How should you respond to a client expressing self-harm or thoughts of harming others?

• A. Dismiss the concerns and continue as planned.
• B. Regard the expressions as a private matter and not report.
• C. Take it seriously, follow safety protocol, assess risk, and refer to mental health resources or emergency services as needed.
• D. Change the topic to non-sensitive subjects.

Answer: (C)

When someone expresses thoughts of self-harm or harming others, the priority is safety and ethical responsibility. Take the concern seriously from the start, acknowledge the feelings nonjudgmentally, and follow a structured safety protocol that includes risk assessment and appropriate referrals.

Begin by assessing risk directly: ask clear questions about intent, plans, means, and timing. For example, inquire whether there is a specific plan, whether they have access to means, and how soon they might act. Based on the responses, determine immediacy. If there is imminent danger, act immediately by involving emergency services or crisis resources, ensuring the client is not left alone, and coordinating with your supervisor or a mental health professional. Even if danger isn’t imminent, document the risk, implement a safety plan, and refer to mental health professionals or crisis services as needed. Throughout, protect the client’s safety while explaining any necessary limits to confidentiality and how information will be used to help them. Provide concrete resources and follow up as appropriate.

Options that dismiss concerns, treat the matter as private, or switch to non-sensitive topics fail to protect safety and can put people at real risk. This approach undermines trust and professional responsibility.