SUICIDAL IDEATION 349 7. Arrange for Hospitalization (7) A. Because the client was judged to be uncontrollably harmful to himself/herself, arrangements were made for psychiatric h ospitalization. B. The client cooperated voluntarily with an admission to a psychiatric hospital. C. The client was referred to a crisis residential program with 24-hour trained staff. D. The client declined voluntary admission to a more secure setting, and he/she did not appear to qualify for involuntary commitment; the client was encouraged to use a crisis home or psychiatric unit. E. Contacts were made with the appropriate court or legal entity to involuntarily admit the client to a psychiatric unit until his/her suicidal crisis is alleviated. F. The appropriate court or legal entity has declined to involuntarily admit the client into a psychiatric unit, and this was told to him/her. G. The appropriate court or legal entity has decided that the clie nt is in need of involuntary hospitalization, and this was told to him/her. 8. Develop a Crisis Care Plan (8) A. A crisis care plan was developed, including supervision from caretakers, friends, and family. B. As the client appears to be in a suicidal c risis, his/her crisis care plan was implemented. C. The client was encouraged to voluntarily move forward with his/her crisis care plan. D. The client has declined the use of the crisis care plan, and closer monitoring of his/her safety was arranged. E. By using natural supports, such as the client's caretakers, friends, and family, his/her suicidal crisis has been averted. F. The client's natural supports do not appear capable of providing the level of safety that he/she needs, and a more structured en vironment was obtained. 9. Remove Lethal Weapons ( 9) A. Significant others were encouraged to remove firearms and other potentially lethal means of suicide from the client's easy access. B. Contact was made with significant others within the client's li fe to monitor his/her behavior and to remove potential means of suicide. 10. Recommend Medication Removal (1 0) A. It was recommended to the client's family and caregivers to limit the amount of available medication to a less-than-lethal or harmful dose. B. The client was advised that his/her medications have been removed from his/her access. C. The client's medications are being dispensed by others on a daily basis. 11. Develop a Suicide Prevention Contract (1 1) A. A suicide prevention contract was de veloped with the client that stipulated what he/she will and will not do when experiencing suicidal thoughts or impulses. B. The client was asked to make a commitment to agree to the terms of the suicide prevention contract and did make such a commitment. C. Verbal and written directions were provided to the client and his/her caregivers about where to call or go if the suicidal ideation persists or increases. 