What is a key sign that indicates a client’s mental state has declined?

The identification of a key sign indicating a decline in a client’s mental state focuses on the presence of harmful thoughts or intentions, particularly regarding self-harm or suicide. This statement about having a plan to overdose is critical because it represents a direct expression of a desire to escape emotional pain through lethal means. Such a plan reveals a serious level of distress and a significant risk factor for potential self-harm, which necessitates immediate attention and intervention.

In contrast, the other statements reflect positive or neutral aspects of the client’s mental health, indicating either participation in treatment or improvements in their condition. Regular attendance in therapy and the ability to sleep without nightmares suggest a certain level of coping and stability. The mention of managing anxiety with medication also points towards a proactive approach in dealing with mental health issues, rather than signaling a decline.