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What is the best intervention for a patient with bipolar disorder who is suggesting suicidal intent?

  1. Avoid raising the issue of suicide

  2. Meet with his spouse

  3. Do a genogram

  4. Ask the patient directly about suicidal thoughts

The correct answer is: Ask the patient directly about suicidal thoughts

Asking the patient directly about suicidal thoughts is essential in assessing their state of mind and gathering crucial information regarding their safety. When a patient with bipolar disorder expresses suicidal intent, it is vital to address these thoughts head-on. This approach demonstrates a willingness to engage with the patient about their feelings and shows that their concerns are taken seriously. Directly inquiring about suicidal thoughts helps to clarify the severity and immediacy of the risk. It allows for a better understanding of the patient's emotional state and can lead to appropriate interventions or safety plans. Engaging in this manner can diminish feelings of isolation and encourage the patient to articulate their distress, which is important in providing effective support and guiding subsequent treatment decisions. In contrast, avoiding the topic can lead to increased risk, as it leaves the patient's feelings unaddressed. Meeting with the spouse or doing a genogram may provide additional context in a broader treatment plan but does not directly engage the patient's immediate concerns regarding suicidal intent. These actions may be more supportive in later stages of treatment after ensuring the patient's safety.