Suicide screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Screening

The United States Preventive Services Task Force (USPSTF) have declared that there is insufficient evidence to determine the benefits of screening for suicide risk in the general population of United States adolescents having no prioe history of mental disorders or previous suicide attempts.

Primary care

• Direct questioning: Screening adolescents for suicidal ideation by directly asking about it in the context of screening for depression (Practice guidelines from the American Academy of Pediatrics)
• Patient Health Questionnaire (PHQ-9): A self-report screening tool, such as the nine-item Patient Health Questionnaire (PHQ-9) modified for teens, which screens for depression and as such, includes one item that asks about suicidal ideation.
• Screening for depression

Emergency department —

• The Ask Suicide-Screening Questions is a four-item instrument that clinicians can administer to screen for risk of suicide in patients who present to pediatric emergency departments with psychiatric or general medical complaints.
• It includes following four items:

• • In the past few weeks, have you wished you were dead?
  • In the past few weeks, have you felt that you or your family would be better off if you were dead?
  • In the past week, have you been having thoughts about killing yourself?
  • Have you ever tried to kill yourself?

• A positive response to atleast one of the above mentioned 4 questions trigger a more extensive evaluation of the patient’s risk for suicide.