I bring them up in my writing and in the context of it being one more option to add to the list of solutions. Over the years, she's asked me flat out a couple of times if I had any plans and if I planned on acting on them. I usually reassure her that I'd never act on them (which is true), and that it only speaks to my frame of mind. I think she trusts me when I say they're just thoughts. I also asked her what her policy is for SUI clients (because I was worried she'd terminate). She said she mobilizes supports if I was in immediate danger; one option she suggested was going with me to a family dr. or the hospital, if I was seriously considering it. It seems like she would go through several other channels before hospitalization, and she would be by my side, as opposed to just listing options and letting me flounder alone.