In the bipolar case, the recommended practice regarding suicidal thoughts is:

• A. Direct inquiry about suicidal thoughts
• B. Ignore
• C. Assume safety without discussion
• D. Rely on collateral information only

Answer: (A)

Directly asking about suicidal thoughts is essential because it elicits accurate information that might not come up otherwise, and it signals to the client that their safety is the clinician’s concern. In bipolar disorder, mood swings and mix-episode states can obscure risk—clients may deny ideation or minimize danger unless asked in a calm, nonjudgmental way. By inquiring directly, you can assess whether there are thoughts of self-harm, how persistent they are, whether there is a plan or means, and the client’s intent, which are all critical pieces for deciding on safety steps. This approach also helps normalize the topic and builds trust, making it more likely the client will disclose true risk rather than withholding it.

If suicidal thoughts are present, you then move into a safety plan: identifying immediate risks, means, and resources; arranging for crisis support or hospitalization if needed; and coordinating with supports while continuing care. Simply ignoring or assuming safety without discussion is unsafe, and relying only on collateral information often misses what the client is experiencing firsthand.