For a patient with bipolar disorder who shows signs of suicidal intent, the best intervention is to:

• A. Ask the patient directly about thoughts of ending life
• B. Monitor the patient without direct questioning
• C. Avoid discussing suicide
• D. Defer to another clinician

Answer: (A)

Directly asking about suicidal thoughts is essential in assessing risk when a patient with bipolar disorder shows signs of intent. Asking clearly and compassionately opens the conversation, demonstrates you take their safety seriously, and yields key information about current thoughts, any plan, and access to means. This information is what guides immediate safety decisions—whether that’s enhanced monitoring, safety planning, or urgent hospitalization if there is imminent danger. Merely monitoring without asking leaves risk unspoken and can miss a critical threat; avoidance of the topic can prevent disclosure and further endanger the patient, and postponing discussion by deferring to another clinician delays needed assessment and action. So the best approach is to ask directly about thoughts of ending life, because it activates an informed, timely safety response and ongoing care.