When a client expresses suicidal thoughts but states they will not act, the social worker should FIRST?

• A. Complete an assessment to determine the reason(s) for the depression
• B. Refer the client to a psychiatrist for an evaluation for antidepressants
• C. Assure the client of concern to alleviate anxieties
• D. Determine the client's suicide risk and protective factors

Answer: (D)

The first step is to assess suicide risk and protective factors. Even when someone says they won’t act on thoughts of suicide, you must determine how real the danger is by exploring their current thoughts, any plans or means they have access to, and their intent and timing. This risk assessment helps you judge how imminent the danger is and what level of intervention is needed.

Context helps: protective factors—like strong social supports, reasons for living, coping skills, or commitments to family or work—can mitigate risk, while risk factors—such as a history of previous attempts, substance use, severe depression, or access to means—can raise it. By weighing these elements, you can decide on the appropriate next steps, such as safety planning, involving trusted others, or seeking urgent clinical or emergency support if the risk is high.

Other steps like addressing depression symptoms, referring for medication evaluation, or offering reassurance are important parts of care, but they don’t establish the immediate safety needed until you’ve clarified the level of risk and put appropriate safeguards in place.