206 THE SEVERE AND PERSI STENT MENTAL ILLNESS PROGRESS NOTES PLAN NER 16. Assess Su icidal Ideation (1 6) A. The client was asked to describe the frequency and intensity of his/her suicidal ideation, the details of any existing suicide plan, the history of any previous suicide attempts, or any family history of depression or suicide. B. The client was encouraged to be forthright regarding the current strength of his/her suicidal feelings and the ability to control such suicidal urges. C. The client was assessed as being at low risk of suicide. D. The client was assessed at being at high risk of suicide, and further intervention was necessary. 17. Remove Medications (1 7) A. As the client was assessed to be at risk for suicide, his/her medications were removed from his/her immediate access. B. Significant others were encouraged to remov e medications or other potentially lethal means of suicide from the client's easy access. C. Arrangement was made to coordinate regular delivery of the client's medications as they have been removed from his/her immediate access. D. Due to the client's s uicide risk, he/she was monitored in the actual taking of his/her medications. E. As the client has decreased his/her suicide risk, he/she has been provided with increased control over his/her medications. 18. Refer to a Supervised Environment (1 8) A. Because the client was judged to be uncontrollably harmful to himself/herself, arrangements were made for psychiatric hospitalization. B. Due to concerns about the client's inability to manage himself/herself within a less restrictive setting, he/she was r eferred to a crisis residential facility. C. The client was supported for cooperating voluntarily with admission to a more supervised environment. D. The client refused to voluntarily admit himself/herself to a more supervised environment; therefore, civ il commitment procedures were initiated. 19. Refer for Personality Testing (19) A. The client was referred for psychological testing to assist in obtaining a more complete clinical picture. B. The client was compliant with the testing, which indicated a specific diagnosis. C. The psychological test results confirm previous diagnostic expectations. D. The psychological testing results indicate that the client's mental illness concerns have significantly abated, and this was reviewed. E. The client was not compliant with the psychological testing and was redirected to this referral. 20. Educate about Lifestyle Effects on the Medications (2 0) A. The client was educated about lifestyle habits (e. g., tobacco use, diet) that can be modified to decrease the side effects of the medications. B. The client displayed an understanding of the effects of his/her lifestyle habits on the efficacy of his/her medications and was provided with positive feedback. 