​​While doing her 15-minute safety rounds, mental health technician Fernanda Basso Alcoforado observed a patient on the Inpatient Psychiatric Unit for depression and suicidal ideation who appeared superficial and preoccupied. The patient denied any need for help, but on the next set of rounding, Alcoforado broke from her routine and returned early to the patient’s room. The patient was in the bathroom, denied any issues, and said they would be out soon. Out of continued concern for the patient, Alcoforado entered the bathroom—to find the patient with a shirt tied around their neck. Alcoforado hit their alarm button and untied the shirt. She then stayed with the patient and took them to the nurse’s station for further assistance.​