How a therapist or pdoc handles this generally depends on a client's history with this sort of thing. My T and pdoc have a very good sense of when I am simply having ideation, which isn't particularly dangerous in itself, and when I have moved on to a stage where they get concerned about impulsivity. For me, that comes before I ever have a plan, so they react more quickly than they might with some patients who would never do anything without a plan ahead of time. What I do isn't parasuidical; it is truly life-threatening, so they don't mess around hemming and hawing about whether to take action or not. Fortunately, I've learned to recognize some clear signals that I have crossed that point (psychosis sets in), so I can indicate to them exactly when I reach that point.

We've had some really helpful and enlightening discussions about that whole process for me which has really gotten us all on the same page. I would encourage you to have that conversation with your therapist and pdoc BEFORE you actually get to that point so that you will all know when to let things go with basic support and when more intensive action should be taken.