key: mh.no_show_history[{client_id}]
    description: No-show pattern state
    schema: { total_no_shows_60d: int, last_no_show: date, last_recovery_outcome: string, clinician_escalated: bool }

  - key: mh.waitlist_status[{client_id}]
    description: Active waitlist position and match data
    schema: { entry_date: date, preferred_clinician: string, presenting_concern: string, insurance: string, availability_window: string, matched: bool }

  - key: mh.42cfr_part2_flag[{client_id}]
    description: Indicates SUD-related content requires extra disclosure protection
    schema: { flagged: bool, sud_intake_started: date }
```

## Message templates

```yaml
templates:
  intake_welcome_24h:
    body: |
      Hi {client_first_name},

      Welcome to {practice_name}. We are looking forward to your first session
      with {clinician_first_name} on {session_date}. To make sure we can use the
      full session for therapy, please fill out the intake paperwork ahead of
      time:

      {secure_paperwork_link}

      The forms take about 15 minutes. Reach out if you have any questions.

      {office_coordinator_first_name}

  intake_gentle_nudge_72h:
    body: |
      Hi {client_first_name},

      Quick note from {practice_name}. Your first session is on {session_date}
      and a couple of intake forms are still pending. Whenever you have a
      moment:

      {secure_paperwork_link}

      No pressure, but the more you complete ahead of time the more focused the
      session can be.

      {office_coordinator_first_name}

  no_show_first_warm_rebook:
    body: |
      Hi {client_first_name},

      No worries, life happens. Whenever you are ready to come back, here are a
      few options:

      {open_slots}

      No pressure, just want you to know we are here. Reach out anytime.

      {clinician_first_name}

  mbc_re_measurement_prompt:
    body: |
      Hi {client_first_name},

      {clinician_first_name} mentioned you might be due for a quick check-in
      questionnaire. Takes about 3 minutes:

      {survey_link}

      Your last score was {last_score_summary}. Whatever this one looks like is
      useful for our work together.

  crisis_escalation_clinician_alert:
    channel: clinician_phone_and_slack
    body: |
      CRISIS-LEVEL FLAG
      Client: {client_first_name} {client_last_name}
      Trigger: {crisis_trigger_description}
      Source: {source_event}
      Recommended action: clinician contact within {response_window}

      Full context: {context_summary}
```

## Required integrations

| Integration             | Purpose                                            | Read | Write |
|-------------------------|----------------------------------------------------|------|-------|
| SimplePractice          | EHR, scheduling, intake, billing, messaging        | yes  | optional |
| TheraNest               | EHR, scheduling, intake                            | yes  | optional |
| TherapyNotes            | EHR, scheduling, intake                            | yes  | optional |
| Valant                  | EHR for psychiatric and group practices            | yes  | optional |
| Tebra (formerly Kareo)  | EHR and billing                                    | yes  | optional |
| Owl Practice            | EHR, intake, telehealth                            | yes  | optional |
| Payer eligibility feeds | Mental health benefits verification                | yes  | no    |
| Qualtrics / REDCap      | HIPAA-compliant survey delivery (optional)         | yes  | yes   |
| Twilio (or similar)     | Outbound SMS                                       | no   | yes   |
| Email provider          | Outbound email                                     | no   | yes   |
| Slack                   | Clinician crisis alerts                            | no   | yes   |
| OpenClaw Memory         | Cross-run state                                    | yes  | yes   |
| OpenClaw Heartbeat      | Scheduled cadence triggers                         | yes  | yes   |

Write-back to the EHR is optional. Most practices start read-only and have the
office coordinator commit any EHR changes manually. After two weeks, flip write
access on for low-risk fields (intake completion stamps, no-show notes).

## Compliance notes

### HIPAA

By default this skill operates on client identifiers, appointment metadata,
intake completion status, and aggregate measurement-based care scores. We
deliberately avoid putting diagnosis codes, session content, treatment plan
detail, or substance use status into outbound SMS. For stricter PHI handling,
set `phi_mode: identifier_only`.

Confirm your BAA covers the cloud AI provider you point OpenClaw at. The skill
itself is local; the model inference is not.

### 42 CFR Part 2

For substance use disorder treatment, 42 CFR Part 2 imposes stricter disclosure
requirements than HIPAA alone. The skill ships a hard guardrail:

- SUD-specific content is tagged in OpenClaw Memory with the `42cfr_part2_flag`
- The agent never includes that content in any outbound SMS, email, or non-portal communication
- The clinician makes all disclosure decisions inside the EHR with the appropriate consent forms

If your practice does substance use treatment, set `compliance_mode: 42cfr_part2_strict` in the config.

### TCPA

The skill respects opt-in status from your EHR's communication preferences.
Outbound SMS goes only to clients who have opted in. The skill includes the
opt-out language as required by TCPA.

## Configuration

```yaml
config:
  practice_name: "Your Practice Name"
  practice_focus: outpatient_therapy     # or "psychiatry", "group_practice", "mixed"
  clinicians:
    - first_name: "Maya"
      last_name: "Rodriguez"
      credentials: LCSW
      voice: warm-relational
    - first_name: "Jordan"
      last_name: "Park"
      credentials: PsyD
      voice: clinical-grounded
  approval_mode: coordinator_approves_all  # or "autonomous_after_2_weeks"
  phi_mode: standard                       # or "identifier_only"
  compliance_mode: standard_hipaa          # or "42cfr_part2_strict"
  mbc_screeners: [PHQ_9, GAD_7, PCL_5]
  mbc_cadence_weeks: [intake, 4, 8, 12, pre_termination]
  crisis_alert_thresholds:
    phq9_q9_above_zero: clinician_within_15m
    phq9_total_above_20: clinician_within_24h
    gad7_above_15: clinician_within_24h
  no_show_recovery_tone:
    first: normalizing_non_pressuring
    second: gentle_direct
    third: escalate_to_clinician_phone
```

## Quick install

```bash
mkdir -p ~/.claude/skills
mv mental-health-practices.md ~/.claude/skills/mental-health-intake-and-no-show.md
# Edit the config block to match your practice
```

Launch OpenClaw and the skill is live. Run `run intake chase` or
`compile measurement based care roster` on demand, or wait for Heartbeat to fire.

## Want it wired to your stack?

This SKILL.md is the starting point. If you want it plugged into your specific
EHR, your specific screener cadence, your specific 42 CFR Part 2 boundaries,
and your specific clinician voice, on a fixed-price two-week clock, with the
founder writing every line of the build, the door is at
https://www.adhirajhangal.com/work

Install in 60 seconds

1. 1

   Drop the file into your OpenClaw skills directory

   Save the downloaded mental-health-practices.md as ~/.claude/skills/mental-health-intake-and-no-show.md. OpenClaw picks up new skill files on next agent launch.

2. 2

   Wire in your EHR and screener tool

   Edit the integrations block to point at your SimplePractice, TheraNest, TherapyNotes, Valant, Tebra, or Owl Practice export. The skill ships prompts to translate the daily session list into the agent's working memory, plus the PHQ-9 and GAD-7 score capture.

3. 3

   Start in clinician approval mode, validate, then move to autonomous

   Run for two weeks with the clinician or office coordinator approving every outbound message. The skill defaults route any crisis language, any 42 CFR Part 2 substance-use content, any safety-related signal, and any clinical question to a human immediately. After two weeks, flip benign intake nudges and routine reminders to autonomous.

Example conversation

Common questions

Related free skills